Sleep Quality In Relation To Social Support And Resilience Among Rural Empty-nest Elderly

Objectives The purpose of the present study is to investigate the status of sleep quality,social support and resilience among rural empty-nest elderly,to analyze the relationship between sleep quality and social support and resilience,and to explore the mediating effect of resilience between social support and sleep quality.From the perspective of positive psychology,it provides a theoretical basis for developing nursing intervention of sleep quality among rural empty-nest elderly.Methods A convenient sampling method was adopted to investigate 250 rural empty-nest elderly in 6 villages in Puyang,Henan province.The questionnaire consists of four parts: the general information questionnaire,the Pittsburgh Sleep Quality Index, Perceived Social Support Scale and Resilience Scale.Epidata3.1 was used to establish the database and to record the data.The data were analyzed by SPSS23.0 statistical software.In this study,the measurement data was described by Mean±SE.The count data was described by frequency and percentage.Chi-square test was used in univariate analysis,and logistic regression analysis was used in multivariate analysis to explore the factors of sleep quality among rural empty-nest elderly.The correlation analysis between sleep quality,social support and resilience used Spearman correlation coefficient method.The mediating effect test used the Bootstrap program to analyze the mediating effect of resilience between social support and sleep quality among rural empty-nest elderly.Results 1.The score of sleep quality among rural empty-nest elderly was 6.74+3.80,and Forty percent of the sample reported poor sleep quality.2.Univariate analysis showed that gender,age,marital status,annual income,smoking,the number of chronic diseases,the number of children,the average educational level of their children,the monthly income of their children,and the communication status with their children were significantly differences in sleep quality(P<0.05).Logistic regression analysis showed that marital status,annual income,number of chronic diseases,communication with their children once a week,and the communication status with their children entered the regression equation of the sleep quality.The rural empty-nest elderly who was widowed or with at least 2 chronic diseases was in poor sleep,and the rural empty-nest elderly whose annual income was 2000-3000 RMB,>3000 RMB and communicating with their children every day was in good sleep.There were significantly differences in sleep quality(P<0.05).3.The score of social support among rural empty-nest elderly was 60.58+10.63,and the score of resilience was 118.35+21.46.4.The total score of social support was positively correlated with the total score of resilience(r=0.834,P<0.01),but it was negatively associated with the sleep quality among rural empty-nest elderly(r=-0.729,P<0.01).The total score of resilience was negatively correlated with the total score of sleep quality(r=-0.679,P<0.01).5.The mediating effect test showed that the interval test results did not contain 0(LLCI=-0.1370,ULCI=-0.0095)under the 95% confidence interval while the sample size was set to 5000,indicating that the mediating effect of resilience was significant,and the mediating effect was-0.0771.After controlling the resilience of mediator variables,social support still had a significant effect on sleep quality.The 95% confidence interval did not contain 0(LLCI=-0.2518,ULCI=-0.1066),indicating that there were missing mediators.And a×b×c'>0 indicated that there might be a mediator variable that was consistent with the direction of the resilience,that was,complementary mediation.Therefore,resilience played a part of mediating role between social support and sleep quality.Conclusions1.The sleep quality of the empty-nest elderly was poor.The common sleep problems were poor subjective sleep quality,long sleep latency,nocturnal sleep disturbance.2.The general data that affected the sleep quality of rural empty-nest elderly included marital status,annual income,the number of chronic diseases,and the communication status with their children.3.The level of social support among rural empty-nest elderly was low,and the social support was negatively correlated with the sleep quality.4.The level of resilience among rural empty-nest elderly was low,and the resilience was negatively correlated with the sleep quality.5.The social support can not only directly predict sleep quality,but also indirectly affect sleep quality through resilience among rural empty-nest elderly.Resilience played a partial mediating role between social support and sleep quality.