To analyze the multiple mediating effects of hope and family function on anxiety and sleep quality in patients with maintenance hemodialysis (MHD).

This study was designed as a cross-sectional study, enrolling MHD patients who underwent regular treatment in our hospital from September 2023 to September 2024. A questionnaire survey was conducted to assess the patients′ hope, family functioning, anxiety, and sleep quality, and various statistical methods were employed for analysis.

A total of 127 MHD patients were included in the study. The assessment analysis revealed that the higher the anxiety level of the patients, the worse their hope level (r=-0.414, P<0.01), family functioning (r=-0.475, P<0.01), and sleep quality (as assessed by the Athens insomnia scale, r=0.477, P<0.01). The patients′ hope was positively correlated with their family functioning (r=0.467, P<0.01). As assessed by the Athens insomnia scale, the higher the patient′s hope level (r=-0.585, P<0.01) and family functioning (r=-0.652, P<0.01), the better their sleep quality. The mediation effect analysis indicated that the hope level and family functioning of the patients played a mediating role between their anxiety and sleep quality, with a total indirect effect value of 0.352 (95%CI: 0.144-0.549), accounting for 71.69% of the total effect. The mediating paths included: anxiety-hope-sleep quality (effect size 0.052), anxiety-family functioning-sleep quality (effect size 0.176), and anxiety-hope-family functioning-sleep quality (effect size 0.087).

The increased anxiety level in the patients with MHD was correlated with decreased sleep quality, and raising the patients′ hope level and family functioning may indirectly improve their sleep quality.