Objective To cluster the symptoms of patients with chronic heart failure (CHF) through the cluster analysis, and to explore the relationships among symptom clusters of CHF, patients’ self-care behaviors and sleep quality, as well as the pathways influencing sleep quality of CHF patients. Methods A convenience sampling approach was used to provide a questionnaire survey to CHF patients who were being followed up with between January and December 2021. The Pittsburgh Sleep Quality Index, Memorial Symptom Assessment Scale-Heart Failure, European Heart Failure Self- care Behavior Scale and a self-created questionnaire on sociodemographic and clinical data characteristics were all included in the survey. Results A total of 304 CHF patients were included. Among them, there were 178 males and 126 females; the average age was (61.31±14.00) years; the average sleep quality score was (8.17±4.51) points, while the average overall self-care behavior score was (21.28±3.80) points. According to the cluster analysis of the symptoms of CHF patients, the patients’ symptoms were separated into clusters related to exhaustion, disease perception, and a single symptom of dry mouth. The sleep quality score was positively correlated with the following factors: age, number of comorbidities, overall score of symptom assessment, fatigue symptom cluster score, and illness perception symptom cluster score (P<0.05). There was no significant correlation between the self-care behavior score and sleep quality (P>0.05). However, sleep quality scores were negatively correlated with body mass index and education level, respectively (P<0.05). Age, gender, score of illness perception symptom cluster, and fatigue symptom cluster all had direct effects on sleep quality of 0.014, 0.206, 0.487, and 0.165 (P<0.05), respectively, according to path analysis. Self-care behavior also had a direct influence of 0.018 (P=0.686). Conclusions CHF patients have somewhat high levels of self-care behaviors, but they have poor sleep quality. They still have a lot of symptoms after being released. Sleep quality is significantly impacted by the patients’ age, body mass index, educational attainment, number of comorbidities, symptom ratings, fatigue symptom clusters, and disease perception symptom clusters. While the route effects of the patients’ self-care actions are not statistically significant, the age, gender, disease perception, and fatigue symptom cluster scores of CHF patients have a direct impact on the quality of their sleep. By managing the same clusters of symptoms, nursing staff can help patients with CHF feel better. They can also help patients sleep better by adopting practical measures.
Objective To explore the relationship between depression and quality of life in schizophrenic patients, and the mediating role of sleep quality and weakness. Methods We selected inpatients with schizophrenia from 4 secondary and above psychiatric hospitals in Chengdu for questionnaire survey by convenient sampling method between March and July 2022. The questionnaires included general demographic data, disease-related questionnaire, Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Fried Frailty Phenotype (FFP) and Schizophrenia Quality of Life Scale (SQLS). Results A total of 594 patients were included, including 373 males (62.8%) and 221 females (37.2%). The univariate analysis of the factors affecting the quality of life of the patients showed that there was no significant difference in the age, sex, only child or not, education level, course of schizophrenia, and combined medication (P>0.05), except for the family history of mental disorders (P<0.05). SQLS score was positively correlated with SDS score (r=0.635, P<0.001), PSQI score (r=0.402, P<0.001) and FFP score (r=0.327, P<0.001). The mediation of sleep quality and weakness on depression and quality of life are significant, and chain-mediated effect of depression and quality of life was significant. Conclusion The depression level of schizophrenia patients can not only directly affect their quality of life, but also indirectly affect their quality of life through the mediation of sleep quality, weakness and chain mediation of sleep quality and weakness.
