Volume 14, Issue 4 (volume 14, number 4 2022)                   IJDO 2022, 14(4): 189-201 | Back to browse issues page

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Majidzadeh R, Rezaei S, Akbari B. Self-Compassion Reduces the Destructive Effects of Perceived Stress on Psychological Well-Being and Self-Care Behaviors: Results from Type II Diabetes Mellitus Patients. IJDO 2022; 14 (4) :189-201
URL: http://ijdo.ssu.ac.ir/article-1-744-en.html
Assistant Professor of Psychology, Department of Psychology, Faculty of Literature and Humanities, University of Guilan, Rasht, Iran.
Abstract:   (258 Views)
Objective: This study investigated the mediating role of self-compassion in the relationship of perceived stress with physiological well-being and self-care behaviors among patients suffering from type II diabetes mellitus (T2DM).
Materials and Methods: In this descriptive, cross-sectional study, 369 patients with T2DM were selected through purposive and consecutive sampling from the cities of Rasht and Rezvanshahr (Northern Iran) in 2020-21. The participants completed the perceived stress scale (PSS-4), summary of diabetes self-care activities (SDSCA) questionnaire, Ryff's scale of psychological well-being (RSPWB), and self-compassion scale (SCS-SF). The data were processed through structural equation modeling (SEM) in AMOS-24. Bootstrapping was carried out in MACRO to analyze the mediating relationships.
Results: The perceived stress had a negative and significant correlation with self-compassion (r= -0.456), psychological well-being (r= -0.699), and self-care behaviors (r= -0.671) (For all cases P< 0.01). In addition, self-compassion had a positive and significant relationship with psychological well-being (r= 0.760) and self-care behaviors (r= 0.657) (P< 0.01). The modified structural model had the desired fitting with the collected data (CFI= 0.955, RMSEA= 0.079, χ2/df= 2.842). Following the bootstrapping analysis, self-compassion significantly mediates the relationship between perceived stress, psychological well-being (P< 0.0001), and self-care behaviors (P< 0.0001).
Conclusion: Self-compassion can serve as a shield against and reduce the destructive effects of stress on the psychological well-being and self-care behaviors of diabetic patients. The beneficial effects of self-compassion can be used in diabetic psychotherapy protocols to improve psychological well-being and self-care behaviors.
Full-Text [PDF 701 kb]   (108 Downloads)    
Type of Study: Research | Subject: Special
Received: 2022/03/7 | Accepted: 2022/04/14 | Published: 2022/11/19

1. Yuen L, Saeedi P, Riaz M, Karuranga S, Divakar H, Levitt N, et al. Projections of the prevalence of hyperglycaemia in pregnancy in 2019 and beyond: Results from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice. 2019;157:107841. [DOI:10.1016/j.diabres.2019.107841]
2. Samadzadeh A, Salehi M, Banijamali S, Ahadi H. The comparison of the effectiveness of cognitive behavioral therapy with mindfulness training on psychological self-care behavior in patients with type 2 diabetes. Journal of psychologicalscience. 2019;18(73):45-54.(in Persian)
3. Abrahamian H, Kautzky-Willer A, Rießland-Seifert A, Fasching P, Ebenbichler C, et al. Psychische Erkrankungen und Diabetes mellitus (Update 2019). Wiener klinische Wochenschrift. 2019;131(1):186-95. [DOI:10.1007/s00508-019-1458-9]
4. Nefs G, Speight J, Pouwer F, Pop V, Bot M, Denollet J. Type D personality, suboptimal health behaviors and emotional distress in adults with diabetes: Results from Diabetes MILES-The Netherlands. Diabetes research and clinical practice. 2015;108(1):94-105. [DOI:10.1016/j.diabres.2015.01.015]
