Effect Of Negative Emotions On Sleep Quality In Patients Receiving Maintenance Hemodialysis

Objectives1.To investigate the current levels of sleep quality in patients receiving maintenance hemodialysis(MHD).2.To analyze the effects of sociodemographic characteristics,disease-related symptoms,serological indicators,negative emotions,hope,and family function on sleep quality in MHD patients.3.To explore the mediating effect of hope and family function between negative emotions and sleep quality in MHD patients,in order to enrich the research content of sleep quality and provide a reference for the intervention plans of sleep quality in MHD patients.MethodsFrom June to September 2021,227 convenience samples were recruited from the Hemodialysis Centers of two tertiary hospitals in Wuhan,Hubei Province,China.The demographic and clinical characteristics questionnaire,hospital anxiety and depression scale,Herth hope index,family APGAR index and athens insomnia scale were recorded using the self-reported questionnaires completed by 227 MHD patients.SPSS version 26.0 and AMOS version 24.0(IBM Corporation,Armonk,New York,USA)were used to analyze the data.Mean and standard deviation(SD),frequency and percentage were used to describe the demographic clinical characteristics and score of each scale.The sleep quality scores of MHD patients with different demographic and clinical characteristics were evaluated by independent sample t test or one-way analysis of variance.Pearson correlation analysis was used to analyze the relationships between the study variables.Multiple linear regression was used to analyze the influencing factors of sleep quality in MHD patients.Exploratory factor analysis was used to test common method biases.AMOS version 24.0 was used to construct the structural equation model.Bias-corrected bootstrapping method was used to test the significance of the mediating effect.were used to evaluate the fit degree of the initial model and the revised model.Ratio of chi-square to degrees of freedom(χ2/df),root mean square error of approximation(RMSEA),goodness-of-fit index(GFI),adjusted goodness-of-fit index(AGFI),comparative fit index(CFI),normed fit index(NFI),and tucker-lewis index(TLI)were used to evaluate the global goodness of fit of the model.The initial model was modified by modification index and path coefficient P value.Results1.Scores of sleep quality,negative emotions,hope,and family function in MHD patientsThe mean score of sleep quality was 7.57(SD=4.74).The mean score of anxiety was 4.36(SD = 4.02)and the prevalence rate was 35.24%(80 cases).The mean score of depression was 5.91(SD=4.37)and the prevalence was 22.03%(50 cases).The mean score of hope was 34.64(SD=7.21),indicating a moderate level of hope.The mean score of family function was 6.21(SD=2.90),indicating a moderate levels of family function.2.Univariate analysis of sleep quality in MHD patientsThere were significant differences in sleep quality scores of MHD patients with age,education level,marital status,family per capita monthly income,dialysis frequency,payment method of medical expenses,dialysis duration,urea reduction ratio,serum potassium,serum sodium,serum calcium and serum magnesium(P<0.05).3.Multivariate analysis of sleep quality in MHD patientsAge,family per capita monthly income,urea reduction ratio,payment method of medical expenses,dialysis frequency,dialysis duration and serum calcium were the main factors affecting sleep quality of MHD patients,accounting for 25.80%of the total variation.4.Pearson correlation analysisThere was positive correlation between sleep quality and anxiety(r=0.474,P<0.01),positive correlation between sleep quality and depression(r=0.472,P<0.01),negative correlation between sleep quality and hope(r=-0.585,P<0.01),and negative correlation between sleep quality and family function(r=-0.652,P<0.01).There was positive correlation between anxiety and depression(r=0.685,P<0.01),negative correlation between anxiety and family function(r=-0.475,P<0.01),and negative correlation between anxiety and hope(r=-0.314,P<0.01).There was positive correlation between family function and hope(r=0.467,P<0.01),depression was negatively correlated with family function(r=-0.443,P<0.01)and with hope(r=-0.432,P<0.01).5.Analysis of chain mediating effectThe negative emotions can directly predict sleep quality(p=0.167,p=0.046),predict sleep quality through hope,predict sleep quality through family function,and predict sleep quality through the chain mediating effect of hope and family function.The total effect size was 71.06%,the total indirect effect value was 0.410,and the total effect value was 0.577.Conclusion1.MHD patients have more serious sleep disorders.The prevalence of anxiety and depression is close to that of the general population.Hope level is medium;Family function is moderately impaired.2.Age,family per capita monthly income,urea reduction ratio,dialysis frequency and serum calcium were the main factors affecting sleep quality of MHD patients.3.MHD patients’ sleep quality,anxiety,depression,hope,and family function were correlated.4.Negative emotions directly affect the sleep quality of MHD patients.Family function and hope plays a chain mediating effect in the relationship between negative emotions and sleep quality.5.Medical staff should pay attention to the negative emotions of MHD patients,help them build up hope for life and future,integrate the support of family system into the rehabilitation process of patients,so as to improve the sleep quality,prolong the dialysis age and improve the quality of life.