Sleep quality and family resilience function as chain mediators in the relationship between depressive mood and treatment compliance in continuous blood purification patients, with the total indirect effect accounting for 41.74% of the total effect.
Depressive mood was significantly associated with poorer sleep quality in CBP patients.
Depressive mood was significantly associated with lower family resilience in CBP patients.
Poorer sleep quality and lower family resilience were each independently associated with lower treatment adherence.
Sleep quality and family resilience together served as significant mediators between depressive mood and treatment compliance.
The specific chain mediation path from depression through sleep quality through family resilience to treatment adherence was significant but accounted for a small proportion of the total effect.
Patients with CBP demonstrated high levels of depressive symptoms, poor sleep quality, and suboptimal treatment adherence as measured by self-report scales.
This research suggests that among patients receiving continuous blood purification (CBP) — an intensive kidney treatment — depression, poor sleep, weakened family support systems, and reduced willingness to follow treatment plans are all closely linked. The study of 195 CBP patients found that those with more depressive symptoms tended to sleep worse and reported lower levels of family resilience (the ability of a family to cope and adapt together). Both of these factors were in turn associated with worse treatment compliance, meaning patients were less likely to follow their prescribed treatment regimens. The study found that the combined indirect pathways through sleep quality and family resilience explained about 42% of the relationship between depression and treatment non-compliance. A specific sequential chain — where depression worsens sleep, poor sleep then undermines family resilience, and reduced family resilience then lowers compliance — also proved statistically significant, though it accounted for a smaller portion (about 5%) of the overall effect. This suggests that the connections between these factors are complex and operate through multiple pathways simultaneously. This research suggests that interventions targeting sleep quality and family resilience — not just depression itself — might help improve treatment adherence in CBP patients. However, the authors caution that this was a cross-sectional study (meaning it measured everything at one point in time and cannot prove cause and effect), and that the treatment adherence measure used was not specifically validated for CBP patients. Future research using longitudinal designs and CBP-specific tools would be needed to confirm these findings and guide clinical practice.
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Upload Your LabsDong W, Zhao X, Gao Q. (2026). The Chain Mediating Effect of Sleep Quality and Family Resilience Between Depressive Mood and Treatment Compliance in Continuous Blood Purification Patients.. Actas espanolas de psiquiatria. https://doi.org/10.62641/aep.v54i4.2183