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慢性心力衰竭患者进展恐惧与睡眠质量之间社会联结的中介效应分析

Mediating Effect Analysis of Social Connectedness Between Fear of Progression and Sleep Quality in Patients With Chronic Heart Failure.

作者信息

Li Yan, Li Jiamin, Qin Jingwen, Zhou Sixin, Gong Kaizheng

机构信息

Department of Cardiology, Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.

School of Nursing School of Public Health, Yangzhou University, Jiangsu, China.

出版信息

Clin Nurs Res. 2025 Jun;34(5):223-233. doi: 10.1177/10547738251344666. Epub 2025 Jun 17.

Abstract

Poor sleep quality is prevalent among patients with chronic heart failure (HF), with fear of progression being one of its independent predictors. However, the pathways through which it exerts its influence have not been fully elucidated. A total of 246 patients with chronic HF, hospitalized in the cardiology department of a hospital from January to June 2024, were selected for this study using a convenience sampling method. Data were collected using the General Information Questionnaire, Social Connectedness Scale, the Fear of Progression Questionnaire-Short Form, and the Pittsburgh Sleep Quality Index. Stratified regression analysis was conducted to assess the effects of fear of progression and social connectedness on sleep quality. The mediating effect of social connectedness in fear of progression and sleep quality was tested by SPSS PROCESS. The mean age of the patients in this study was 73.84 years (, 11.53), with 52.4% being female. The study revealed that patients with chronic HF had sleep quality, fear of progression, and social connectedness had mean scores of 11.83 (, 3.76), 29.52 (, 7.03), and 3.51 (, 0.67), respectively. Regression analysis showed that fear of progression positively predicted poor sleep quality ( = .539,  < .001) and social connectedness negatively predicted poor sleep quality ( = -.301,  < .001). Furthermore, fear of progression exerted an indirect effect on sleep quality through its influence on social connectedness. Social connectedness exerts a significant influence on the relationship between fear of progression (FoP) and sleep quality among chronic HF patients. Enhancing social connectedness potentially offers an effective intervention to ameliorate sleep quality in chronic HF patients exhibiting a high level of FoP.

摘要

睡眠质量差在慢性心力衰竭(HF)患者中普遍存在,对病情进展的恐惧是其独立预测因素之一。然而,其发挥影响的途径尚未完全阐明。本研究采用便利抽样法,选取了2024年1月至6月在某医院心内科住院的246例慢性HF患者。使用一般信息问卷、社会联结量表、病情进展恐惧问卷简表和匹兹堡睡眠质量指数收集数据。进行分层回归分析,以评估病情进展恐惧和社会联结对睡眠质量的影响。通过SPSS PROCESS检验社会联结在病情进展恐惧与睡眠质量之间的中介作用。本研究患者的平均年龄为73.84岁(标准差11.53),女性占52.4%。研究显示,慢性HF患者的睡眠质量、病情进展恐惧和社会联结的平均得分分别为11.83(标准差3.76)、29.52(标准差7.03)和3.51(标准差0.67)。回归分析表明,病情进展恐惧正向预测睡眠质量差(β = 0.539,P < 0.001),社会联结负向预测睡眠质量差(β = -0.301,P < 0.001)。此外,病情进展恐惧通过对社会联结的影响对睡眠质量产生间接效应。社会联结对慢性HF患者的病情进展恐惧(FoP)与睡眠质量之间的关系有显著影响。增强社会联结可能为改善表现出高水平FoP的慢性HF患者的睡眠质量提供一种有效的干预措施。

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