The mediating effect of resilience on the relationship between perceived stress and sleep quality in patients with coronary heart disease

Abstract

Objective To analyze the relationship among perceived stress, resilience and sleep quality in patients with coronary heart disease, and to examine the mediating effect of resilience between perceived stress and sleep quality. Methods Totally 231 patients with coronaryheartdisease were selected. The Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and 10-item Connor-Davidson Resilience Scale (CD-RISC-10) were used to assess the sleep quality, perceived stress and resilience respectively. Results The average scores of PSQI were (7.2 ± 2.8) points, and 71.4% (165/231) of the participants had sleep problems (PSQI >5). CD-RISC-10 scores were negatively correlated with PSQI scores and PSS scores (r = -0.62,-0.43, P<0.01), and PSS scores were positively correlated with PSQI scores (r=0.33, P<0.01). Furthermore, Bootstrap-generated 95%CI was (0.130-0.319, P<0.01) and did not include 0, which indicated that resilience significantly mediated the relationship between perceived stress and sleep quality. The mediating effect size of resilience was 56.1%. Conclusion It suggests that patients with coronary heart disease have poor sleep quality. Perceived stress and resilience could affect sleep quality, and resilience could mediate the relationship between perceived stress and sleep quality. Key words: Resilience, psychological; Sleep quality; Perceived stress; Mediating effect; Coronary heart disease