This study aimed to assess the rate of depressive symptoms and the interrelationships among sleep quality, fatigue, social isolation, and depressive symptoms in patients with heart failure (HF) in China. A cross-sectional study at a general hospital, 300 patients with HF were conveniently sampled from January to March 2024. To measure whether fatigue and social isolation mediated the association between sleep quality and depressive symptoms, descriptive analysis, Pearson correlation, and parallel mediation analyses were conducted via SPSS 26.0. Results showed that 72.3% of the participants had moderate to severe depressive symptoms. Fatigue and social isolation parallelly mediated the relationship between sleep quality and depressive symptoms. These findings highlight the prevention and management of depressive symptoms in HF patients. Future studies need to design and evaluate the effectiveness of interventions that incorporate multiple components on targeting sleep quality, social isolation, and fatigue in patients with HF.
BahramiMEtemadifarSShahriariM, et al. (2014) Caregiver burden among Iranian heart failure family caregivers: A descriptive, exploratory, qualitative study. Iranian Journal of Nursing and Midwifery Research19(1):s 56–63.
2.
BeckATRialWYRickelsK (1974) Short form of depression inventory: Cross-validation. Psychological Reports34(3_suppl): 1184–1186.
3.
Ben SimonEWalkerMP (2018) Sleep loss causes social withdrawal and loneliness. Nature Communications9(1): 3146.
4.
BottoJMartinsSMoreiraE, et al. (2021) The magnitude of depression in heart failure patients and its association with NYHA class. European Psychiatry64(S1): S342–S342.
5.
BujangMASa’atNBakarTMITA (2017) Determination of minimum sample size requirement for multiple linear regression and analysis of covariance based on experimental and non-experimental studies. Epidemiology, Biostatistics, and Public Health14(3): e12117.
6.
BuysseDJReynolds IIICFMonkTH, et al. (1989) The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research28(2): 193–213.
7.
ChangYPLorenzRAPhillipsM, et al. (2020) Fatigue in family caregivers of individuals with dementia: Associations of sleep, depression, and care recipients’ functionality. Journal of Gerontological Nursing46(9): 14–18.
8.
ChangQShaFChanCH, et al. (2018) Validation of an abbreviated version of the Lubben Social Network Scale (“LSNS-6”) and its associations with suicidality among older adults in China. PLoS One13(8): e0201612.
9.
ChattuVKManzarMDKumaryS, et al. (2018). The global problem of insufficient sleep and its serious public health implications. Healthcare7(1): 1.
10.
ChuangL-LChuangY-FHsuM-J, et al. (2018) Validity and reliability of the traditional Chinese version of the multidimensional fatigue inventory in general population. PLoS One13(5): e0189850.
11.
FinneySJDiStefanoC (2006) Non-normal and categorical data in structural equation modeling. Structural equation modeling: A second course10(6): 269–314.
12.
GableSLBedrovA (2022) Social isolation and social support in good times and bad times. Current Opinion in Psychology44: 89–93.
13.
HayesAF (2012) PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling. University of Kansas, KS.
14.
HwangKK (2010) Chinese relationalism: Theoretical construction and methodological considerations. Journal for the Theory of Social Behaviour30(2): 155–178.
15.
LainsamputtyFChenH-M (2018) The correlation between fatigue and sleep quality among patients with heart failure. NurseLine Journal3(2): 100–114.
16.
LinX-xGaoB-BHuangJ-y (2020) Prevalence of depressive symptoms in patients with Heart Failure in China: A meta-analysis of comparative studies and epidemiological surveys. Journal of Affective Disorders274: 774–783.
17.
LubbenJBlozikEGillmannG, et al. (2006) Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. The Gerontologist46(4): 503–513.
18.
MaXJiangGFuS, et al. (2018) Enhanced network efficiency of functional brain networks in primary insomnia patients. Frontiers in Psychiatry21(9): 46.
19.
MhannaMSauerMCSafiM, et al. (2023) Cognitive behavioral therapy for depression in patients with heart failure: A systematic review and metanalysis of randomized control trials. Heart Failure Reviews28(5): 1091–1100.
20.
MoradiMDoostkamiMBehnamfarN, et al. (2022) Global prevalence of depression among heart failure patients: A systematic review and meta-analysis. Current Problems in Cardiology47(6): 100848.
NorraCKummerJBoeckerM, et al. (2012) Poor sleep quality is associated with depressive symptoms in patients with heart disease. International Journal of Behavioral Medicine19: 526–534.
23.
PalmerCAAlfanoCA (2017) Sleep and emotion regulation: An organizing, integrative review. Sleep Medicine Reviews31: 6-16.
24.
PavlovicNVGilotraNALeeCS, et al. (2022) Fatigue in persons with heart failure: A systematic literature review and meta-synthesis using the biopsychosocial model of health. Journal of Cardiac Failure28(2): 283–315.
25.
RedekerNSConleySMohseninV, et al. (2018) Effects of cognitive behavioral therapy for insomnia on sleep, symptoms, stress, and autonomic function among patients with heart failure. Behavioral sleep medicine18(2): 190–202.
26.
RedekerNSKlarYHSamanthaC, et al. (2021) Cognitive behavioral therapy for insomnia has sustained effects on insomnia, fatigue, and function among people with chronic heart failure and insomnia: The heartsleep study. Sleep45(1): zsab252.
27.
SavareseGBecherPMLundLH, et al. (2022) Global burden of heart failure: A comprehensive and updated review of epidemiology. Cardiovascular Research118(17): 3272–3287.
28.
SbolliMFiuzatMCaniD, et al. (2020) Depression and heart failure: The lonely comorbidity. European Journal of Heart Failure22(11): 2007–2017.
29.
ShefflerJLSchmiegeSJSussmanJ, et al. (2021) A longitudinal analysis of the relationships between depression, fatigue, and pain in patients with heart failure. Aging & Mental Health25(12): 2272–2278.
30.
SmetsEGarssenBBonkeB, et al. (1995) The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research39(3): 315–325.
31.
TsaiP-SWangS-YWangM-Y, et al. (2005) Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Quality of Life Research14: 1943–1952.
32.
TsaoCWAdayAWAlmarzooqZI, et al. (2022) Heart disease and stroke statistics—2022 update: a report from the American Heart Association. Circulation145(8): e153–e639.
33.
WangLFangWAnY, et al. (2021) Identification of factors associated with social dysfunction in patients with heart failure. European Journal of Cardiovascular Nursing20(5): 475–484.
34.
WangCWangD (2021) Validity and reliability of Chinese version of 28-item Substance Use Risk Profile Scale in Chinese adolescents and young adults. Current Psychology40: 4507–-4515.
35.
ZhangJChaiXYeY, et al. (2022) Association between sleep and quality of life in heart failure patient–caregiver dyads and mediation of fatigue: An actor–partner interdependence mediation model. Journal of Advanced Nursing78(8): 2436–2447.
36.
ZhengT (2021) Sleep disturbance in heart failure: A concept analysis. Nursing Forum56(3): 710–716.
