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This study aimed to determine the mediating roles of perceived control and resilience in the association between mutuality and quality of life (QoL) in caregivers of adults with heart failure.
A multi-centre cross-sectional study.
We recruited 268 patient-caregiver dyads with heart failure using convenience sample enrolled from four hospitals in Henan Province, China from March to December 2023. Caregivers' mutuality, perceived control, resilience and QoL were assessed. A multiple-mediation model was tested using the PROCESS macro in SPSS.
Caregivers' mental QoL positively correlated with mutuality, perceived control, and resilience. Caregivers' physical QoL was correlated with mutuality. Conversely, perceived control and resilience showed no significant correlation with physical QoL. Moreover, the association between mutuality and mental QoL was mediated by perceived control and resilience, respectively, and together in series, accounting for 32.3%, 14.1% and 28.2% of the total effect, respectively.
Perceived control and resilience mediated the link between mutuality and mental QoL in caregivers of adults with heart failure. Interventions targeted at strengthening perceived control and resilience may improve caregivers' mental QoL. Additionally, the mental QoL may be improved by indirectly enhancing mutuality among caregivers of adults with heart failure.
It is important to develop multimodal intervention strategies that combine perceived control and resilience to amplify the positive impact of mutuality on the mental QoL of caregivers in individuals with heart failure.
The STROBE guideline was adopted to report this study.
No patient or public contribution.
The objective of this study was to construct and validate a structural equation model (SEM) to identify factors associated with sleep quality in awake patients in the intensive care unit (ICU) and to assist in the development of clinical intervention strategies.
In this cross-sectional study, 200 awake patients who were cared for in the ICU of a tertiary hospital in China were surveyed via several self-report questionnaires and wearable actigraphy sleep monitoring devices. Based on the collected data, structural equation modelling analysis was performed using SPSS and AMOS statistical analysis software. The study is reported using the STROBE checklist.
The fit indices of the SEM were acceptable: χ2/df = 1.676 (p < .001) and RMSEA = .058 (p < 0.080). Anxiety/depression had a direct negative effect on the sleep quality of awake patients cared for in the ICU (β = −.440, p < .001). In addition, disease-freeness progress had an indirect negative effect on the sleep quality of awake patients cared for in the ICU (β = −.142, p < .001). Analgesics had an indirect negative effect on the sleep quality of awake patients cared for in the ICU through pain and sedatives (β = −.082, p < .001). Sedation had a direct positive effect on the sleep quality of conscious patients cared for in the ICU (β = .493; p < .001).
The results of the SEM showed that the sleep quality of awake patients cared for in the ICU is mainly affected by psychological and disease-related factors, especially anxiety, depression and pain, so we can improve the sleep quality of patients through psychological intervention and drug intervention.
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