The Relationship Between Rumination And Sleep Quality Of Parents With Acute Leukemia Children

ObjectivesTo investigate the current situation on rumination,perceived stress,anxiety and sleep quality in parents of children with acute leukemia,explore the multiple mediating effects of perceived stress and anxiety between rumination and sleep quality,so as to provide theoretical basis for determining and conducting intervention studies on sleep quality for parents of children with acute leukemia.MethodsBy using the convenience sampling method,the father or mother of 326 children with acute leukemia who met the inclusion and exclusion criteria in 3 third class grade A hospitals in Jinan,Shandong from August 2018 to January 2020 were selected as research objects.Survey tools include general information questionnaires for children and their parents,ruminative responses scale(RRS),perceived stress scale-4(PSS-4),generalized anxiety disorder-7(GAD-7),Pittsburg sleep quality index scale(PSQI).SPSS23.0 was used for data statistical analysis,including descriptive analysis,independent sample t test,variance analysis,correlation analysis,and hierarchical regression model.Meanwhile,Amos22.0 was used to establish the structural equation model,and the mediation test was carried out by Bootstrap method.Results1.In this study,a total of 352 questionnaires were distributed and 326 valid questionnaires were recovered,with an effective rate of 92.6%.The average age of the research objects was(34.37 ± 5.12)years old.2.The average PSQI score for parents of children with acute leukemia was(8.69 ±3.57)pionts.Those with sleep problems(the total PSQI score>5 points)accounted for 77.6%,of which the average PSQI score was higher than the national norm.The average scores of rumination,perceived stress and anxiety were(45.89 ± 12.77)pionts,(8.06±3.02)pionts and(9.02±5.68)pionts,respectively.3.The results of univariate analysis showed that there were statistically significant differences in PSQI scores of parents of children with acute leukemia from the perspective of different parent occupations,residence of parents,religious beliefs of parents,age of the child patient,gender of the child patient,diagnosis time of the child patient,and chemotherapy treatment course(P<0.05).4.Correlation analysis showed that the PSQI scores for parents of children with acute leukemia were significantly and positively correlated with rumination(r=0.490),perceived stress(r=0.408),and anxiety(r=0.463)(all P<0.01).5.Hierarchical regression analysis showed that the influencing factors on parents'sleep quality of child patients with acute leukemia included religious beliefs of parents,age of the child patient,rumination,perceived stress,and anxiety.The five variables jointly explained 36.2%of the total variation in parents' sleep quality,among which rumination plays the most important role in prediction.6.The structural equation model was established ?/df=2.127,GFI=0.950,NFI=0.942,TLI=0.957,CFI=0.968,IFI=0.968,RMSEA=0.059,showing that the model fit well.By the mediation test of Bootstrap,path lwas obtained:rumination?anxiety?sleep quality,95%CI was[0.024?0.085],and 0 was not included,indicating that anxiety has a partial mediating effect between rumination and sleep quality.Path 2:rumination? perceived stress? anxiety? sleep quality,95%CI was[0.006?0.030],and 0 was not included,indicating that perceived stress and anxiety have a chain-mediated role between rumination thinking and sleep quality.Conclusions1.The sleep quality in parents of children with acute leukemia is lower than the national norm,and sleep problems with different degrees are common.2.There is a significant positive correlations between rumination,perceived stress,anxiety and sleep quality among parents of children with acute leukemia,and rumination,perceived stress and anxiety are important predictors of sleep quality.Therefore,reducing rumination,reducing perceived stress,and controlling anxiety have a significant effect on improving sleep quality.3.Rumination can indirectly affect the sleep quality among parents of children with acute leukemia by improving individual perceived stress and increasing the experience of anxiety.Therefore,in order to maintain good sleep quality for this group,attention should be given to perceived stress and anxiety as the entry point of intervention when high-level rumination occurs,so as to eliminate the adverse effects of rumination on sleep quality.