Depressive Symptoms and Sleep Quality Mediate the Relationship Between Race and Quality of Life Among Patients With Heart Failure: A Serial Multiple Mediator Model.
Jia-Rong Wu, Debra K Moser, Chin-Yen Lin and 2 others
PMID 38227624WHAT IT FOUND
Race itself showed no direct link to quality of life, but Black patients with heart failure reported higher depressive symptoms and poorer sleep quality, and both were linked to worse quality of life.
Key findings
01Race was not directly associated with quality of life, but was indirectly associated through depressive symptoms, sleep quality, and both together.
02Black participants with heart failure reported higher depressive symptoms, poorer sleep quality, and worse quality of life than White participants.
03Higher depressive symptoms and poorer sleep quality were each associated with worse quality of life.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional analysis, so it cannot show that race, depressive symptoms, or sleep quality caused worse quality of life. Sleep quality was measured by self-report, which can be affected by recall and social desirability bias. The analysis used baseline data collected more than 10 years earlier. Participants were recruited from outpatient cardiology clinics in one region and excluded people living in long-term care, with dementia, end-stage kidney disease, terminal illness, severe psychiatric disorder, or recent serious substance abuse. No intervention was tested, so the study cannot say what treatment would improve quality of life.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the mediation results as proof that treating depression or poor sleep will improve quality of life in patients with heart failure. The study was cross-sectional and showed associations, not causation.