Objective To investigate the current status of fear of disease progression and sleep quality among laryngeal cancer patients, and analyze the correlation between them. Methods Laryngeal cancer patients who were hospitalized in West China Hospital of Sichuan University between March 2021 and February 2022 were selected for this cross-sectional survey. Sociodemographic and disease-related data questionnaires, Chinese version of Fear of Progression Questionaire Short Form, and Pittsburgh Sleep Quality Index (PSQI) Scale were used to investigate the laryngeal cancer patients who met the inclusion criteria, and the correlation between fear of disease progression and PSQI score in laryngeal cancer patients was analyzed by Spearman correlation analysis. Multiple linear stepwise regression analysis was used to analyze the effects of sociodemographic and disease-related characteristics on the total score of fear of disease progression in laryngeal cancer patients, and the effects of sociodemographic, disease-related characteristics and total score of fear of disease progression on the total score of PSQI of laryngeal cancer patients. Scores were expressed as median (lower quartile, upper quartile). Results A total of 312 copies of questionnaires were distributed and 309 valid copies were recovered, with an effective recovery rate of 99.0%. The total score of fear of disease progression in the laryngeal cancer patients was 22.00 (16.00, 30.00), including 12.00 (8.00, 17.00) in physiological health dimension, and 10.00 (7.00, 14.00) in social and family dimension. The total score of PSQI was 5.00 (3.00, 8.50). The correlations of the physiological health dimension score, the social and family dimension score, and the total score of fear of disease progression with the total score of PSQI in laryngeal cancer patients were positive with statistical significance (rs=0.294, P<0.001; rs=0.234, P<0.001; rs=0.287, P<0.001). Multiple linear stepwise regression analyses showed that the total score of fear of disease progression in laryngeal cancer patients was affected by the stage of disease, occupation, primary caregiver and treatment plan (P<0.05), and the total score of PSQI of laryngeal cancer patients was affected by level of education, treatment plan and the total score of fear of disease progression (P<0.05). Conclusions The fear of disease progression in laryngeal cancer patients has a significant negative correlation with the sleep quality. Meanwhile, alleviating the level of fear of disease progression may improve sleep quality.
Objective To investigate the prevalence characteristics of psychotic-like experiences (PLE) in adolescents and to explore the mechanisms through which sleep quality, anxiety, and depression affect PLE, with a specific focus on testing the parallel mediating roles of anxiety and depression in the relationship between sleep quality and PLE. Methods Students from three grades of high schools in Zhongshan City of Guangdong Province were selected in May 2024. Assessments were conducted using the Community Assessment of Psychic Experiences, Pittsburgh Sleep Quality Index, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7. Parallel mediation analysis was performed using Structural Equation Modeling. Results A total of 4009 students were surveyed. Among them, there were 1963 male students and 2046 female students. The average age was (16.83±1.08) years old. PLE was widespread among adolescents and their distribution was significantly influenced by demographic characteristics and multi-dimensional risk factors. PLE was positively associated with sleep quality, anxiety, and depressive symptoms (P<0.01). The mediation model showed that sleep quality not only directly and positively predicted PLE (β=0.115, P<0.001), but also had a significant indirect impact on PLE through the mediating paths of anxiety (β=0.560, P<0.001) and depression (β=0.623, P<0.001). Both anxiety (β=0.359, P<0.001) and depression (β=0.277, P<0.001) could predict PLE, but the effect of anxiety was stronger. The effect decomposition indicated that the total indirect effect far exceeded the direct effect. Both the mediating paths of “sleep quality → anxiety → PLE” and “sleep quality → depression → PLE” were significant. Conclusions PLE among adolescents is influenced by multi-dimensional risk factors and is closely related to sleep and emotional problems. Sleep quality not only directly predicts PLE, but more importantly, indirectly affects PLE through the parallel mediating paths of anxiety and depression, with the “sleep quality → anxiety → PLE” path having a stronger effect. Measures such as improving sleep and anxiety can be selected as potential entry points to interrupt the development path of PLE, which is conducive to early identification and intervention of PLE in adolescents.
Chronic kidney disease (CKD) is a global public health issue, with its prevalence and incidence increasing annually, imposing significant health and economic burdens on patients and society. A growing body of research indicates that both shortened and prolonged sleep duration, as well as poor sleep quality, are closely associated with the prevalence, progression, and adverse clinical outcomes of CKD. This article summarizes the relationship between sleep duration, sleep quality, and CKD, explores potential mechanisms by which sleep disturbances may contribute to the development and progression of CKD, analyzes the impact of CKD on sleep, and summarizes intervention measures targeting sleep problems in CKD patients. It aims to provide new insights for future clinical practice.