Neuropsychiatric Disease and Treatment (Dec 2021)
The Mediating Role of Self-Efficacy in Sleep Disorder and Depressive Symptoms Among Chinese Caregivers of Stroke Inpatients: A Structural Equation Modeling Analysis
Abstract
Longjuan Cong,1 Yanhong Ju,2 Ling Gui,3 Bo Zhang,1 Fangyan Ding,3 Changqing Zou4 1Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, People’s Republic of China; 2Section of Statistics, 4th People’s Hospital of Shenyang, Shenyang, Liaoning, People’s Republic of China; 3Department of Health Service Management, College of Health Management, China Medical University, Shenyang, Liaoning, People’s Republic of China; 4School of Health Humanities, China Medical University, Shenyang, Liaoning, People’s Republic of ChinaCorrespondence: Changqing Zou Tel +86 189 0405 6411Email [email protected]: Caregivers of stroke inpatients are at high risk of sleep disorder, which may lead to depressive symptoms. Self-efficacy has always been regarded as a protective factor against psychological disorders such as depressive symptoms. This study aims to investigate the sleep disorder and depressive symptoms of caregivers of stroke inpatients in China and explore the mediating effect of self-efficacy between sleep disorder and depressive symptoms among Chinese caregivers of stroke inpatients.Patients and Methods: In this cross-sectional study, a total of 305 caregivers who were hospitalized with stroke patients completed the PROMIS Sleep Disorder Short Form Scale, General Self-Efficacy Scale and Patient Health Questionnaire-9 in two general public hospitals in northeast and southeast China. A structural equation model with bootstrap method was performed to determine the mediation of self-efficacy between sleep disorder and depressive symptoms.Results: Among the participants, 55.4% of caregivers reported depressive symptoms. Sleep disorder and self-efficacy were significant predictors of depressive symptoms. The direct impact of sleep disorder on depressive symptoms was positive, and the path coefficient of sleep disorder with depressive symptoms was decreased from 0.45 to 0.38 (P < 0.01) after addition of self-efficacy in the model. This indicated that self-efficacy played as mediator.Conclusion: The caregivers of stroke inpatients were in poor physical and psychological health, and more than half of the caregivers (55.4%) suffered from depressive symptoms. Our research revealed the mediation of self-efficacy between sleep disorder and depressive symptoms, and emphasized the importance of enhancing self-efficacy to reduce depressive symptoms among caregivers of stroke inpatients. These results demonstrate that focusing on self-efficacy interventions can enhance mental health and reduce depressive symptoms effectively.Keywords: self-efficacy, sleep disorder, depressive symptoms, Chinese caregivers of stroke inpatients
