Tao Yuxiu, Liu Tongcun, Zhuang Kaipeng, Fan Lijuan, Hua Yan, Ni Chunping
School of Nursing, Air Force Medical University, Xi'an, China.
Department of Joint Surgery, The 940th Hospital of PLA Joint Logistics Support Force, Lanzhou, China.
Front Psychol. 2023 Jun 29;14:1172350. doi: 10.3389/fpsyg.2023.1172350. eCollection 2023.
Patients' and caregivers' physical and mental health may interact. The theory of dyadic illness management holds that patients and caregivers should be regarded as a whole in health management. Previous studies have found that hemodialysis patients and their family caregivers experience poor sleep quality. Perceived stress and social support have effects on insomnia. However, the dyadic interaction between perceived stress, social support, and insomnia among hemodialysis patients and caregivers is unclear. This study aimed to explore the mediating role of social support in the association between perceived stress and insomnia in hemodialysis patient-caregiver dyads.
A total of 259 hemodialysis patient-caregiver dyads completed the Chinese Perceived Stress Scales (CPSS), the Perceived Social Support Scale (PSSS), and the Athens Insomnia Scale (AIS) in Lanzhou, China, from May 2022 to July 2022. The actor-partner interdependence mediation model analysis was used for data analysis.
In the actor effect, there was a significant positive correlation between perceived stress and insomnia in hemodialysis patients ( = 0.091, = 0.001) and their family caregivers ( = 0.588, < 0.001). Patient's and caregiver's social support played partial mediating roles in the relationship between caregiver's perceived stress and insomnia ( = 0.135, < 0.001 and = 0.111, < 0.001). In the partner effect, caregiver's perceived stress was positively connected with patient's insomnia ( = 0.915, < 0.001), and the mediating effect of patient's social support on the relationship between caregiver's perceived stress and patient's insomnia was statistically significant ( = -0.040, = 0.046).
The perceived stress, social support and insomnia of hemodialysis patients and their family caregivers had interactive effects. Effective dyadic-based interventions should be developed to improve hemodialysis patients' and caregivers' sleep quality.
患者及其照顾者的身心健康可能相互影响。二元疾病管理理论认为，在健康管理中应将患者和照顾者视为一个整体。既往研究发现，血液透析患者及其家庭照顾者睡眠质量较差。感知压力和社会支持会对失眠产生影响。然而，血液透析患者及其照顾者之间感知压力、社会支持和失眠的二元交互作用尚不清楚。本研究旨在探讨社会支持在血液透析患者-照顾者二元组中感知压力与失眠之间关联的中介作用。
2022年5月至2022年7月，在中国兰州，共有259对血液透析患者-照顾者二元组完成了中文版感知压力量表（CPSS）、感知社会支持量表（PSSS）和雅典失眠量表（AIS）。采用行为者-伙伴相互依赖中介模型分析进行数据分析。
在行为者效应中，血液透析患者（r = 0.091，p = 0.001）及其家庭照顾者（r = 0.588，p < 0.001）的感知压力与失眠之间存在显著正相关。患者和照顾者的社会支持在照顾者感知压力与失眠的关系中起部分中介作用（r = 0.135，p < 0.001和r = 0.111，p < 0.001）。在伙伴效应中，照顾者的感知压力与患者的失眠呈正相关（r = 0.915，p < 0.001），患者的社会支持对照顾者感知压力与患者失眠关系的中介效应具有统计学意义（r = -0.040，p = 0.046）。
血液透析患者及其家庭照顾者的感知压力、社会支持和失眠存在交互作用。应制定有效的基于二元组的干预措施，以改善血液透析患者及其照顾者的睡眠质量。
