مدل‌یابی ساختاری راهبردهای مقابله‌ای و خودمراقبتی در بیماران مبتلا به دیابت نوع 2: بررسی نقش واسطه‌ای خودکارآمدی و سخت رویی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکترا، گروه روانشناسی، واحد امارات، دانشگاه آزاد اسلامی، دبی، امارات متحده عربی.

2 استادیار گروه روانشناسی، واحد کرج، دانشگاه آزاد اسلامی،کرج، ایران.

3 استاد گروه روانشناسی، دانشگاه علامه طباطبائی، تهران، ایران.

4 استادیار گروه روانشناسی، واحد تهران جنوب، دانشگاه آزاد اسلامی، تهران، ایران.

چکیده

زمینه و هدف: هدف پژوهش حاضر نیز مدل‌یابی ساختاری راهبردهای مقابله-ای و خودمراقبتی در بیماران مبتلا به دیابت نوع 2؛ بر اساس نقش واسطه‌ای خودکارآمدی و سخت رویی بود.
مواد و روش‌ها: تحقیق حاضر به لحاظ روش توصیفی از نوع همبستگی و از منظر هدف بنیادی بود. جامعۀ آماری این پژوهش شامل کلیۀ بیماران مبتلا به دیابت نوع 2 مراکز درمانی شبکه بهداشت و درمان خمینی شهر اصفهان بود که به صورت تصادفی تعداد 400 نفر (پنج برابر تعداد مجموع سوالات پرسشنامه‌ها) به عنوان نمونه انتخاب و وارد پژوهش شدند. برای جمع‌آوری داده‌ها از پرسشنامه‌های خودمراقبتی نیکنامی و همکاران (1392)، سخت‌ رویی کوباسا (1976)، خودکارآمدی شرر، راهبردهای مقابله‌ای لازاروس و و فولکمن استفاده شد. تجزیه و تحلیل داده‌ها با استفاده از معادلات ساختاری و از طریق نرم افزار لیزرل انجام شد.
یافته‌ها: نتایج تجزیه و تحلیل داده‌ها نشان داد که نسبت مربع کای به درجه آزادی (X2/df)، شاخص نیکویی برازش (GFI)، شاخص برازش هنجارشده (NFI)، شاخص برازش تطبیقی (CFI)، شاخص برازش اضافی (IFI)، شاخص برازش نسبی (RFI)، شاخص توکر-لوئیس (TLI) و ریشه مجذور مانده‌ها (RMR) معنادار و مطلوب هستند و مدل برازش مناسبی دارد.
نتیجه‌گیری: یافته‌های به دست آمده نشان می‌دهد که در رابطه بین راهبردهای مقابله‌ای با خودمراقبتی بیماران دیابتی نوع 2، سخت رویی و خودکارامدی نقش میانجیگرایانه ایفا می‌کنند. از این‌رو، برای افزایش خودمراقبتی بیماران دیابتی، می‌توان به تقویت سخت رویی و خودکارآمدی آنان اقدام کرد. همچنین با آموزش راهبردهای مقابله‌ای مثبت می‌توان به تقویت خودکارآمدی و سخت رویی دست زد و این منجر به افزایش خودمراقبتی می‌گردد.

کلیدواژه‌ها

عنوان مقاله [English]

Structural Modeling of Coping and Self-Care Strategies in Patients with Type 2 Diabetes: A Mediating Role of Self-Efficacy and Hardiness

نویسندگان [English]

  • soroor arshi 1
  • Maryam Kalhornia Golkar 2
  • hasan ahadi 3
  • Mastooreh Sedaghat 4
1 Ph.D. student, Department of Psychology, UAE Branch, Islamic Azad University, Dubai, UAE.
2 Assistant Professor, Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran.
3 Professor, Department of Psychology, Allameh Tabataba'i University, Tehran, Iran
4 Department of Psychology, South Tehran Branch, Islamic Azad University, Tehran, Iran.
چکیده [English]

Background and Aim: The aim of the present study was to structurally model coping strategies and self-care in patients with type 2 diabetes; It was based on the mediating role of self-efficacy and rigidity.
Materials and Methods: The present study was a correlational descriptive method and a fundamental goal. The statistical population of this study included all patients with type 2 diabetes in Khomeini Khomeini Health Network in Isfahan. 200 people (five times the total number of questionnaire questions) were randomly selected as the sample and entered the study. For data collection, Niknam et al.'s (2013) self-care questionnaire, Kubasa (1976) hardiness, Scherer self-efficacy, Lazarus and Volkman and coping strategies were used. Data analysis was performed using structural equations and LISREL software.
Findings: The results of data analysis showed that the ratio of chi-square to degree of freedom (X2 / df), good fit index (GFI), normalized fit index (NFI), adaptive fit index (CFI), excess fit index (IFI), relative fit index (RFI), Tucker-Lewis index (TLI) and square root of residues (RMR) are significant and desirable and have a good fit model.
Conclusion: The findings show that rigidity and self-efficacy play a mediating role in the relationship between coping strategies and self-care of type 2 diabetic patients. Therefore, to increase the self-care of diabetic patients, it is possible to strengthen their assertiveness and self-efficacy. Also, by teaching positive coping strategies, self-efficacy and perseverance can be strengthened, and this leads to increased self-care.

