با همکاری مشترک دانشگاه پیام نور و انجمن روانشناسی سلامت

نوع مقاله : علمی- پژوهشی

نویسندگان

1 دانشجوی کارشناس ارشد روانشناسی، گروه روانشناسی، موسسه علامه فیض کاشانی، کاشان، ایران.

2 دانشیار، گروه روانشناسی، دانشکده علوم انسانی، دانشگاه کاشان، کاشان، ایران.

10.30473/hpj.2025.72797.6142

چکیده

مقدمه: هدف از پژوهش حاضر بررسی تدوین مدل ارتباطی کیفیت زندگی، ذهن­آگاهی و شفقت به خود با میانجی­گری رفتارهای خودمراقبتی در بیماران بیماران دیالیزی بود.
روش: روش این مطالعه توصیفی- همبستگی بود. جامعه آماری پژوهش بیماران دیالیزی شهر کاشان از فروردین تا مرداد سال 1403 بودند. حجم نمونه بر اساس مدل کلاین (2023) و با روش نمونه‏گیری در دسترس 300 نفر انتخاب شد. ابزار گردآوری داده­­های پژوهش شامل پرسشنامه کیفیت زندگی سازمان بهداشت جهانی (2004)، سیاهه ذهن ­آگاهی فرایبورگ والش و همکاران (2006)، فرم کوتاه مقیاس شفقت به خود رائس و همکاران (2011) و مقیاس تجربه توان خودمراقبتی کئرنی و فلیسچر (1979) بود. داده‌ها با استفاده از همبستگی پیرسون و معادلات ساختاری تحلیل شد. نرم افزار تحلیل داده­ها برنامه SPSS و AMOS نسخه 28 بود.
یافته‌ها: یافته‏های پژوهش نشان داد که اثرات مستقیم ذهن‏آگاهی (51/0=β و 001/0=sig) و شفقت به خود (54/0=β و 001/0=sig) بر کیفیت زندگی معنادار بود. همچنین نتایج نشان داد که رفتارهای خودمراقبتی در رابطه بین ذهن­آگاهی (61/0=β و 001/0=sig) و شفقت به خود (52/0=β و 001/0=sig) با کیفیت زندگی نقش میانجی و معنادار دارد. مدل نهایی پژوهش از برازش مطلوبی برخوردار بود (03/0=RMSEA و 05/0>p).
نتیجه‌گیری: با توجه به یافته‏های این پژوهش و اهمیت نقش ذهن‏آگاهی و شفقت به خود در کیفیت زندگی بیماران دیالیزی استفاده از آموزش ذهن­آگاهی و درمان مبتنی بر شفقت به خود برای بهبود کیفیت زندگی در این بیماران پیشنهاد می­ شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Developing Relationship Model Quality of Life, Mindfulness, and Self-Compassion with Mediating Role Self-Care Behaviors among Dialysis Patients

نویسندگان [English]

  • Fatemeh Abdoli Arani 1
  • MohammadReza Tamannaeifar 2

1 M.Sc Student in Psychology, Department of Psychology, Institute of Allameh Feyz Kashani, Kashan, Iran

2 , Associate Professor, Department of Psychology, Faculty of Humanities, University of Kashan, Kashan, Iran

چکیده [English]

Objective: The growing trend of diseases such as type 2 diabetes, high blood pressure, as well as the increase in the obese and elderly population in different countries caused the growth rate of chronic kidney diseases globally to be higher than the annual growth rate of the world population. It is estimated that more than 850 million people worldwide are affected by this disease. If kidney diseases are not diagnosed on time and treated appropriately, it leads to end-stage kidney disease. The purpose of the present study was to investigate developing relationship model quality of life, mindfulness and self-compassion with mediating role self-care behaviors among dialysis patients. This was descriptive-correlation research. Method: The statistical population of the study was dialysis patient’s Kashan city in March to July of year 2024. The sample size was selected based on Klein's model (2023) and with subjectivw sampling of 300 dialysis patient’s. Data collection tools include the quality of life-BRIEF of World Health Organization (2004), Freiburg mindfulness inventory of Walach and et al (2006), short form of the self‐compassion scale of Raes and et al (2011) and exercise of self‐care agency scale of Kearney and Fleischer (1979). Data were analyzed using Pearson correlation and structural equations modeling. Data analysis software was SPSS and AMOS version 28. Results:   Te results showed direct effect of mindfulness (β=0.51 and sig=0.001) and self-compassion (β=0.54 and sig=0.001) were significant on quality of life. Also, the results showed that self-care behaviors had a mediating role in relationship between mindfulness (β=0.61 and sig=0.001) and self-compassion (β=0.52 and sig=0.001) with quality of life. Also, the final research model had a good fit (RMSEA=0.03, p<0.05). Conclusion: In explaining the mediating role of self-care behaviors in the relationship between mindfulness and quality of life, it can be said that a dialysis person with mindfulness can help himself to experience more peace and relaxation, this peace and relaxation has helped him to Adhere to self-care and fulfill medical and pharmaceutical orders, and this adherence to self-care in dialysis patients makes them experience a better quality of life. Also, In explaining the mediating role of self-care behaviors in the relationship between self-compassion and quality of life, it can be said that self-compassion can lead to an increase in the level of self-care behaviors and a person can take better and more effective care of him and therefore follow up on his treatment process. slow and adheres to medical and medication orders, as a result, it shows a higher recovery rate, which makes the quality of life of patients better than other dialysis patients. According to the findings of this research and the importance of the role of the mindfulness and self-compassion in quality of life of dialysis patients, it is suggested to experts in this field to use the training of mindfulness and self-compassion to improve quality of life in dialysis patients.

