Mediating Effect Analysis of Social Connectedness Between Fear of Progression and Sleep Quality in Patients With...

Poor sleep quality is prevalent among patients with chronic heart failure (HF), with fear of progression being one of its independent predictors. However, the pathways through which it exerts its influence have not been fully elucidated. A total of 246 patients with chronic HF, hospitalized in the cardiology department of a hospital from January to June 2024, were selected for this study using a convenience sampling method. Data were collected using the General Information Questionnaire, Social Connectedness Scale, the Fear of Progression Questionnaire-Short Form, and the Pittsburgh Sleep Quality Index. Stratified regression analysis was conducted to assess the effects of fear of progression and social connectedness on sleep quality. The mediating effect of social connectedness in fear of progression and sleep quality was tested by SPSS PROCESS. The mean age of the patients in this study was 73.84 years (SD, 11.53), with 52.4% being female. The study revealed that patients with chronic HF had sleep quality, fear of progression, and social connectedness had mean scores of 11.83 (SD, 3.76), 29.52 (SD, 7.03), and 3.51 (SD, 0.67), respectively. Regression analysis showed that fear of progression positively predicted poor sleep quality (β = .539, p < .001) and social connectedness negatively predicted poor sleep quality (β = -.301, p < .001). Furthermore, fear of progression exerted an indirect effect on sleep quality through its influence on social connectedness. Social connectedness exerts a significant influence on the relationship between fear of progression (FoP) and sleep quality among chronic HF patients. Enhancing social connectedness potentially offers an effective intervention to ameliorate sleep quality in chronic HF patients exhibiting a high level of FoP.