Structural model of health-related quality of life in diabetic patients based on mental well-being and quality of sleep mediated by self-care behaviors

Document Type : Original Article

Authors

1 Department of Health Psychology, Khorramshahr- Persian Gulf International Branch, Islamic Azad University, Khorramshahr,Iran.

2 Assistant Professor, Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran.

10.30483/rijm.2021.254212.1059

Abstract

Background: Diabetes has long-term complications and therefore affects the health of the community in addition to the individual. Diabetes can have significant psychological effects on health and delay the recovery of the disease.
Objective: This study aimed to determine the causal model of health-related quality of life based on subjective well-being and sleep quality mediating by self-care behaviors in diabetic patients.
Methods: This correlational study was conducted using the path analysis statistical method. The statistical population included all middle-aged patients with diabetes who were referred to the endocrinologists of Bushehr province in 2019, among whom 195 people were selected by the available sampling method. Data obtained by SF-36 Health-Related Quality of Life Questionnaire, Diabetes self-care questionnaire, Pittsburgh Sleep Quality Questionnaire, and Mental Well-Being Scale. The data were analyzed using the path analysis method using SPSS.22 and Amos.22 software.
Results: The results showed that both the variables of sleep quality and mental well-being through self-care had a direct and significant relationship with quality of life (p <0.001). The direct relationship between sleep quality and quality of life was not significant. But there was a significant direct relationship between mental well-being and quality of life (p <0.001).
Conclusion: It can be concluded that sleep quality and mental well-being affect the self-care that the patient chooses, they can predict the quality of life of diabetic patients.