5. Mahmoud Alilou M, Asbaghi M, Narimani M, Agamohammadzadeh N. Relationship between personality characteristics with self-care behavior and consequences of treatment in patients with Diabetes. Iranian Journal of Psychiatric Nursing. 2014;2(3):77-85.(in Persian)
6. Massey CN, Feig EH, Duque-Serrano L, Wexler D, Moskowitz JT, Huffman JC. Well-being interventions for individuals with diabetes: A systematic review. Diabetes Research and Clinical Practice. 2019;147:118-33. [DOI:10.1016/j.diabres.2018.11.014]
7. Karimi Ali Abadi P, Ahmadi M, Khalilian A, Ganji J. Relationship between Social Capital, Psychological Well-Being, and Quality of Life in Patients with Diabetes Mellitus. Journal of Mazandaran University of Medical Sciences. 2020;30(184):154-60.(in Persian)
8. Ryff CD, Singer BH, Dienberg Love G. Positive health: connecting well-being with biology. Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences. 2004;359(1449):1383-94. [DOI:10.1098/rstb.2004.1521]
9. Speight J, Hendrieckx C, Pouwer F, Skinner TC, Snoek FJ. Back to the future: 25 years of 'Guidelines for encouraging psychological well-being'among people affected by diabetes. Diabet Med. 2020;37(8):1225-9. [DOI:10.1111/dme.14165]
10. Woodman J, Ballard K, Hewitt C, MacPherson H. Self-efficacy and self-care-related outcomes following Alexander Technique lessons for people with chronic neck pain in the ATLAS randomised, controlled trial. European Journal of Integrative Medicine. 2018;17:64-71. [DOI:10.1016/j.eujim.2017.11.006]
11. 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. [DOI:10.1016/j.jdiacomp.2011.11.002]
12. Alhariri A, Daud F, Almaiman A, Saghir S. Factors associated with adherence to diet and exercise among type 2 diabetes patients in Hodeidah city, Yemen. Life. 2017;7(3):264-71.
13. Marinho FS, Moram C, Rodrigues PC, Leite NC, Salles GF, Cardoso CR. Treatment adherence and its associated factors in patients with type 2 diabetes: results from the Rio de Janeiro type 2 diabetes cohort study. Journal of diabetes research. 2018;2018. [DOI:10.1155/2018/8970196]
14. Azarmy M, Abolfathi A, Ahmadi Jouybari T, Ataee M, Lotfi B, Aghaei A. Comparison of serum and urinary cortisol levels in women with gestational diabetes and healthy pregnant women. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2015;17(135):16-25.(in Persian)
15. Alonso-Morán E, Satylganova A, Orueta JF, Nuño-Solinis R. Prevalence of depression in adults with type 2 diabetes in the Basque Country: relationship with glycaemic control and health care costs. BMC Public Health. 2014 Dec;14(1):1-8. [DOI:10.1186/1471-2458-14-769]
16. Mansouri A, Shahdadi H, Arefi F, Shahaki Vahed A. Study of the relationship between perceived Stress and aggression in patients with type II diabetes referring to diabetes clinic of Zabol. Journal of Diabetes Nursing. 2016;4(2):40-7.(in Persian)
17. Rosenzweig S, Reibel DK, Greeson JM, Edman JS. Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: a pilot study. Alternative therapies in health and medicine. 2007;13(5):36.
18. Zamani-Alavijeh F, Araban M, Koohestani HR, Karimy M. The effectiveness of stress management training on blood glucose control in patients with type 2 diabetes. Diabetology & metabolic syndrome. 2018;10(1):1-9. [DOI:10.1186/s13098-018-0342-5]
19. Kumari M, Head J, Marmot M. Prospective study of social and other risk factors for incidence of type 2 diabetes in the Whitehall II study. Archives of internal medicine. 2004;164(17):1873-80. [DOI:10.1001/archinte.164.17.1873]
20. 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. [DOI:10.1016/j.diabres.2004.04.001]
21. Zareipour M, Jadgal KM, Zare F, Valizadeh R, Ghelichi Ghojogh M. The relationship between perceived stress and blood sugar levels in patients with type 2 diabetes. Rahavard Salamat J. 2017;2(4):1-3.
