关键词: 心房颤动, 睡眠质量, 心理状况, 症状, 结构方程模型

Abstract: Objective: To explore the relationship between sleep quality, psychological status, and symptom severity in patients with atrial fibrillation, and to provide evidence for symptom management in these patients. Methods: A total of 208 hospitalized patients with atrial fibrillation were selected from the cardiology department. Data were collected using a general information questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Mental Health Inventory-5 (MHI-5), and the Atrial Fibrillation Severity Scale (AFSS). Mediation effects were analyzed using AMOS 23.0, with hypothesis models estimated by maximum likelihood and tested for significance through Bootstrap. Results: The mean PSQI score was 8.76± 3.98, the mean MHI-5 score was 73.29±16.24, and the mean symptom severity score was 9.06±4.81. Sleep quality scores were positively correlated with symptom severity (r=0.223, P<0.01), while negatively correlated with psychological status (r=-0.221, P<0.01). Psychological status was negatively correlated with symptom severity (r=-0.272, P<0.01). The direct effect of sleep quality on psychological status was-0.22 (-0.38,-0.05), the direct effect of psychological status on symptom severity was-0.28 (-0.45,-0.12), and the indirect effect of sleep quality on symptom severity was 0.06 (0.02, 0.14). Conclusion: Psychological status fully mediates the relationship between sleep quality and symptom severity in patients with atrial fibrillation. Symptom management strategies for atrial fibrillation should incorporate sleep management and psychological care to reduce the impact of symptoms and enhance quality of life.

Key words: Atrial fibrillation, Sleep quality, Psychological status, Symptoms, Structural equation model