Abstract 12704: Race And Quality of Life Among Patients With Heart Failure—A Serial Multiple Mediator Model

Abstract

BACKGROUND: Black patients have worse quality of life than Whites. Depression and sleep quality are associated with quality of life (QoL). However, the manner in which depression and sleep quality influence the relationship between race and QoL in patients with HF is unclear. Objective: To explore whether depressive symptoms and/or sleep quality mediate the relationship between race and QoL among patients with HF. METHOD: We performed a secondary analysis of data from 271 adults with HF in this descriptive study. Participants were enrolled from out-patient settings in the Northeastern US. Self-reported race (White or Black), depressive symptoms (Patient Health Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), and QoL (Kansas City Cardiomyopathy Questionnaire) were collected at baseline. A serial multiple mediator analysis was conducted with a regression framework, using the PROCESS macro for SPSS. Results: Ninety-six patients (35.4%) were Black. Race was directly associated with depressive symptoms and sleep quality. Black patients had more depressive symptoms and poorer sleep quality than White patients. Depressive symptoms were directly associated with sleep quality and QoL. Sleep quality was directly associated with QoL. Race was not directly associated with QoL; but indirectly associated with QoL through the following three paths: 1) depressive symptoms; 2) sleep quality; 3) depressive symptoms and sleep quality. Due to more depressive symptoms and/or poorer sleep quality, Black patients had poorer QoL than Whites (Figure). Conclusion: Depressive symptoms and sleep quality independently and in combination mediated the relationship between race and QoL. These findings suggest that screening for depressive symptoms and sleep quality could identify patients at risk for poor QoL, especially in racial minority groups.