کلیدواژه‌ها [English]

  • Dialysis
  • Mindfulness
  • Quality of Life
  • Self-Care Behaviors
  • Self-Compassion
Abdollahi, A., Taheri, A., & Allen, K. A. (2020). Self‐compassion moderates the perceived stress and self‐care behaviors link in women with breast cancer. Psycho‐Oncology29 (5), 927-933. https://doi.org/10.1002/pon.5369
Aliche, C. J., Ifeagwazi, C. M., Nwamarah, J. U., Okechukwu, F. O., & Ngwu, E. C. (2024). Mediating roles of positive reappraisal and stigma resistance in the relationship between mindfulness and quality of life among stable schizophrenia patients. Current Psychology43 (4), 3124-3133. https://doi.org/10.1007/s12144-023-04563-8
Aljawadi, M. H., Babaeer, A. A., Alghamdi, A. S., Alhammad, A. M., Almuqbil, M., & Alonazi, K. F. (2024). Quality of life tools among patients on dialysis: a systematic review. Saudi Pharmaceutical Journal, 1 (3), 1-10.https://doi.org/10.1016/j.jsps.2024.101958
Alshamrani, M., Almalki, A., Qureshi, M., Yusuf, O., & Ismail, S. (2018). Polypharmacy and medication-related problems in hemodialysis patients: a call for deprescribing. Pharmacy6 (3), 76-86.https://doi.org/10.3390/pharmacy6030076
Arpacı, R., & Tanriverdi, D. (2023). Post-Traumatic Growth and Self-Compassion Level in Hemodialysis Patients. Illness, Crisis & Loss, 1 (2), 1-10..https://doi.org/10.1177/10541373231203362
Bartolo, A., Sousa, H., Ribeiro, O., & Figueiredo, D. (2022). Effectiveness of psychosocial interventions on the burden and quality of life of informal caregivers of hemodialysis patients: a systematic review. Disability and Rehabilitation, 44 (26), 8176-8187.
Baslet, G., Ehlert, A., Oser, M., & Dworetzky, B. A. (2020). Mindfulness-based therapy for psychogenic nonepileptic seizures. Epilepsy & Behavior103(2), 5-12.https://doi.org/10.1016/j.yebeh.2019.106534
Bat-Erdene, E., Tumurbaatar, E., Tumur-Ochir, G., Jamiyandorj, O., Jadamba, T., Yamamoto, E., ... & Lkhagvasuren, B. (2023). Validation of the abbreviated version of the World Health Organization Quality of Life in Mongolia: a population-based cross-sectional study among adults in Ulaanbaatar. Nagoya Journal of Medical Science85 (1), 79.-92.https://doi.org/10.18999%2Fnagjms.85.1.79
Beato, A. F., da Costa, L. P., & Nogueira, R. (2021). “Everything is gonna be alright with me”: The role of self-compassion, affect, and coping in negative emotional symptoms during coronavirus quarantine. International journal of environmental research and public health18 (4), 1-10https://doi.org/10.3390/ijerph18042017
Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease, 174 (12), 1-9.https://www.researchgate.net/profile/Eve-Carlson/publication/336107396_
Bitar, Z., Fekih Romdhane, F., Rogoza, R., Ghorab, H. M., Obeid, S., & Hallit, S. (2024). Psychometric properties of the short form of the Freiburg Mindfulness Inventory in the Arabic language. International Journal of Environmental Health Research34 (7), 2702-2713. https://doi.org/10.1080/09603123.2023.2267483
Brophy, K., Brähler, E., Hinz, A., Schmidt, S., & Körner, A. (2020). The role of self-compassion in the relationship between attachment, depression, and quality of life. Journal of affective disorders260 (1), 45-52.https://doi.org/10.1016/j.jad.2019.08.066
Byrne, C. D., & Targher, G. (2020). NAFLD as a driver of chronic kidney disease. Journal of hepatology72 (4), 785-801.https://doi.org/10.1016/j.jhep.2020.01.013
Carswell, C., Reid, J., Walsh, I., McAneney, H., Lee, J. B., & Noble, H. (2021). Complex arts-based interventions for patients receiving haemodialysis: A realist review. Arts & health13 (2), 107-133.https://doi.org/10.1080/17533015.2020.1744173
