ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Azizi Karaj   M. (* )
Dehghani   F. (1 )
Kamali Zarch   M. (2)






(* ) Psychology Department, Yazd Branch, Islamic Azad University, Yazd, Iran
(1 ) Psychology & Counseling Department, Psychology & Educational Sciences Faculty, Yazd University, Yazd, Iran
(2) Psychology Department, Education & Psychology Faculty, Peyam-e-Noor University, Tehran, Iran

Correspondence

Address: Psychology Department, Jomhoori Boulevared, Islamic Azad University, Yazd, Iran
Phone: +983535242059
Fax: -
sadaf2352@gmail.com

Article History

Received:  January  1, 2017
Accepted:  May 25, 2017
ePublished:  July 22, 2017

BRIEF TEXT


Diabetes is one of the most common and costly chronic diseases that has many limitations in patient's activity. The characteristic of this chronic intravenous diseases is malfunction in glucose metabolism due to drawbacks in the production or use of insulin hormone. Many factors include psychological support, self-efficacy, health beliefs, and behavioral or lifestyle factors affect diabetes. Among these factors, self-efficacy is one of the most important variables that promotes self-care behaviors in diabetic patients [1].

… [2-21]. Based on the theory of emotional control, events with emotional changes produce excitement for people involved in those events. Excitement is the boundary between feelings and beliefs about individual identity. Gellman [22] considers emotional intelligence to be a better way of using one`s intelligence through the self-control, enthusiasm, perseverance, self-esteem, and self-motivation. According to Gellman, emotional intelligence includes individual and social components that one of its individual components is self-regulation. Self-regulation is defined as a psychological effort in controlling the internal state, processes, and functions for achieving higher goals [23]. … [24-25].

The purpose of this study was to investigate the role of emotional self-regulation mediation in the relationship between mindfulness and self-efficacy in patients with type 2 diabetes who referred to the diabetic center of Yazd

This research is descriptive-correlational.

This study was conducted in 2016 in patients with type 2 diabetes who were members of Yazd Diabetic Center (4050 people).

260 patients aged 25 to 60 years with diabetes type 2 who had not received the psychological treatments before this study as well as the psychiatric drugs at least 6 months before the study were selected through convenience sampling method, and after review, 243 questionnaires were included in the study.

To measure the self-efficacy, mindfulness, and emotional self-regulation variables in the diabetic patients, three questionnaires were used. 1- The Self-Efficacy Questionnaire for Diabetics: This questionnaire has been designed by Larig [26], and it has 8 questions for measuring self-efficacy in diabetic patients. The range of scores for self-efficacy is between zero and 80 and the questions are arranged in 10-degree scale. This instrument is standard and after translation by a proficient bilingual team (Persian-English) who were expert with respect to diabetes, the questionnaire was used after evaluation of reliability and validity [27]. To determine the reliability of the questionnaire, test-retest method was used for internal consistency that the internal consistency was 0.89 [27]. 2- Mindfulness Questionnaire: to measure mindfulness, a short form of Freiburg mindfulness questionnaire was used. This questionnaire has 14 items and the subjects are asked to answer the question on a Likert scale from “always” to “Rarely” (one score). In a study in Iran by Ghasemi-Jubaneh et al. [28], the short form of Freiburg's mindfulness questionnaire, was first translated into Persian and then its validity and reliability were examined. Concurrent validity with the scales of self-control and emotional adjustment was appropriate at significant level of 0.01. The results of the confirmatory factor analysis model showed that the structure of the questionnaire has an acceptable fit with the data and is desirable factor in the validity. Also, the calculated reliability was obtained by using coefficients for Cronbach's alpha 0.92, combinational teta 0.93, and retest reliability after four weeks 0.83 [28]. … [29-30]. Emotional Self-Regulation Questionnaire: Hoffman and Kishdan Emotional Self-Regulation Questionnaire includes 20 questions that its questions are ranged based on five-degree Likert scale and the scores of the questionnaire range from 20 to 100. The questionnaire, after translation and re-translation, was considered by the relevant psychologist in terms of content validity and its content validity was confirmed. The questionnaire consists of three components of secrecy (8 questions), compromise (7 questions), and tolerance (5 questions). After data collection, factor analysis was used to verify the construct validity. The results of factor analysis showed that sample size is sufficient and the factors are interpretable (p<0.001). The reliability of the Cronbach's alpha for the subscales of secrecy, compromise, and tolerance were 0.07, 0.75 and 0.50 respectively and the total reliability was obtained 0.81 [31]. Statistical analysis: Data were analyzed by SPSS 16 software. At first, the default of data normalization was investigated using the Kolmogorov-Smirnov test, which showed that the distribution of data from the research variables was normal. Investigating the relationship between the variables was conducted using Pearson correlation coefficient. In order to study the predictive power of the variables, first, the concurrent regression analysis was used that the mindfulness was considered as a predictive variable and self-efficacy was determined as a criterion variable. To study the role of emotional self-regulation intermediates in the relationship between self-efficacy and mindfulness, multiple regression was used that self-efficacy as a criterion variable, and mindfulness and emotional self-regulation were considered as predictive variables.

