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

Abstract

According to the importance of type 2 diabetes and the variety and intensity of physical, mental, economic and social effects and factors such as psychological hardiness, self-efficacy, self-esteem, social support to manage treatment of this type of diabetes, this study is aimed in assessing the model of relationship of hardiness with self-efficacy with the mediating role of self-esteem and social support in these patients. In a cross-sectional survey, 212 patients with type 2 diabetes (90 male and 122 female) in Health Centers of Islmashahr were selected using available random sampling. The data collection was done using psychological hardiness scale, Coppersmith self-esteem inventory, self-efficacy and social support scales and the data were then analyzed using structural equation modeling (SEM) using Lisrel and SPSS-22 software. Correlation of main research variables were tested using Pearson correlation test and normality of variables were tested using regression analysis. Then, model fitness and coefficients of variables were measured. Most paths with significant coefficients were maintained in final model. The results obtained from the study are as follows: 1) psychological hardiness can affect self-efficacy directly 2) psychological hardiness can affect self-efficacy indirectly with the mediation of social supports and self-esteem 3) the proposed model is fit based on obtained fitness indices (GFI= 0.94; AGFI= 0.93; RMSEA= 0.032; NNFI= 0.94; SRMR= 0.031; NFI= 0.97 and IFI= 0.97). The correlations between variables in this study are mostly in consistence with the existing literature and theories. It could be concluded that variables such as psychological hardiness, self-efficacy, self-esteem and social support have been considered as effective factors to manage and treat patients with type 2 diabetes in domestic and foreign literature. The proposed model shows potential infrastructural mechanisms that can facilitate the process of treatment and better coping and even reduction of costs of the disease through training patients and their families under current social and economic conditions of Iran. Due to the applied significance of the results for clinical specialists and diabetes treatment centers, appropriate interventions are required in this filed. Paying attention to these results is important to enhance self-care behaviors of diabetes, reduction of complications and reduction of relevant costs and more importantly, general health of society.