智能手机成瘾、负面情绪和心理韧性在医学生社会支持与睡眠质量关系中的中介作用

摘要(中文译文)

睡眠质量差及其严重后果已成为紧迫的公共卫生问题，但医学生群体中缺乏相关证据。本研究旨在考察医学生睡眠质量、社会支持、心理韧性、手机成瘾和负性情绪之间的多重关联，为制定针对性干预措施提供依据。采用横断面研究设计，纳入716名医学生，使用自评问卷评估人口学特征、领悟社会支持量表、康纳-戴维森韧性量表-10、手机成瘾指数、抑郁-焦虑-压力量表-21和匹兹堡睡眠质量指数。采用Pearson相关分析和结构方程模型（SEM）检验社会支持、手机成瘾、负性情绪、心理韧性与睡眠质量之间的关联。相关分析显示，社会支持（r=-0.386，P<0.01）和心理韧性（r=-0.383，P<0.01）与睡眠质量差呈负相关，手机成瘾（r=0.447，P<0.01）和负性情绪（r=0.551，P<0.01）与睡眠质量差呈正相关。SEM结果表明，社会支持对睡眠质量产生直接正向效应，同时通过手机成瘾和负性情绪对睡眠质量产生间接效应，二者分别作为独立中介和链式中介发挥作用。相比之下，心理韧性对睡眠质量无直接影响，但通过手机成瘾和负性情绪相同的双重中介路径对睡眠质量产生间接效应。本研究通过SEM分析阐明了社会支持和心理韧性影响睡眠质量的不同路径。这些发现补充了睡眠质量影响因素的理论框架，突出了手机成瘾和负性情绪的核心中介作用，并为制定改善个体睡眠健康的干预措施提供了针对性见解。

Abstract

Poor sleep quality and its serious consequences have become an urgent public health issue, but there is a lack of evidence in medical students. This study aimed to examine the multiple associations between sleep quality, social support, psychological resilience, smartphone addiction, and negative emotions among medical students, in order to provide a basis for targeted intervention measures. A cross-sectional study involving 716 medical students was conducted using a self-report questionnaire that assessed demographic characteristics, Perceived Social Support Scale, Connor-Davidson Resilience Scale-10, Mobile Phone Addiction Index, Depression Anxiety Stress Scales-21, and Pittsburgh Sleep Quality Index. Pearson correlation analysis and structural equation modeling (SEM) were performed to examine the association between social support, smartphone addiction, negative emotion, psychological resilience and sleep quality. Correlation analysis showed that social support (r=-0.386, < 0.01) and psychological resilience (r=-0.383, < 0.01) were negatively correlated with poor sleep quality, and smartphone addiction (r=0.447, < 0.01) and negative emotion (r=0.551, < 0.01) were positively correlated with poor sleep quality. The SEM results indicated that social support exerts a direct positive effect on sleep quality and also an indirect effect on sleep quality via smartphone addiction and negative emotion, which serve as both separate and chain mediators. In contrast, psychological resilience has no direct impact on sleep quality, but it exerts an indirect effect on sleep quality through the same dual mediating pathways of smartphone addiction and negative emotion. This study clarifies the differential pathways through which social support and psychological resilience influence sleep quality via SEM analysis. These findings supplement the theoretical framework of sleep quality influencing factors, highlight the core mediating role of smartphone addiction and negative emotion, and provide targeted insights for formulating interventions to improve individuals' sleep health.

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