摘要
Abstract
Objective:To explore the mediating effect of anxiety and depression in the relationship between perceived stress and sleep quality in patients with initial diagnosis of pulmonary nodules.
Methods:A total of 410 patients with initial diagnosis of pulmonary nodules in the Mianyang Hospital Affiliated to School of Medicine,University of Electronic Science and Technology from October 2020 to October 2023 were selected as the study subjects.The Hospital Anxiety and Depression Scale(HADS),the Perceived Stress Scale(PSS),and the Pittsburgh Sleep Quality Index(PSQI)were used to evaluate the anxiety and depression mood,perceived stress,and sleep quality of the patients.The relationship between HADS,PSS,and PSQI scores in patients with initial diagnosis of pulmonary nodules and the mediating role of anxiety and depression on perceived stress and sleep quality were analyzed.
Results:The HADS anxiety and depression scores of the 410 patients with initial diagnosis of pulmonary nodules were 12.36±3.28 and 10.97±3.05,respectively,while the PSS and PSQI scores were 32.89±4.82 and 12.69±2.98,respectively.PSS was positively correlated with PSQI scores(r=0.552,P＜0.001),and HADS anxiety and depression scores were positively correlated with PSS(r=0.591,r=0.613)and PSQI(r=0.293,r=0.326)scores(all P＜0.05).After controlling for confounding factors,HADS anxiety and depression scores explained 46.6%and 50.3%of PSQI scores,and PSS scores explained 55.9%of PSQI scores after introducing PSS scores.In the final model,discomfort symptoms,HADS anxiety and depression scores,and PSS scores were included in the regression equation,and these influencing factors explained 67.7%of PSQI in patients with initial diagnosis of pulmonary nodules.Perceived stress positively predicted sleep quality(β=0.436,P＜0.001).Anxiety and depression positively predicted perceived stress(β=0.574,P＜0.001;β=0.496,P＜0.001).Perceived stress(β=0.299,P=0.006),anxiety(β=0.396,P＜0.001),and depression(β=0.445,P＜0.001)positively predicted sleep quality.Anxiety and depression partially mediated the relationship between perceived stress and sleep quality,with mediation effects accounting for 63.60%and 64.79%,respectively.
Conclusion:Perceived stress in patients with initial diagnosis of pulmonary nodules can directly affect sleep quality and also indirectly affect sleep quality through anxiety and depression,suggesting that medical staff should actively provide psychological counseling to alleviate patients'perceived stress and anxiety and depression,thereby improving sleep quality.关键词
焦虑/抑郁/首诊/肺结节/感知压力/睡眠质量/中介作用Key words
anxiety/depression/initial diagnosis/pulmonary nodules/perceived stress/sleep quality/mediating effect
