Associations between sleep quality, fatigue, social isolation, and depressive symptoms in patients with heart failure: a parallel mediation analysis

Abstract

Background Depression is a common comorbidity in patients with heart failure (HF) which could lead to increased mortality and morbidity. Meanwhile, a majority of patients with HF suffer from poor sleep quality which has negative impacts of patients’ physical, social, and mental health, leading to a risk of fatigue, social isolation, and depressive symptoms. However, the interrelationships among the four factors remain unclear in the literature. This study aimed to assess the rate of depressive symptoms and the interrelationships among sleep quality, fatigue, social isolation, and depressive symptoms in patients with HF in China. Methods This cross-sectional study was conducted at a general hospital in China. A convenience sample of 300 patients with HF was recruited from January to March 2024. Self-reported instruments were used to measure sleep quality, fatigue, social isolation, and depressive symptoms. Descriptive, Pearson correlation, and parallel mediation analyses were conducted via SPSS 26.0. Results Results showed that 72.3% of the participants had moderate to severe depressive symptoms. Fatigue and social isolation performed parallel mediation effects on the relationship between sleep quality and depressive symptoms. Conclusion These findings highlight the prevention and management of depressive symptoms in patients with HF. Future studies are needed to design and evaluate the effectiveness of interventions that incorporate multiple components on improving sleep quality, social isolation, and fatigue in patients with HF.