Depression and Anxiety Mediate the Association between Sleep Quality and Self-Rated Health in Healthcare Students

• Published in: Behavioral sciences Vol. 13; no. 2; p. 82
• Main Authors: Zhu, Yihong, Jiang, Chen, Yang, You, Dzierzewski, Joseph M., Spruyt, Karen, Zhang, Bingren, Huang, Mengyi, Ge, Hanjie, Rong, Yangyang, Ola, Bolanle Adeyemi, Liu, Tingjie, Ma, Haiyan, Meng, Runtang
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 19.01.2023; MDPI
• Subjects: Alzheimer's disease; Analysis; Anxiety; Cardiovascular disease; College students; Coronaviruses; COVID-19; Data collection; depression; Diabetes; Employment; Health surveys; healthcare students; Life Sciences; Likert scale; mediation; Mental depression; Mental health; Missing data; Part time employment; Preventive medicine; Psychological aspects; Questionnaires; Schizophrenia; self-rated health; Sleep; Sleep disorders; sleep quality; Software; Statistical analysis; Stress; Students; Type 2 diabetes; Validity; Variance analysis; China; anxiety; depression; mediation; healthcare students; sleep quality; self-rated health; Sleep quality; Depression; Healthcare students; Anxiety; Self-rated health; Mediation
• ISSN: 2076-328X; 2076-328X
• DOI: 10.3390/bs13020082

Objectives: This study aimed to investigate factors associated with sleep quality in healthcare students and to determine whether depressive and anxiety symptoms may explain some of the associations between sleep quality and self-rated health. Study design: This is a cross-sectional study at wave one. Methods: A total of 637 healthcare students were recruited via a stratified random sampling method in Hangzhou, China. The Sleep Quality Questionnaire (SQQ) and the four-item Patient Health Questionnaire (PHQ-4) were used to assess sleep quality and depressive and anxiety symptoms, respectively. Self-rated health was assessed via a self-developed questionnaire of both physical and psychological health. Structural equation modeling was used to examine the direct and indirect effects of sleep quality on self-rated health through depressive and anxiety symptoms. Results: Students engaged in part-time employment (p = 0.022), with poor perceived employment prospects (p = 0.009), and who did not participate in recreational sports (p = 0.008) had worse sleep quality. Structural equation modeling revealed a significant total effect of sleep quality on self-rated health (b = 0.592, p < 0.001), a significant direct effect of both sleep quality and depressive and anxiety symptoms on self-rated health (b = 0.277, 95% CI: 0.032–0.522), and a significant indirect effect of sleep quality on self-rated health through depressive and anxiety symptoms (b = 0.315, 95% CI: 0.174–0.457). Conclusions: Depressive and anxiety symptoms partially explain the association between sleep quality and self-rated health. Intervening upon sleep quality, depressive, and anxiety symptoms may bolster the self-rated health of healthcare students.