Illness perception and insomnia among patients with maintenance hemodialysis: a moderated mediation model of fear of progression and self-compassion.

This research examined the impact of illness perception, fear of progression, and self-compassion on insomnia among maintenance hemodialysis patients in China. A cross-sectional study was conducted in Chongqing from January 2025 to May 2025. The Brief Illness Perception Questionnaire, Athens Insomnia Scale, Fear of Progression Questionnaire-Short Form, and Self-Compassion Scale-Short Form were evaluated in 332 maintenance hemodialysis patients. This research found that 55.72% of the patients suffered from insomnia. Insomnia showed a positive relationship with illness perception (r = 0.629, p < 0.01) and fear of progression (r = 0.479, p < 0.01), but a negative relationship with self-compassion (r = -0.451, p < 0.01). The mediating role of fear of progression in the relationship between illness perception and insomnia accounted for 17.5% of the total impact. Analysis of simple slopes revealed that illness perception was a significant predictor of fear of progression at both low (B = 0.477, t = 5.131, and p < 0.001) and high (B = 0.732, t = 8.187, and p < 0.001) self-compassion levels. Our study's findings contribute to the understanding of factors affecting insomnia among maintenance hemodialysis patients and offer a theoretical foundation and practical advice for improving their sleep quality.