Of the 243 cases examined, 151 were female and 216 were married. Also, 76, 143, 22, and 2 participants had the education level below diploma, diploma, undergraduate, and graduate respectively. There was a direct and significant correlation between mean scores of mindfulness and self-efficacy, mindfulness and emotional self-regulation, and self-efficacy and emotional self-regulation in diabetic patients (p<0.05; Table 1). In self-efficacy predictive power prediction by mindfulness variable, according to R2 coefficient, 18.3% of self-efficacy changes were explained by mindfulness (β = 0.428, p <0.05). In examining the role of emotional self-regulation mediators in the relationship between self-efficacy and mindfulness, according to the R2 coefficient, 20.4% of the self-efficacy changes were explained by mindfulness and emotional self-efficacy variables (p<0.01). By entering the emotional self-regulation variable, the beta value was decreased from the previous stage (β=0.393). However, it was still significant and emotional self-regulation was intermediate in the relationship between self-efficacy and mindfulness (p<0.01).

The results showed that there is direct relationship between mindfulness and self-efficacy among diabetic patients. These results are consistent with the findings of Callole et al. [32], Chang et al. [33], Jacobson and Vico [34], and Mesulyis et al. [35], as well as the findings of Mohammadizadeh et al. [36] and Mebliyan [12]. Also, the results showed that there is a direct relationship between mindfulness and emotional self-regulation among diabetic patients. These findings are consistent with the results of research by Tetel et al. [14], Bishop et al. [19], Junckin [37], Guai et al. [38], Pintrich and Grout [39], Feldman et al. [40], Bayer et al. [41] and Roemer et al. [42]. Also, the results were in line with the studies done by Kazemian [43], and Ghashghai et al. [44]. … [45-56].

Repetition of the study on other patient groups of the society (such as students) and people with normal conditions and the control of some disturbing variables, such as patients' mental and physical condition, economic and social conditions, and living conditions and occupation is suggested. It is also suggested that in the future researches, the copying styles among diabetic patients and their relationship with self-efficacy status as well as personality factors and their relationship with the emotional adjustment be studied. It is recommended to teach emotional regulation skills to diabetic patients.

The conduction of this study was faced with some limitations; the samples of this study were patients from Yazd city. However, sampling from the whole population of Yazd was time and cost consuming. Therefore, statistical population where patients who had record in Diabetic Center in Yazd Province. One of the other limitations of this study was that the samples in this study were selected only from the patients with type 2 diabetes in Yazd province. Certain cultural, religious, and other factors may have been influential in the results of this study. Therefore, this problem limits the ability of the present research to be extended to other groups and societies, and the limits on the external validity. Research results may be affected by some of the intrusive factors that the lack of control of these disturbing factors (such as economic, social and cultural conditions of patients) was another limitation of the research.

Mindfulness is associated with self-efficacy and emotional self-regulation as well as emotional self-regulation with self-efficacy in patients with type 2 diabetes. The role of mediating in the relationship between mindfulness and self-efficacy is related to emotional self-regulation.

We appreciate the cooperation of all the participants.

Non-declared

To do this research, informed consent was obtained from the patients.

This research has been funded personally.

TABLES and CHARTS

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