Mediating effect of anxiety and depression between family function and hope in patients receiving maintenance hemodialysis: A cross-sectional study

Abstract Objectives: The aim of this study was to explore the mediating effect of anxiety and depression on family function and hope in patients on maintenance hemodialysis (MHD), and to increase the knowledge about hope.Methods: The family APGAR index, hospital anxiety and depression scale, and Herth hope index were recorded using the self-reported questionnaires completed by 227 MHD patients.Results: The family function can directly predict hope, positively predict hope through depression (β = 0.052, p = 0.001), and positively predict hope through the chain mediating of anxiety and depression (β = 0.087, p = 0.001), according to chain mediation analysis. The total effect size was 28.31%. The total indirect effect value was 0.139, and the total effect value was 0.491.Conclusions: Our findings suggest that family function has a direct impact on MHD patients' hope, and that lowering anxiety and depression can help to feel more hopeful.