PURPOSE This study aimed to examine the relationship between illness perception, stress, and sleep, focusing on the influence of illness perception on the quality of sleep through the mediating effect of stress in patients with metabolic syndrome risk factors. METHODS A cross-sectional correlational study was conducted with 219 patients with two metabolic syndrome risk factors. Participants were recruited from outpatient clinics in Daegu and Gyeongbuk between June and July 2016. Data were collected using a self-administered structured questionnaire that included items from the Brief Illness Perception Scale, the Perceived Stress Inventory, and the Pittsburgh Sleep Quality Index. Pearson's correlation coefficient, independent t-test, one-way ANOVA, multiple linear regression analysis, and a SPSS macro bootstrap approach were performed. RESULTS There were significant correlations between illness perception and sleep (r=.42, p<.001) and between stress and sleep (r=.49, p<.001). Illness perception was a significant predictor of stress (t=7.99, p<.001) and sleep (t=5.83, p<.001) after adjusting for the influence of age, gender, job status, and body mass index. A mediating effect of stress on the relationship between illness perception and sleep was demonstrated by Baron and Kenny's approach (Z=4.57, p<.001) and the PROCESS macro for SPSS (95% confidence interval=0.04~0.13). CONCLUSION This study suggests that the negative impact of illness perception on sleep can be reduced by regulating stress. Further, it is necessary to develop intervention programs that can reduce stress linked to the illness perception among patients with metabolic syndrome risk factors.
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