22. Emami SS, Firoozi M. Prediction of Self-Care Behaviors Based on Perceived Stress and Goal Setting Skill in Patients with Type 2 Diabetes. Iranian Journal of Endocrinology and Metabolism. 2020;21(6):337-44.(in Persian)
23. Trovato GM, Catalano D, Martines GF, Spadaro D, Di Corrado D, Crispi V, et al. Psychological stress measure in type 2 diabetes. European review for medical and pharmacological sciences. 2006;10(2):69.
24. Ruzibiza C, Grattan RE, Eder R, Linscott RJ. Components of schizophrenia liability are not uniformly associated with stress sensitivity, resilience, and coping. Psychiatry research. 2018;260:10-6. [DOI:10.1016/j.psychres.2017.11.039]
25. Smith GD, Yang F. Stress, resilience and psychological well-being in Chinese undergraduate nursing students. Nurse education today. 2017;49:90-5. [DOI:10.1016/j.nedt.2016.10.004]
26. Moatamedy A, Borjali A, Sadeqpur M. Prediction of psychological well-being of the elderly based on the power of stress management and social support. Iranian Journal of Ageing. 2018;13(1):98-109. [DOI:10.21859/sija.13.1.98]
27. Dilgony T, Dolatian M, Shams J, Zayeri F, Mahmoodi Z. Correlation of spirituality and psychological well-being with pregnancy-specific stress. Journal of Research on Religion & Health. 2016;2(4):35-43.(in Persian)
28. Strizhitskaya O, Petrash M, Savenysheva S, Murtazina I, Golovey L. Perceived stress and psychological well-being: the role of the emotional stability. In7th icCSBs 2018 The Annual International Conference on Cognitive-Social, and Behavioural Sciences.2018:155-2.
29. Heizomi H, Allahverdipour H, Hejazi SB, Jafarabadi MA, Shirazi A. Factors Associating Perceived Stress and Psychological Well-being among Iranian Female Adolescents. International Journal of Depression and Anxiety. 2018;1(003). [DOI:10.23937/ijda-2017/1710003]
30. Afshari A. Prediction of diabetic patients' treatment adherence by self-compassion, emotional regulation and spritual welbeing. Journal of Research in Behavioural Sciences. 2018;16(4):466-75.(in Persian) [DOI:10.52547/rbs.16.4.466]
31. Ferrari M, Dal Cin M, Steele M. Self‐compassion is associated with optimum self‐care behaviour, medical outcomes and psychological well‐being in a cross‐sectional sample of adults with diabetes. Diabetic Medicine. 2017;34(11):1546-53. [DOI:10.1111/dme.13451]
32. Neff KD, Pommier E. The relationship between self-compassion and other-focused concern among college undergraduates, community adults, and practicing meditators. Self and identity. 2013;12(2):160-76. [DOI:10.1080/15298868.2011.649546]
33. Neff KD, Kirkpatrick KL, Rude SS. Self-compassion and adaptive psychological functioning. Journal of research in personality. 2007 Feb 1;41(1):139-54. [DOI:10.1016/j.jrp.2006.03.004]
34. Imtiaz S. Rumination, optimism, and psychological well-being among the elderly: Self-compassion as a predictor. Journal of Behavioural Sciences. 2016;26(1):32.
35. Phillips WJ, Ferguson SJ. Self-compassion: A resource for positive aging. Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2013;68(4):529-39. [DOI:10.1093/geronb/gbs091]
36. Allen AB, Goldwasser ER, Leary MR. Self-compassion and well-being among older adults. Self and Identity. 2012;11(4):428-53. [DOI:10.1080/15298868.2011.595082]
37. Saeedi Z, Ghorbani N, Sarafraz Mr, Sharifian Mh. The Effect Of Inducing Self-Compassion And Self-Esteem On The Level Of The Experience Of Shame And Guilt. Contemporary Psychology. 2013; 8(1): 91-2.(in Persian)
38. Homan KJ. Self-compassion and psychological well-being in older adults. Journal of Adult Development. 2016;23(2):111-9. [DOI:10.1007/s10804-016-9227-8]
39. Terry ML, Leary MR. Self-compassion, self-regulation, and health. Self and identity. 2011;10(3):352-62. [DOI:10.1080/15298868.2011.558404]
40. Rahmani S, Mansoobifar M, Sirifi MR, Ashayeri H, Bermas H. Effectiveness of family empowerment therapy based on self-compassion on self-care and glycosylated hemoglobin in female patients with Type 2 diabetes mellitus: A randomized controlled clinical trial. Women's Health Bulletin. 2020;7(2):33-42.