کلیدواژه‌ها [English]

  • coping strategies
  • self-care
  • self-efficacy
  • hardiness
  • and patients with type 2 diabetes

مراجع

  1. Thiel DM, Al Sayah F, Vallance JK, Johnson ST, Johnson JA. Association between physical activity and health-related quality of life in adults with type 2 diabetes. Canadian journal of diabetes. 2017;41(1):58-63.
  2. Dabelea D, Mayer-Davis EJ, Saydah S, Imperatore G, Linder B, Divers J, et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. Jama. 2014;311(17):1778-86.
  3. Katon WJ, Rutter C, Simon G, Lin EH, Ludman E, Ciechanowski P, et al. The association of comorbid depression with mortality in patients with type 2 diabetes. Diabetes care. 2005;28(11):2668-72.
  4. Cannon A, Handelsman Y, Heile M, Shannon M. Burden of illness in type 2 diabetes mellitus. Journal of managed care & specialty pharmacy. 2018;24(9-a Suppl):S5-S13.
  5. Das-Munshi J, Stewart R, Ismail K, Bebbington PE, Jenkins R, Prince MJ. Diabetes, common mental disorders, and disability: findings from the UK National Psychiatric Morbidity Survey. Psychosomatic medicine. 2007;69(6):543-50.
  6. Koopmanschap M. Coping with Type II diabetes: the patient’s perspective. Diabetologia. 2002;45(1):S21-S2.
  7. Clarke S, Foster J. A history of blood glucose meters and their role in self-monitoring of diabetes mellitus. British journal of biomedical science. 2012;69(2):83-93.
  8. Hernandez R, Ruggiero L, Prohaska TR, Chavez N, Boughton SW, Peacock N, et al. A cross-sectional study of depressive symptoms and diabetes self-care in African Americans and Hispanics/Latinos with diabetes: the role of self-efficacy. The Diabetes Educator. 2016;42(4):452-61.
  9. Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. Journal of diabetes & Metabolic disorders. 2013;12(1):1-5.
  10. Felix HC, Narcisse M-R, Long CR, English E, Haggard-Duff L, Purvis RS, et al. The effect of family diabetes self-management education on self-care behaviors of Marshallese adults with type 2 diabetes. American journal of health behavior. 2019;43(3):490-7.
  11. Shams S-A, Moradi Y, Zaker MR. Effectiveness of self-care training on physical and mental health of patients with diabetic type 2. Avicenna Journal of Nursing and Midwifery Care. 2017;25(2):54-60.
  12. Borji M, Otaghi M, Kazembeigi S. The impact of Orem’s self-care model on the quality of life in patients with type II diabetes. Biomedical and Pharmacology Journal. 2017;10(1):213-20.
  13. D'Souza MS, Karkada SN, Parahoo K, Venkatesaperumal R, Achora S, Cayaban ARR. Self-efficacy and self-care behaviours among adults with type 2 diabetes. Applied Nursing Research. 2017;36:25-32.
  14. He X, Li J, Wang B, Yao Q, Li L, Song R, et al. Diabetes self-management education reduces risk of all-cause mortality in type 2 diabetes patients: a systematic review and meta-analysis. Endocrine. 2017;55(3):712-31.
  15. Chai S, Yao B, Xu L, Wang D, Sun J, Yuan N, et al. The effect of diabetes self-management education on psychological status and blood glucose in newly diagnosed patients with diabetes type 2. Patient education and counseling. 2018;101(8):1427-32.
  16. Cortez DN, Macedo MML, Souza DAS, Dos Santos JC, Afonso GS, Reis IA, et al. Evaluating the effectiveness of an empowerment program for self-care in type 2 diabetes: a cluster randomized trial. BMC Public Health. 2017;17(1):1-10.
  17. Gæde P, Lund-Andersen H, Parving H-H, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. New England Journal of Medicine. 2008;358(6):580-91.
  18. Scott SB, Sliwinski MJ, Blanchard-Fields F. Age differences in emotional responses to daily stress: the role of timing, severity, and global perceived stress. Psychology and aging. 2013;28(4):1076.
  19. Klaiber P, Wen JH, DeLongis A, Sin NL. The ups and downs of daily life during COVID-19: Age differences in affect, stress, and positive events. The Journals of Gerontology: Series B. 2021;76(2):e30-e7.
  20. Krohne HW. Stress and coping theories. International Encyclopedia of the Social Behavioral Sceinces. 2002;22:15163-70.
  21. Wang Z, Chen J, Boyd JE, Zhang H, Jia X, Qiu J, et al. Psychometric properties of the Chinese version of the Perceived Stress Scale in policewomen. PloS one. 2011;6(12):e28610.
  22. Ghanbari A, Moaddab F, Salari A, Nezhad Leyli EK. Depression status and related factors in patients with heart failure. Iranian Heart Journal. 2015;16(3):22-7.
