Research Management and Development Department, Kiang Wu Nursing College of Macau, 999078, Macao.
Education Department, Kiang Wu Nursing College of Macau, 999078, Macao.
J Affect Disord. 2025 Jan 15;369:345-351. doi: 10.1016/j.jad.2024.10.004. Epub 2024 Oct 3.
Existing research has examined the link between family health and mental health outcomes like depression and anxiety, but the mechanisms are unclear. Sleep quality may play a mediating role, and the effects of family health on mental health can differ based on living arrangements, which influence experiences and social support. This study aimed to investigate the mediating role of sleep quality in the relationship between family health and depression or anxiety across diverse living statuses.
This cross-sectional study was conducted from June to September 2023 in five regions of China, including Guangdong Province, Guangxi Province, Jiangsu Province, Sichuan Province, and Macao Special Administrative Region. Family health was assessed using the Short Form of the Family Health Scale, while sleep quality was measured using the Self-Rating Scale of Sleep. Depression and anxiety were evaluated using the Hospital Anxiety and Depression Scale. Mediation analysis was conducted to examine the mediating effect of sleep quality on the relationship between family health and mental health outcomes. Subgroup analyses were conducted to explore potential variations in the mediating role of sleep quality across different living status.
This study sample comprised 4918 participants, with a mean age of 30.1 years (SD = 12.6). The direct effect analysis demonstrated a significant negative correlation between family health and symptoms of depression (β = -0.216, p < 0.001) or anxiety (β = -0.199, p < 0.001). The mediation analysis results revealed that family health had a significant indirect effect on symptoms of depression (β = -0.040, p < 0.001) or anxiety (β = -0.050, p < 0.001) through sleep quality. Specifically, both the living with family group and the living in a shared accommodation group showed a significant mediation effect of sleep quality in the relationship between family health and mental health outcomes. However, the living alone group did not show a significant mediation role.
Sleep quality mediated the relationship between family health and symptoms of depression or anxiety, with significant effects in those living with family or in shared accommodations, but not those living alone. These findings underscore the importance of considering living status when examining mental health outcomes and developing interventions.
现有研究已经检验了家庭健康与抑郁和焦虑等心理健康结果之间的联系，但其中的机制尚不清楚。睡眠质量可能起着中介作用，并且家庭健康对心理健康的影响可能因生活安排而异，这些安排会影响体验和社会支持。本研究旨在探讨睡眠质量在不同生活状况下家庭健康与抑郁或焦虑之间关系中的中介作用。
本横断面研究于 2023 年 6 月至 9 月在中国五个地区（广东省、广西壮族自治区、江苏省、四川省和澳门特别行政区）进行，使用家庭健康量表的简短形式评估家庭健康，使用自评睡眠量表评估睡眠质量。使用医院焦虑和抑郁量表评估抑郁和焦虑。进行中介分析以检验睡眠质量对家庭健康与心理健康结果之间关系的中介作用。进行亚组分析以探索睡眠质量在不同生活状况下的中介作用的潜在变化。
本研究样本包括 4918 名参与者，平均年龄为 30.1 岁（标准差=12.6）。直接效应分析表明，家庭健康与抑郁症状（β=-0.216，p<0.001）或焦虑症状（β=-0.199，p<0.001）呈显著负相关。中介分析结果显示，家庭健康对抑郁症状（β=-0.040，p<0.001）或焦虑症状（β=-0.050，p<0.001）有显著的间接影响，这是通过睡眠质量实现的。具体来说，在与家人同住的组和住在合住住所的组中，睡眠质量在家庭健康与心理健康结果之间的关系中都表现出显著的中介作用。然而，独居组没有表现出显著的中介作用。
睡眠质量中介了家庭健康与抑郁或焦虑症状之间的关系，在与家人同住或住在合住住所的人群中具有显著影响，但在独居人群中没有显著影响。这些发现强调了在检查心理健康结果和制定干预措施时考虑生活状况的重要性。
