2型糖尿病患者孤独感、抑郁与睡眠质量的关系

Relationships among loneliness,depression and sleep quality in patients with type 2 diabetes mellitus

目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者孤独感、抑郁和睡眠质量的关系,并分析抑郁在孤独感和睡眠质量间的中介作用。方法:使用加州大学洛杉矶分校孤独感量表、流调用抑郁自评量表和匹兹堡睡眠质量指数量表对350例T2DM住院患者进行调查。结果:最终有效调查T2DM患者341例(97.43%),其孤独感、抑郁和睡眠质量得分依次为32.00(26.00,38.00)、9.00(5.00,15.00)、8.00(6.00,11.00)分。孤独感与抑郁、睡眠质量呈正相关,抑郁和睡眠质量呈正相关(均P<0.01)。孤独感可直接影响抑郁(β=0.590),抑郁可直接影响睡眠质量(β=0.557),孤独感可通过抑郁的中介作用间接影响睡眠质量(β=0.329)。抑郁能够解释孤独感34.80%的变量,睡眠质量被整个模型的解释度为23.70%。结论:医护工作者应尽早发现T2DM患者的孤独感和抑郁,以采取有效措施降低其孤独感,减少抑郁的负面调节作用,最终改善患者的睡眠质量。

Objective:To explore the relationship among loneliness,depression and sleep quality in patients with type 2 diabetes mellitus(T2DM),and to analyze the mediating effect of depression on loneliness and sleep quality.Methods:A survey of 350 hospitalized patients with T2DM was conducted using University of California at Los Angeles loneliness scale,center for epidemiological studies depression scale and Pittsburgh sleep quality index.Results:The final effective investigation was conducted on 341 T2DM patients(97.43%),with loneliness,depression and sleep quality scores of 32.00(26.00,38.00),9.00(5.00,15.00),and 8.00(6.00,11.00)respectively.Loneliness was significantly positively correlated with depression and sleep quality,and depression and sleep quality were significantly positively correlated(all P<0.01).Loneliness can directly affect depression(β=0.590),depression can directly affect sleep quality(β=0.557),and loneliness can indirectly affect sleep quality through the mediating effect of depression(β=0.329).The explanatory power of loneliness for depression was 34.80%,and the explanatory power of sleep quality was 23.70%for the whole model.Conclusion:Medical workers should detect the occurrence of loneliness and depression in T2DM patients as soon as possible,so as to take effective measures to reduce the loneliness,reduce the negative adjustment effect of depression,and ultimately improve the sleep quality.