Abstract
Background: Black patients with heart failure (HF) report worse quality of life (QoL) than White patients. Few investigators have examined mediators of the association between race and QoL, but depressive symptoms and sleep quality are associated with QoL.
Objective: The aim of this study was to determine whether depressive symptoms and sleep quality are mediators of the relationship between race and QoL among patients with HF.
Methods: This was a cross-sectional study. We included 271 outpatients with HF. Self-reported race (White/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 using the PROCESS macro for SPSS.
Results: Ninety-six patients (35.4%) were Black. Black participants reported higher levels of depressive symptoms and poorer sleep quality than White participants. Race was not directly associated with QoL but indirectly associated with QoL through depressive symptoms and poorer sleep quality. Because of higher levels of depressive symptoms and poorer sleep quality, Black participants reported poorer QoL than White participants.
Conclusions: Depressive symptoms and sleep quality together 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 Black patients.
Document Type
Article
Publication Date
9-2024
Digital Object Identifier (DOI)
https://doi.org/10.1097/JCN.0000000000001079
Funding Information
This study was supported by funding from the National Institutes of Health; the National Heart, Lung, and Blood Institute (R01 HL084394- 01A1); and the National Institute of Nursing Research (R01 NR020478- 01; Principal Investigator, J.-R. Wu). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health; the National Heart, Lung, and Blood Institute; or the National Institute of Nursing Research.
Repository Citation
Wu, Jia-Rong; Moser, Debra K.; Lin, Chin-Yen; Chiang, Ambrose A.; and Riegel, Barbara, "Depressive Symptoms and Sleep Quality Mediate the Relationship between Race and Quality of Life among Patients with Heart Failure: A Serial Multiple Mediator Model" (2024). UK CARES Faculty Publications. 55.
https://uknowledge.uky.edu/ukcares_facpub/55
Notes/Citation Information
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