Mediating Role of Quality of Life between Perceived Stress and Sleep Quality among Patients with Rheumatoid Arthritis

Background: Arthritis is a chronic illness that affects millions of people worldwide. This study aimed to investigate the effects of perceived stress, life satisfaction, and sleep quality on people with arthritis. Its specific goal was to ascertain how this population's quality of life influences the relationship between perceived stress and sleep quality. Objective: To examine the mediating role of quality of life in the relationship between perceived stress and sleep quality among patients with rheumatoid arthritis (RA). Methods: A cross-sectional study design was employed, involving 200 RA patients aged 20 to 90 years from various hospitals in Faisalabad. Participants were recruited through support groups and outpatient programs. Data were collected using the Sleep Quality Scale (SQS), Perceived Stress Scale (PSS), and the WHO Quality of Life (WHOQOL) Questionnaire. The study adhered to ethical guidelines set forth in the Declaration of Helsinki. Statistical analyses, including descriptive statistics, Pearson correlation, independent samples t-tests, and mediation analysis using Sobel, Aroian, and Goodman tests, were conducted using SPSS version 25. Results: The mean sleep quality score was 40.52 (SD = 5.34), the mean perceived stress score was 22.36 (SD = 3.22), and the mean quality of life score was 85.45 (SD = 14.13). Significant gender differences were found in perceived stress (p = 0.026), with males reporting higher stress levels. Sleep quality negatively correlated with perceived stress (r = -0.38, p < 0.05) and positively correlated with quality of life (r = 0.82, p < 0.01). Perceived stress and quality of life were negatively correlated (r = -0.62, p < 0.05). Mediation analysis showed that quality of life significantly mediated the relationship between perceived stress and sleep quality (Sobel test statistic = 2.32, p = 0.021). Conclusion: Perceived stress and sleep quality were significantly associated among RA patients, with quality of life serving as a mediating factor. Higher perceived stress correlated with poorer sleep quality and lower quality of life. Addressing stress and improving quality of life could enhance sleep quality and overall well-being in RA patients. Further research, particularly longitudinal studies, is recommended to deepen understanding and develop targeted interventions.