41. Abdollahi A, Taheri A, Allen KA. Self‐compassion moderates the perceived stress and self‐care behaviors link in women with breast cancer. Psycho‐oncology. 2020;29(5):927-33. [DOI:10.1002/pon.5369]
42. Jay Miller J, Lee J, Niu C, Grise-Owens E, Bode M. Self-compassion as a predictor of self-care: A study of social work clinicians. Clinical Social Work Journal. 2019;47(4):321-31. [DOI:10.1007/s10615-019-00710-6]
43. Biber DD, Ellis R. The effect of self-compassion on the self-regulation of health behaviors: A systematic review. Journal of health psychology. 2019;24(14):2060-71. [DOI:10.1177/1359105317713361]
44. Allen AB, Leary MR. Self-compassionate responses to aging. The Gerontologist. 2014;54(2):190-200. [DOI:10.1093/geront/gns204]
45. Kline RB. Data preparation and psychometrics review. Principles and practice of structural equation modeling. 4th ed. New York, NY: Guilford. 2016.
46. Toobert DJ, Glasgow RE. Assessing diabetes self-management: the summary of diabetes self-care activities questionnaire. Handbook of psychology and diabetes: A guide to psychological measurement in diabetes research and practice. 1994;351:75.
47. Zareban I. Predictors of self-care behavior and its effective factors among women's with type 2 diabetes patients in Zahedan via Health Belief model. Journal of Health System Research. 2014;9(14):1797-05.(in Persian)
48. Cohen S, Williamson GM. Perceived stress in a probability sample of the United States. The social psychology of health: Sage; 1988.
49. Khanjani M, Shahidi S, Fathabadi J, Mazaheri MA, Shokri O. Factor structure and psychometric properties of the Ryff's scale of Psychological well-being, short form (18-item) among male and female students. Thoughts and Behavior in Clinical Psychology. 2014 ;9(32):27-36.(in Persian)
50. Ryff CD, Singer BH. Best news yet on the six-factor model of well-being. Social science research. 2006;35(4):1103-19. [DOI:10.1016/j.ssresearch.2006.01.002]
51. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the self‐compassion scale. Clinical psychology & psychotherapy. 2011;18(3):250-5. [DOI:10.1002/cpp.702]
52. Neff KD, Germer CK. A pilot study and randomized controlled trial of the mindful self‐compassion program. Journal of clinical psychology. 2013;69(1):28-44. [DOI:10.1002/jclp.21923]
53. Shahbazi M. Confirmatory factor analysis of the Persian version of the self-compassion rating scale-revised. Psychological methods and models. 2015;6(19):31-46.
54. Blunch NJ. Introduction to structural equation modeling using IBM SPSS statistics and EQS. Sage Publications. 2015:24-32. [DOI:10.4135/9781473922273]
55. Roche LA. Reply upon SET research. American Psychologist. 1999;54(7):517-8. [DOI:10.1037/0003-066X.54.7.517]
56. Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ. Evaluating the use of exploratory factor analysis in psychological research. Psychological methods. 1999;4(3):272. [DOI:10.1037/1082-989X.4.3.272]
57. Cohen J. Statistical power analysis. Current directions in psychological science. 1992;1(3):98-101. [DOI:10.1111/1467-8721.ep10768783]
58. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior research methods. 2008;40(3):879-91. [DOI:10.3758/BRM.40.3.879]

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