The Impact of Psychological Resilience on Chronic Patients’ Depression During the dynamic Zero-COVID policy: The Mediating Effect of Stigma and the Moderating Role of Sleep

Abstract

Abstract Objective Chronic patients are experiencing depression caused by themselves or the surrounding environment, how to cope with the change of mentality and adjust the psychological stress response, especially under the background of the current dynamic Zero-COVID policy in China, is a problem worth further discussion. The researchers constructed a mediating regulation model to test the influence of psychological resilience on depression of chronic patients during dynamic Zero-COVID, as well as the mediating role of stigma and the regulating role of and the moderating role sleep. Method From October 2021 to February 2022, a multi-stage stratified sampling method was used to collect data in Shangcheng District of Hangzhou City, Zhejiang Province. We used the random number table method. Firstly, a third-class hospital was randomly selected from Shangcheng District. Secondly, departments were randomly selected from the hospital. Thirdly, survey points were set up in each department, and chronic patients were randomly selected from each survey point. In addition, chronic medical illness burden was assessed using the Cumulative Illness Rating Scale-Geriatrics (CIRS-G), psychological resilience was measured by the Conner-Davidson Resilience Scale (CD-RISC), stigma was measured by the Stigma Scale for Chronic Illness (SSCI), sleep was measured by the Pittsburgh Sleep Quality Index(PSQI) and depressive symptoms were estimated by the Patient Health Questionaire-9(PHQ-9). SPSS (version 21) and PROCESS (version 4.0) were used for correlation analysis, mediation analysis, and mediated moderation analysis. Results Psychological resilience was negatively correlated with depression, stigma and sleep. Depression was positively correlated with stigma and sleep. Stigma and sleep were positively correlated; Stigma played a mediating role in the relationship between psychological resilience and depression; Sleep moderated the first half of the pathway " psychological resilience → stigma → depression" . Conclusion Psychological resilience affected depression directly and also indirectly through stigma. At the same time, sleep played a moderating role between psychological resilience and depression. The correlation between psychological resilience and stigma was stronger when levels of sleep levels were higher.