Mediating Effect of Illness Perception on the Relationship Between Perceived Family Function and Sleep Quality Among Patients With Atrial Fibrillation.
Xiaoqing Lu, Zifen An, Yuying Xu and 5 others
PMID 39578703WHAT IT FOUND
In 191 hospitalised patients with atrial fibrillation, better family function was linked to better sleep, and more negative illness perception was linked to poorer sleep.
Higher AF symptom severity was also linked to worse sleep. These links cannot show cause.
Key findings
01The paper states that 191 analysed patients had mean PSQI 10.57 and approximately 71.2% poor sleep quality.
02Family function was negatively correlated with sleep-quality score (r = -0.439), illness perception was positively correlated (r = 0.411), and illness perception accounted for 11.8% of the family-function association with sleep (indirect effect β = -0.043, 95% CI -0.169 to -0.014).
03In adjusted analysis, EHRA III and EHRA IV were associated with worse sleep than EHRA II (B = 2.134, 95% CI 0.609 to 3.659; B = 3.277, 95% CI 1.365 to 5.189), and commercial medical insurance was associated with better sleep than self-financed (B = -9.497, 95% CI -16.373 to -2.622).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a cross-sectional survey, so it cannot show that family function or illness perception causes sleep quality to change, or that improving them would improve sleep. The mediation result is a statistical association, not proof of a clinical mechanism. The sample was a convenience sample from one hospital in Wuhan, China, so it may not represent other AF populations. All measures were self-reported, and the paper notes this may not reflect the actual situation. The sleep-quality reporting is inconsistent: it says 71.2% scored less than 7, but scores above 7 indicate poor sleep, and the summary says 71.2% had poor sleep quality. The study analysed 191 of 200 recruited patients after excluding missing or erroneous responses.
Declared interests
The authors declare no conflicts of interest. The supplied text does not report funding sources.
The easy way to misread this
Do not conclude that nurses can improve AF patients' sleep by changing family function or illness perception. This was an observational survey of associations, not a trial of a nursing intervention.