| ObjectiveBy investigating the psychological flexibility,self-management,personality characteristics and sleep quality s tatus of hypertension patients,the potential mechanism of psychological flexibility and self-management between personality characteristics and sleep quality was studied.To provide theoretical basis for carrying out Acceptance and Commitment Therapy based on improving psychological flexibility and improving sleep quality of hypertension patients.MethodsThis study used convenience sampling to select 241 patients with hypertension of a tertiary grade A hospital as the survey objects in Dalian,and the cross-sectional study method was used.The survey tools included the self-designed general information questionnaire,C hinese Big Five Personality Inventory Brief Version,Pittsburgh Sleep Quality Index,Acceptance and Action QuestionnaireⅡ,and Self-Management Scale for Patients with Hypertension.Excel 2013,spss20.0 and amos24.0 were used to manage and analyze the data.Independent sample t-test,one-way ANOVA,Pearson correlation analysis,multiple linear regression analysis and path analysis were used for statistical methods.Results1.Among 241 patients with hypertension,59.3% of cases were male and 40.7% of cases were female.The average age was(45.9±11.2)years old,the average body mass index was(26.8±4.1),the average waist circumference was(93.3±11.7)cm,78.4% of cases had high school education or above,86.7% of cases were married,41.5% of cases worked in enterprises,47.3% of cases had income of more than 5000 yuan,90.5% of cases had medical insurance,90.5% of cases lived in cities,43.2% of cases lived with spouses and children,81.7% of cases had tertiary hypertension,61.8% of cases had hypertension for more than one year,35.3% of cases had drinking,24.9% of cases had smoking,60.7% of cases had family history,32.0% of cases had complications.2.The PSQI score of hypertension patients ranged from 0 to 20,with an average score of(7.4±3.8).64.3% of cases with the total score of more than 5 were poor sleep quality.All dimensions of PSQI showed that 93.4% of cases had sleep disturbances,82.2% of cases had daytime dysfunction,67.6% of cases had sleep latency of more than 15 minutes,42.4% of cases had sleep duration of less than 6 hours,38.6% of cases had poor subjective sleep quality,37.3% of cases had habitual sleep efficiency of less than 85%,and 7.1% of cases had use of sleeping medications.3.The results of univariate analysis showed that the PSQI scores of female patients were higher than that of male patients(t=-2.408,P=0.017).Pearson correlation analysis showed that the PSQI scores of hypertension patients were po sitively correlated with age(r=0.295,P<0.01).There were no significant difference of PSQI score in other general data(P>0.05).4.Neuroticism were related to psychological flexibility,self-management and sleep quality.While extraversion,conscientiousness,openness and agreeableness were not related to psychological flexibility,self-management and sleep quality.Neuroticism and psychological flexibility were positively correlated with sleep quality(P<0.001),self-management was negatively correlated with sleep quality(P<0.001),neuroticism and psychological flexibility were negatively correlated with self-management(P<0.001),neuroticism was positively correlated with psychological flexibility(P<0.001).5.Multiple linear regression analysis showed that gender,age,neuroticism,psychological flexibility and self-management variables had significant influence on sleep quality(P<0.001).Gender,age,neuroticism and self-management were the major factors(P<0.05).6.Neuroticism predicted sleep quality through multiple mediating effects of psychological flexibility and self-management,with an indirect prediction effect of 0.055.The bootstrapped 95%CI(0.021,0.106)did not include zero,indicating the existence of multiple mediating effects of psychological flexibility and selfmanagement(P=0.002)。 Conclusion1.Nearly two-thirds of hypertension patients have poor sleep quality,especially in sleep disturbances,daytime dysfunction,sleep duration and so on.In addition,the sleep quality of female,old age,low education level,poor e conomic status and patients with comorbidity deserves more attention of researchers.2.Psychological flexibility of hypertension patients are significantly related to neuroticism,self-management and sleep quality.Neuroticism and self-management can predict sleep quality,while psychological flexibility can indirectly predict sleep quality through self-management.3.Psychological flexibility of hypertension patients has mediating effect between neuroticism and self-management.Self-management has mediating effect between psychological flexibility and sleep quality.Psychological flexibility and self-management have multiple mediating effects between neuroticism and sleep quality.4.In view of the fact that personality is a stable tendency,which is difficult to change in a short period of time.Medical staff can start with psychological and behavioral intervention methods such as Acceptance and Commitment Therapy to improve psychological flexibility and self-management level of hypertension patients,so as to ensure high-quality sleep. |
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