Social support and sleep quality in patients with stroke: The mediating roles of depression and anxiety symptoms

Abstract

Background Research has demonstrated that higher social support is associated with better psychological health, quality of life, cognition, activities of daily living and social participation, but the relationship between social support and sleep quality remains unknown. Aims This study aimed to assess the incidence of poor sleep quality, clarify the relationship between social support and sleep quality amongst stroke patients and determine whether anxiety and depression symptoms mediate this relationship. Methods We conducted a quantitative, cross‐sectional study involving 238 patients with stroke (median age of 61 [range 29–87] years, 68.1% male) recruited from a comprehensive tertiary care hospital between September 2019 and January 2020. A self‐administered, structured questionnaire was used for the survey. The mediating effect of anxiety and depression symptoms was assessed using the bootstrap method via Model 4 (parallel mediation) of the SPSS PROCESS macro. Results Results showed that the incidence of poor sleep quality amongst stroke patients was 65%. Mediation analysis showed that social support exerted significant direct effects on sleep quality, and anxiety and depression symptoms mediated the relationship between social support and sleep quality. Conclusion Measures should be taken to enhance social support to improve the sleep quality of stroke patients.

The mediating effect of post‐stroke depression between social support and quality of life among stroke survivors: A meta‐analytic structural equation modeling

“…35 In recent years, psychosocial factors have attracted widespread attention as potential modifiable factors. 36 It seems plausible that PSD is likely to account for poor QOL of stroke patients with low SS.…”

Perceived social support and sleep quality in patients with arteriosclerotic obliterans: The mediating roles of psychological flexibility

“…Long‐term low‐quality sleep affects the quality of life (QOL) as well as physical and psychological health of individuals (Lund et al, 2010 ). Studies (Lee et al, 2022 ; Zhao et al, 2021 ) have shown that pain patients often experience psychological problems and stressful life events that affect sleep quality. Sleep quality is a modifiable risk factor of the rehabilitation process and has become a focus on clinical scholars (Lao et al, 2018 ).…”

“…Perceived social support (PSS) generally refers to the help and support that individuals receive from social relationships and interactions, including significant others (family members, relatives and friends) and extended relationships (neighbours, classmates and colleagues) (Thoits, 2011). A cross-sectional survey (Zhao et al, 2021) also confirmed that social support has a significant direct effect on sleep quality. Furthermore, social support is a protective factor of individuals experiencing stressful life events (Laopoulou et al, 2020).…”

Indirect effects of social support and hope on quality of life via emotional distress among stroke survivors: A three-wave structural equation model

“…Perceived social support has shown significant temporal associations with greater community participation ( 6 ), lower depression levels ( 7 ), and better functional status following stroke onset ( 8 , 9 ). Among stroke patients, social support has been found to mediate the effect of functional ability on depression and QoL ( 10 ), and anxiety and depressive symptoms have been found to mediate the relationship between social support and sleep quality ( 11 ). However, most of the studies of stroke survivors were limited by a cross-sectional design ( 10 , 12 – 14 ) or a small sample size ( N < 50) ( 8 , 9 , 15 , 16 ).…”