  23. Kh M, Hasavari F, Sedghi Sabet M, Kazemnejad-Leili E, Gholipour M. Self-care status and its related factors in patients with heart failure. Journal of Health and Care. 2018;19(4):232-41.
  24. Al-Khawaldeh OA, Al-Hassan MA, Froelicher ES. Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus. Journal of Diabetes and its Complications. 2012;26(1):10-6.
  25. Bohanny W, Wu SFV, Liu CY, Yeh SH, Tsay SL, Wang TJ. Health literacy, self‐efficacy, and self‐care behaviors in patients with type 2 diabetes mellitus. Journal of the American Association of Nurse Practitioners. 2013;25(9):495-502.
  26. Lin K, Park C, Li M, Wang X, Li X, Li W, et al. Effects of depression, diabetes distress, diabetes self-efficacy, and diabetes self-management on glycemic control among Chinese population with type 2 diabetes mellitus. Diabetes research and clinical practice. 2017;131:179-86.
  27. Kobasa SC, Maddi SR, Zola MA. Type A and hardiness. Journal of behavioral medicine. 1983;6(1):41-51.
  28. Maddi SR. Hardiness: Turning stressful circumstances into resilient growth: Springer science & Business media; 2012.
  29. da Silva RM, Goulart CT, Lopes LFD, Serrano PM, Costa ALS, de Azevedo Guido L. Hardy personality and burnout syndrome among nursing students in three Brazilian universities—an analytic study. BMC nursing. 2014;13(1):1-6.
  30. Toobert DJ, Glasgow RE. Assessing diabetes self-management: The Summary of Diabetes Self-Care Activities Questionnaire. In: Bradley C, editor. Handbook of psychology and diabetes: A guide to psychological measurement in diabetes research and practice. New York: Harwood Academic Publishers/Gordon.; 1994. p. 351-75.
  31. Riazi A, Pickup J, Bradley C. Daily stress and glycaemic control in Type 1 diabetes: individual differences in magnitude, direction, and timing of stress-reactivity. Diabetes Research and Clinical Practice. 2004;66(3):237-44.
  32. Hashemi SH, Ahadi H, Azad Yekta M. Relationship between psychological hardiness and self-efficacy in patients with type 2 diabetes:(The mediating role of self-esteem and social support) using structural equation modeling. European Online Journal of Natural and Social Sciences. 2017;6(2):pp. 273-87.
  33. Ghodrati Mirkohi M, Rahimian Boogar I. Predicting diabetes management self-efficacy base on hardiness and coping strategies in patients with type 2 diabetes mellitus. The Journal of Qazvin University of Medical Sciences. 2016;20(4):43-51.
  34. ElGerges NS. Effects of therapeutic education on self-efficacy, self-care activities and glycemic control of type 2 diabetic patients in a primary healthcare center in Lebanon. Journal of Diabetes & Metabolic Disorders. 2020:1-9.
  35. Shao Y, Liang L, Shi L, Wan C, Yu S. The effect of social support on glycemic control in patients with type 2 diabetes mellitus: the mediating roles of self-efficacy and adherence. Journal of diabetes research. 2017;2017.
  36. Lee Y-J, Shin S-J, Wang R-H, Lin K-D, Lee Y-L, Wang Y-H. Pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycemic control in patients with type 2 diabetes mellitus. Patient education and counseling. 2016;99(2):287-94.
  37. Gonzalez JS, Shreck E, Psaros C, Safren SA. Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control. Health psychology. 2015;34(5):505.
  38. Huang Y-M, Shiyanbola OO, Chan H-Y. A path model linking health literacy, medication self-efficacy, medication adherence, and glycemic control. Patient education and counseling. 2018;101(11):1906-13.
  39. Maddi SR. Hardiness: An operationalization of existential courage. Journal of humanistic psychology. 2004;44(3):279-98.
  40. O’Donell M. Cognition matters in cardiovascular disease and heart failure. European heart journal. 2012;33:1721-3.
  41. Chen PY, Chang H-C. The coping process of patients with cancer. European Journal of Oncology Nursing. 2012;16(1):10-6.
  42. Li CC, Chang SR, Shun SC. The self‐care coping process in patients with chronic heart failure: A qualitative study. Journal of clinical nursing. 2019;28(3-4):509-19.
  43. Li C-C, Shun S-C. Understanding self care coping styles in patients with chronic heart failure: A systematic review. European Journal of Cardiovascular Nursing. 2016;15(1):12-9.
مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 64، شماره 6 - شماره پیاپی 6
بهمن و اسفند 1400
صفحه 4349-4360

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