The impact of social support and social constraints on sleep disturbances in patients with lung cancer undergoing chemotherapy: Serial mediators of sleep cognition and anxiety-depression.

Objectives: This study aimed to investigate the serial mediating roles of dysfunctional beliefs about sleep and anxiety-depression symptoms in the relationship between social support, social constraints, and sleep disturbances. Methods: A total of 396 patients with lung cancer receiving chemotherapy were recruited. Core variables were assessed using the Social Support Rating Scale, Social Constraint Scale, Dysfunctional Beliefs and Attitudes about Sleep Scale, Hospital Anxiety and Depression Scale, and Patient-Reported Outcome Measurement Information System (PROMIS)-Breast-Chemotherapy-Sleep Disturbance Scale. Path analyses were conducted using AMOS 23.0 to examine the proposed mediation model. Results: Path analyses revealed that dysfunctional beliefs about sleep and anxiety-depression symptoms functioned as serial mediators in the association between social constraints and sleep disturbances. Specifically, the effects were mediated by dysfunctional sleep cognition ( Conclusions: This study elucidates the psychosocial pathways through which social support and social constraints affect sleep disturbances in patients with lung cancer. To alleviate sleep problems in this population, health care providers should focus on enhancing perceived social support and reducing social constraints. Simultaneously, interventions targeting dysfunctional sleep cognition (e.g., sleep hygiene education, cognitive behavioral therapy for insomnia) and addressing anxiety-depression symptoms are essential components of comprehensive care.