Keywords


1-            Amirehsani KA, Hu J, Wallace DC, Silva ZA, Dick S. Hispanic families’ action plans for a healthier lifestyle for diabetes management. The Diabetes Educator. 2019 Feb;45(1):87-95. https://doi.org/10.1177/0145721718812478
2-            Mallick N, Maharana SP, Garg S, Sembiah S, Banerjee R. Self-care practices among diabetes patients attending a health center in a slum of Kolkata: a qualitative study. Medical Journal of Dr. DY Patil Vidyapeeth. 2018 Nov 1;11(6):506. https://doi.org/10.4103/mjdrdypu.mjdrdypu_16_18
3-            American Diabetes Association. 5. Lifestyle management: standards of medical care in diabetes—2019. Diabetes Care. 2019 Jan 1;42(Supplement 1):S46-60. https://doi.org/10.2337/dc19-S005
4-            Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. Journal of diabetes & Metabolic disorders. 2013 Dec 1;12(1):14. https://doi.org/10.1186/2251-6581-12-14
5-            World Health Organization. Global tuberculosis report 2013. World Health Organization; 2013.
6-            Fisher KL. Assessing psychosocial variables. The Diabetes Educator. 2006 Jan;32(1):51-8. https://doi.org/10.1177/0145721705285113
7-            Owens-Gary MD, Zhang X, Jawanda S, Bullard KM, Allweiss P, Smith BD. The importance of addressing depression and diabetes distress in adults with type 2 diabetes. Journal of general internal medicine. 2019 Feb 15;34(2):320-4. https://doi.org/10.1007/s11606-018-4705-2
8-            Brown SA, García AA, Brown A, Becker BJ, Conn VS, Ramírez G, Winter MA, Sumlin LL, Garcia TJ, Cuevas HE. Biobehavioral determinants of glycemic control in type 2 diabetes: a systematic review and meta-analysis. Patient education and counseling. 2016 Oct 1;99(10):1558-67. https://doi.org/10.1016/j.pec.2016.03.020
9-            Aikens JE. Prospective associations between emotional distress and poor outcomes in type 2 diabetes. Diabetes care. 2012 Dec 1;35(12):2472-8. https://doi.org/10.2337/dc12-0181
10-        Williams, M., & Penman, D. (2011). Mindfulness: a practical guide to finding peace in a frantic world. Hachette UK.
11-        Hollis-Walker L, Colosimo K. Mindfulness, self-compassion, and happiness in non-meditators: A theoretical and empirical examination. Personality and Individual differences. 2011 Jan 1;50(2):222-7. https://doi.org/10.1016/j.paid.2010.09.033
12-        Kristeller, J. L., Baer, R. A., & Quillian-Wolever, R. (2006). Mindfulness-based approaches to eating disorders. Mindfulness-based treatment approaches: Clinician’s guide to evidence base and applications75. https://doi.org/10.1016/B978-012088519-0/50005-8
13-        Bogusch LM, O'Brien WH. The effects of Mindfulness-based interventions on diabetes-related distress, quality of life, and metabolic control among persons with diabetes: A meta-analytic review. Behavioral Medicine. 2019 Jan 2;45(1):19-29. https://doi.org/10.1080/08964289.2018.1432549
14-        Roberts KK, Cochet AE, Lamb PB, Brown PJ, Battafarano DF, Brunt EM, Harrison SA. The prevalence of NAFLD and NASH among patients with psoriasis in a tertiary care dermatology and rheumatology clinic. Alimentary pharmacology & therapeutics. 2015 Feb;41(3):293-300. https://doi.org/10.1111/apt.13042
15-        Akbarnejad KH, Tol A, Majlessi F, Yaseri M, Alizadeh H. Predictors of health-oriented lifestyle among health workers of Amol City. Hospital. 2016;15(4):103-14.
16-        Hamadzadeh S, Ezatti ZH, Abedsaeidi ZH, Nasiri N. Coping styles and self-care behaviors among diabetic patients. Iran Journal of Nursing. 2013 Feb;25(80):24-33.
17-        Aflakseir A. Predicting self-care behaviors based on patient-doctor relationship and emotional distress in adolescents with diabetes. Iranian Journal of Diabetes and Metabolism. 2018 Mar 15;17(3):147-56.
18-        Beck AT, Steer RA, Brown GK. Beck depression inventory-II. San Antonio. 1996;78(2):490-8. https://doi.org/10.1037/t00742-000
19-        Rafiei, M. Seifi, A. An Investigation into the Reliability and Validity of Beck Anxiety Inventory among the University Students. Thoughts and Behavior in Clinical Psychology, 2013; 8(27): 37-46.
20-        Khodabakhsh Pirkalani, R., Rahim Jamarouni, H. Effectiveness of Mixed Cognitive-behaviorial Therapy and Mindfulness Based stressreduction in Treating a Case of Generalized Anxiety Disorder. Clinical Psychology Studies, 2013; 4(13): 121-147.
21-        Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., ... & Williams, J. M. G. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment15(3), 329-342. https://doi.org/10.1177/1073191107313003
22-        Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. Journal of personality and social psychology. 2003 Apr;84(4):822. https://doi.org/10.1037/0022-3514.84.4.822
23-        Ahmadvand Z, Heidarinasab L, Shoeiri M. Explaining psychological well-being based on the components of mindfulness. Quarterly Journal of Health Psychology, 2013; 1(2): 60-69.
24-        Mohammadi Zeidi I, Pakpour Hajiagha A, Mohammadi Zeidi B. Reliability and validity of Persian version of the health-promoting lifestyle profile. Journal of Mazandaran University of Medical Sciences. 2012 Mar 15;21(1):102-13.
25-        Lin EH, Katon W, Von Korff M, Rutter C, Simon GE, Oliver M, Ciechanowski P, Ludman EJ, Bush T, Young B. Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes care. 2004 Sep 1;27(9):2154-60. https://doi.org/10.2337/diacare.27.9.2154
26-        Haji-Arabi E, Nobahar M, Ghorbani R. Relationship between depression and knowledge about diabetes with the amount of self-care in patients with type 2 diabetes. Koomesh. 2018 Mar 14:210-20.
27-        Schinckus L, Dangoisse F, Van den Broucke S, Mikolajczak M. When knowing is not enough: Emotional distress and depression reduce the positive effects of health literacy on diabetes self-management. Patient education and counseling. 2018 Feb 1;101(2):324-30. https://doi.org/10.1016/j.pec.2017.08.006
28-        Zare H, Zare M, Amirabadi F, Shahriari H. Mindfulness and diabetes: evaluation of effectiveness of Mindfulness Based Stress Reductionon glycemic control in diabetes. Razi Journal of Medical Sciences. 2013 Jun 15;20(108):40-52.
29-        Kabat-Zinn J. Bringing mindfulness to medicine: an interview with Jon Kabat-Zinn, PhD. Interview by Karolyn Gazella. Advances in mind-body medicine. 2005;21(2):22.
30-        Emanuel AS, Updegraff JA, Kalmbach DA, Ciesla JA. The role of mindfulness facets in affective forecasting. Personality and Individual Differences. 2010 Nov 1;49(7):815-8. https://doi.org/10.1016/j.paid.2010.06.012