Parallel mediating effects of anxiety and depression on the relationship between sleep quality and fear of progression in individuals recovering from COVID-19.

BACKGROUND

The COVID-19 pandemic caused by the SARS-CoV-2 virus is one of the most significant public health emergencies of this century. The rapid outbreak of COVID-19 infections has instilled fear in populations. Therefore, it is essential to investigate the risk factors and mechanisms associated with fear of progression (FoP) among individuals recovering from COVID-19. This information is crucial for alleviating the physical and psychological discomfort of individuals after recovery and enhancing their long-term quality of life.

METHODS

A cross-sectional study involving 861 individuals recovering from COVID-19 was conducted in China from January to February 2023. The Pittsburgh Sleep Quality Index, the Self-Rating Depression Scale, the Self-Rating Anxiety Scale, and the Fear of Progression Scale were utilized to assess mood status, sleep quality, and fear of progression. Receiver operating characteristic curves, Pearson's correlation analysis, binary logistic regression analysis, and Hayes' PROCESS Macro analysis were employed to test the model.

RESULTS

The results showed that sleep quality, anxiety, depression, and fear of progression were positively correlated, with coefficients ranging from 0.380 to 0.814. After addressing potential bias, sleep quality, anxiety, and depression emerged as risk factors for fear of progression (FoP). In the ROC curve analysis, these three factors predicted the occurrence of FoP (AUC: 0.646, 0.703, and 0.658, respectively). Anxiety and depression played a parallel mediating role between sleep quality and FoP, accounting for 59.9 and 13.8% of the total effect, respectively.

CONCLUSION

The results indicate that anxiety and depression both serve a parallel mediating role in the relationship between sleep quality and fear of pain (FoP). These findings provide potential guidance for the development and implementation of group-based interventions to address the mental health challenges of the post-COVID-19 era.