predicting pain perception based on psychological distress in patients with rheumatoid arthritis: the mediating role of sleep quality

Background and objective: patients with rheumatoid arthritis (ra) often suffer from chronic pain due to the nature of the disease, and in addition to the disease itself, this pain can be aggravated under the influence of psychological fac-tors. the study aimed to predict pain perception based on psychological distress and the mediating role of sleep quality in people with ra.materials and methods: this research was conducted by path analysis, including 202 patients with ra who were se-lected using the convenience sampling method. the study instruments included mcgill pain questionnaire (mpq), pittsburgh sleep quality index (psqi), and depression, anxiety, and stress scale (dass-21). descriptive statistics reported frequency, mean, standard deviation (sd), and pearson correlation. in analytical statistics, path analysis was used. data were analyzed using spss and amos software.results: psychological distress (anxiety, stress, and depression) had a direct, statistically significant effect on sleep quality. sleep quality had a direct effect on pain perception. on the other hand, anxiety, stress, and depression, with the mediating role on sleep quality, had a significant influence on pain perception by 0.11, 0.12, and 0.09, respectively. descriptive statistics showed that a significant correlation existed among independent, mediation, and criteria variables. the proposed predictive model had a good fit.conclusion: along with medical treatments, we need to pay attention to the role of psychological factors such as psychological distress, depression, and sleep quality in patients with ra.