Latent Profiles of Perceived Social Support and Illness-Related Coping in Hospitalized Patients With Coexisting Hypertension and Diabetes: A Multicenter Cross-Sectional Study
This multicenter cross-sectional study of 514 hospitalized patients with coexisting hypertension and diabetes identified five distinct latent profiles primarily differentiated by the level and sources of perceived social support, revealing that while sleep quality varied non-monotonically across these groups, neither depressive nor anxiety symptoms, nor any measured demographic or clinical characteristics, significantly distinguished profile membership.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
When a person is hospitalized with two serious chronic conditions at once, such as high blood pressure and diabetes, the medical team focuses heavily on the numbers: blood pressure readings, blood sugar levels, and how well the organs are functioning. Yet, the experience of illness is not just a collection of biological data points. It is also a psychological and social journey. Patients must navigate the stress of being in a hospital, manage complex daily routines, and rely on others for help. Researchers have long understood that the way a person feels about the support they receive from family, friends, and partners can shape how they handle their illness. This support acts as a resource, much like a tool in a toolbox, that helps a person cope with the demands of being sick. At the same time, the quality of a patient's sleep and their emotional state are deeply intertwined with how they manage these demands. Understanding how these pieces fit together is crucial because it helps doctors and nurses see the whole person, not just the disease.
A team of researchers in China recently set out to look at this complex picture in a new way. Instead of asking how social support and coping strategies affect patients on average, they wanted to see if there were distinct groups of people who experienced these things in unique combinations. They studied 514 patients who were currently in the hospital for both hypertension and diabetes. These patients came from twenty-four different departments across four hospitals in Hubei Province. The researchers asked each patient to fill out a series of questionnaires about how much support they felt they had from family, friends, and significant others, and how they typically reacted to the stress of their illness. They also asked about their mood, their anxiety levels, and how well they had been sleeping. By looking at all these answers together, the researchers used a statistical method to sort the patients into groups, or profiles, based on their shared patterns of experience.
The analysis revealed five distinct groups of patients. The largest group, making up nearly 43 percent of the patients, consisted of people who felt they had low levels of support from all sources. Another large group, about 30 percent, felt they had moderate to high support from everyone. A smaller group, roughly 15 percent, reported very high support across the board. There was also a small group of about 8 percent who felt they received strong support primarily from their family, but less from friends or partners. Finally, a very small group of just 19 patients, less than 4 percent of the total, reported feeling a profound lack of support from everyone around them. The most striking finding was that these groups were defined almost entirely by how much support they felt and where it came from. The way these patients coped with their illness—whether they faced it head-on, tried to avoid it, or accepted it—did not vary enough to create separate groups. In other words, the landscape of their social world was far more diverse than the landscape of their coping strategies.
When the researchers compared these groups to see how they were doing emotionally and physically, the results were surprising. They found no consistent difference in depression or anxiety symptoms between the groups. A patient who felt very supported was not necessarily less depressed or anxious than a patient who felt unsupported. However, sleep quality told a different story. The groups did differ in how well they slept, but the pattern was not a simple straight line where more support always meant better sleep. The group with low support generally slept worse than the group with high support, which aligns with what many might expect. Yet, the tiny group with very low support actually reported better sleep than the low-support group and the moderate-to-high support group. The researchers noted that because this very low-support group was so small, this specific finding should be viewed with caution. It is possible that other factors, such as the specific nature of their hospital stay or unmeasured health issues, influenced this result. The key takeaway is that the relationship between feeling supported and sleeping well is complex and does not follow a predictable, step-by-step gradient.
Perhaps the most practical finding for healthcare providers is that you cannot guess a patient's support needs just by looking at their age, their gender, how sick they appear, or even by checking if they have a family member staying with them. The study found that none of these common demographic or clinical characteristics reliably predicted which group a patient belonged to. A patient with a family caregiver might still feel they lack adequate emotional or practical support, while a patient without a designated caregiver might feel well-supported by friends or staff. This suggests that relying on routine checklists or assumptions about who needs help is not enough. Instead, the researchers argue that nurses and doctors need to ask directly. They need to listen to patients about who they feel supported by, how adequate that support feels, and whether it matches their needs. By understanding these specific, personal configurations of support, medical teams can better tailor their care to help patients manage their sleep, their stress, and their recovery, rather than making assumptions based on the patient's chart.
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