The associations between stress perception, psychological flexibility, and sleep quality among people with type 2 diabetes mellitus: A cross-sectional survey.

BACKGROUND

Type 2 diabetes mellitus is a chronic condition associated with genetic, behavioral, and environmental factors, leading to hyperglycemia and complications, including psychological stress and poor sleep quality. The role of psychological flexibility in regulating stress and improving sleep in T2DM patients is under-researched.

OBJECTIVE

To explore the relationships between stress perception, psychological flexibility, and sleep quality in T2DM patients and the mediating role of psychological flexibility.

METHODS

A cross-sectional study of 300 T2DM patients from two hospitals in Liaoning Province used questionnaires for general information, stress perception (CPSS), sleep quality (PSQI), and psychological flexibility (AADQ). Data were analyzed with SPSS 27.0and AMOS 28.0 software, employing descriptive analysis, correlation analysis, and structural equation modeling.

RESULTS

Pearson's correlation showed significant positive relationships between stressperception and psychological flexibility (r = 0.209, p < 0.01), stress perception and sleep quality (r = 0.279, p < 0.01), and psychological flexibility and sleep quality (r = 0.63, p < 0.01). Structural equation modeling path analysis revealed stress perception significantly influenced psychological flexibility (B = 0.054, P < 0.001) and sleep quality (B = 0.020, P < 0.001), with a mediation effect of 0.016.

CONCLUSION

There is a significant association between stress perception, psychological flexibility, and sleep quality in T2DM patients, with psychological flexibility mediating the relationship between stress perception and sleep quality. Physicians should consider strategies to enhance psychological flexibility, such as ACT, to improve sleep quality.