@2024 Afarand., IRAN

---

ISSN: 2252-0805    The Horizon of Medical Sciences 2018;24(2):153-161

Background
Diabetes mellitus is one of the most common chronic diseases that its incidence has increased in recent decades and the effect of effective psychological factors on it has been considered [1].
Previous Studies
.... [2, 3]. Type 1 and type 2 diabetes are greatly affected by stress and negative emotions, such as fear and anger, and those diabetics have difficulty in control their stress and emotions [4]. ... [5]. Emotion regulation is one of the important factors that affects the self-care behavior of people with diabetes, which includes using behavioral and cognitive strategies to change the duration or intensity of an emotional experience [6]. ... [7, 13]. Mindfulness seems to be one of the factors associated with emotion cognitive regulation in diabetic patients. [14]. .... [15, 16]. The results show that mindfulness can increase positive emotions and increase flexibility in response to environmental stimuli [17]. .... [18-20]. Diabetes is affected by several factors, including biological, psychosocial, and social support. In this regard, family support as one of the most important sources of social support has the greatest impact on diabetes [21] ... [22, 23]. Social support has a significant impact on reducing stress, depression and distress and has a direct correlation with the reduced time of suffering from diseases [24]. Social support can provide psychological and sensible resources for individuals in order to cope with the stressful situations of life and daily concerns [25]. Evidence from numerous studies has shown that social support plays an important role in maintaining the health individuals and in minimizing the negative effects of the many stresses due to the environment and society. The increased social support can lead to the reduced mortality rate of the patients as well as their physical and mental health problems [26].
Aim(s)
The aim of the current study is to examine the predictive role of emotion cognitive regulation through mindfulness and social support in patients with Type 2 Diabetes.
Research type
This research is a descriptive correlational study.
Research society, place and time
This descriptive study was done on patents with type2 diabetes in Yazd, Iran.
Sampling method and number
The study population included 25-55-year-old men and women with type 2 diabetes who attended the Diabetes Center in Yazd in 2016. About 4,020 patients with type 2 diabetes had records at the center, of whom, 350 subjects were selected using the Cochran formula and convenience sampling.
Used devices&materials
The researcher Referred to the Diabetes Center in Yazd and communicated with the patients individually and received their consent to participate in the research. In order to observe the ethical considerations of the research, the subjects had the right for withdrawal of the study, all the information of the subjects remained confidential and their names did not mention and data was analyzed only as groups. Inclusion criteria included diagnosis of type 2 diabetes at least a year before the study, no mental retardation, no psychological disorders prior to diabetes, no severe psychological disorder after diagnosis of diabetes and informed consent to participate in the study. In this research, three questionnaires were used to measure the variables: Cognitive Emotion Regulation: Since there was not a proper questionnaire for measuring emotion cognitive regulation, in this study, emotion cognitive regulation questionnaire by Granefski et al. was used (2001). Mindfulness: To measure mindfulness, a short form of Freiburg’s Mindfulness Questionnaire was used. Social support: Philips’ Social Support Questionnaire was used to measure social support. Data was analyzed using Pearson correlation coefficient and multiple regression analysis.
Findings by Text
Of the 350 participants, 203 subjects were women and 147 were men. 98 subjects had below diploma education, 148 subjects had diploma, 93 samples had bachelor degree and 11 subjects had graduate degree. The mean emotion cognitive regulation was 11.662±16.30, social support was 44.16±10.13 and mindfulness obtained 30.42±6.00. Normal distribution of data was confirmed by Kolmogorov-Smirnov test and there was no significant difference with normal distribution. There was a negative correlation between the mindfulness and the negative strategies of emotion cognitive regulation (r=-263) and social support and negative strategies of emotion cognitive regulation (r=-171), and also there was a positive correlation between mindfulness and positive strategies of emotion cognitive regulation (r=0.668) and social support and positive strategies of emotion cognitive regulation (r=0.527). Multiple regression analysis was used to investigate the predictive power of variables and mindfulness and social support were considered as predictive variables and emotion cognitive regulation as criterion. According to R2 coefficient, 11.5% of the changes emotion cognitive regulation was explained by mindfulness and social support (F=14.191, P <0.01; Table 3). There was a relationship between mindfulness and social support (t=14.771, P<0.05) with emotion cognitive regulation that according to the beta value, it determines relative contribution of each of the predictor variables in predicting the dependent variable. Of total variance of emotion cognitive regulation, 25.3% was explained by mindfulness and 13.2% by social support (Table 4).
Main comparison to the similar studies
.... [27-31]. According to the results of this study, there is a direct relationship between positive strategies of emotion cognitive regulation and mindfulness, which means that mindfulness can predict using positive strategies in diabetic people. These results were consistent with the findings of Anderson et al. [32], Ortner et al. [33], Davidson et al. [34], and Lynch & Bronner [35]. According to the results, there was a direct relationship between the positive strategies of emotion cognitive regulation and social support. In this regard, social support can predict using positive strategies for emotion cognitive regulation in diabetic patients. These results are consistent with the findings of Sayah Sayari et al. [36], Ecochian et al. [37], Gross [38], Saarni [39], Tugade & Frederickson [40] and Toljamo & Hentinen [41]. According to the results, mindfulness can predict negative strategies for emotion cognitive regulation in diabetic people. It can be concluded that by increasing mindfulness of the emotional situations in diabetic patients, they less use the negative and inefficient strategies. These results are consistent with the studies by Omidi et al. [42], Goldin & Gross [43], Toneatto & Nguyen [44], Teasdale et al. [45], Huston et al. [46] and Schroevers et al. [47]. The results showed that there is an inverse relationship between negative strategies of emotion cognitive regulation and social support. These results were consistent with the findings of Salehi et al. [48], Stoker and Richmand [49], Bal et al. [50], Stacciarini & Troccoli [51], Granefski & Kraaij [52]. According to the findings, mindfulness and social support can predict emotion cognitive regulation in diabetic patients. These results were consistent with the findings of the research by Roemer et al. [53], Hill et al. [54], Stanton et al. [55] and Toljamo & Hentinen [41].
Suggestions
It is suggested to use the results of this research as an educational program for managing students' emotions in educational system of Iran.
Limitations
The findings can not be generalized to other communities, which is one of the limitations of this study.
Conclusions
With regard to the findings, mindfulness and social support are effective in selecting and applying positive strategies for emotion cognitive regulation in patients with Type2 Diabetes.
Acknowledgments
All diabetic patients and all those who helped us to do this research are appreciated.
Conflict of interest
None declared.
Ethical Permissions
None declared.
Funding Sources
This research is funded by the authors.

TABLES and CHARTS

Show attach file