Stress-buffering effects of hope on depressive symptoms and health related QOL in persons with insomnia and mild depression

Abstract

BACKGROUND: Stress influences depressive symptoms and also health related quality of life. Hope is an important protective coping resource. However, the role of hope in adjusting to stress usually was neglected. This study aims to investigate the effects of hope on associations between stress level, depressive symptoms and health related quality of life among people with mild depression. METHODS: 225 participants with sleep complaints in the community were screened for depressive disorder by Chinese version Center for Epidemiologic Studies Depression Scale (CESD). Outcome measures included CES-D, Pittsburgh Sleep Quality Index (PSQI), perceived stress scale (PSS), adult trait hope scale (ATHS) and SF-12 for health related quality of life (HRQoL). Correlation coefficient and partial correlation coefficient analyses were conducted. RESULTS: The mean age was 55.7 (SD = 9.2). The majority were female (n=172, 76.4%). Participants had higher perceived stress level (PSS: mean = 20.8, SD = 3.9), severe sleep disturbance [PSQI: 13.3 (3.0)], mild to moderate depression [CES-D: 21.8(6.6)] and poor HRQoL [SF-12 Physical component scale (PCS) = 39.8 (SD=8.8) and mental component scale (MCS) = 42.1 (8.5)].We found that stress was positively associated with CES-D (r = 0.479, p < .001) and negatively associated with HRQoL (PCS: r = - 0.184, p= .006; MCS: r = - 0.375, p < .001) and hope scale (r= - 0.420, p < .001), but not for PSQI (r = 0.009, p = .902). CES-D was negatively associated with HRQoL (PCS: r = - 0.186, p=.005; MCS: r= - 0.550, p < .001). However, hope was negatively associated with stress (PSS: r = -0.420, p < .001) and CES-D (r = -0.483, p < .001), and positively associated with HRQoL (PCS: r = 0.209, p=.002; MCS: r = 0.376, p < .001), but not for PSQI (r = -0.047, p=.532).Controlling for hope, the association between stress and CES-D was reduced (r = 0.346, p < .001), as well as MCS (r = -0.257, p < .001), but not for PCS (r = -0.108, p=.108). The correlation coefficient was also reduced between CES-D and MCS (r = 0.451, p < .001), but not for PCS (r = -0.096, p=.155). CONCLUSION: This study showed that hope had mediating effects on associations between stress and depressive symptoms and HRQoL. It implied that hope had stress buffering effects on the adjustment of depressive symptoms and HRQoL.