Choi, M. K., & Choe, M. (2007). Self care behavior of hemodialysis patients. Journal of Korean Biological Nursing Science9 (2), 105-117. https://koreascience.kr/article/JAKO200704050607386.page
Chukwuorji, J. C., Odi, C. P., Chike-Okoli, A., Morah, N. M., Osondu, O. M., Rukmi, D. K., ... & Eze, J. E. (2024). Health-related quality of life of people living with HIV: contributions of emotion regulation and self-compassion. Venereology, 3 (3), 136-146.
Colombijn, J. M., Colombijn, F., van Berkom, L., van Dijk, L. A., Senders, D., Tierolf, C., ... & Van Jaarsveld, B. C. (2024). Polypharmacy and Quality of Life Among Dialysis Patients: A Qualitative Study. Kidney Medicine6 (1), 1-10. https://doi.org/10.1016/j.xkme.2023.100749
Creswell, J. D., Lindsay, E. K., Villalba, D. K., & Chin, B. (2019). Mindfulness training and physical health: mechanisms and outcomes. Psychosomatic medicine81 (3), 224-232. https://doi.org/10.1097%2FPSY.0000000000000675
Dehghani, M., Rahimi, B., Makhdomi, K., & Jebraeily, M. (2023). Determining Key Performance Indicators in Dialysis Management Dashboard for Monitoring Service Quality. JMIS, 9 (1), 46-55. (In Persian)http://dx.doi.org/10.32598/JMIS.9.1.8
Dehghani, Z., Mardani, Z., & Rezvanian, H. (2024). The Effectiveness of Compassion Focused Therapy on Improving Treatment Adherence & Blood Lipids (Cholesterol, Triglycerides, LDL & HDL) in Patients with type 2 Diabetes. Health Psychology, 13 (50), 77-96. (In Persian) https://doi.org/10.30473/hpj.2024.67476.5785
Doan, V., Shoker, A., & Abdelrasoul, A. (2024). Quality of Life of Dialysis Patients: Exploring the Influence of Membrane Hemocompatibility and Dialysis Practices on Psychosocial and Physical Symptoms. Journal of Composites Science8 (5), 172-182.
Emerson, L. M., De Diaz, N. N., Sherwood, A., Waters, A., & Farrell, L. (2020). Mindfulness interventions in schools: Integrity and feasibility of implementation. International Journal of Behavioral Development44 (1), 62-75.
Finaulahi, K. P., Sumich, A., Heym, N., & Medvedev, O. N. (2021). Investigating Psychometric Properties of the Self-Compassion Scale Using Rasch Methodology. Mindfulness, 12 (3), 730-740.https://psycnet.apa.org/doi/10.1007/s12671-020-01539-8
Fletcher, B. R., Damery, S., Aiyegbusi, O. L., Anderson, N., Calvert, M., Cockwell, P., ... & Kyte, D. (2022). Symptom burden and health-related quality of life in chronic kidney disease: A global systematic review and meta-analysis. PLoS medicine19 (4), 1-10.
Gao, T. Y., Huang, F. H., Liu, T., Sum, R. K. W., De Liu, J., Tang, D., ... & Ma, R. S. (2024). The role of physical literacy and mindfulness on health-related quality of life among college students during the COVID-19 pandemic. Scientific Reports14 (1), 237-247. https://doi.org/10.1038/s41598-023-50958-9
Ghasemi Jobaneh, R., Arab Zadeh, M., Jalili Nikoo, S., Mohammad Alipoor, Z., & Mohsenzadeh, F. (2015). Survey the Validity and Reliability of the Persian Version of Short Form of Freiburg Mindfulness Inventory. JRUMS, 14 (2): 137-150.  (In Persian)
Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological medicine9 (1), 139-145. https://doi.org/10.1017/s0033291700021644
Goldberg, S. B., Knoeppel, C., Davidson, R. J., & Flook, L. (2020). Does practice quality mediate the relationship between practice time and outcome in mindfulness-based stress reduction?. Journal of counseling psychology67(1), 115-121.
Heydari Aghdam, B., Khademi, A.L, & Zahedi, R. (2021). Prediction of self-care beahavior based on self-compassion and health loucus of control among diabeting patients. Nursing and Midwifery Journal, 18 (12), 977-985. (In Persian) https://unmf.umsu.ac.ir/article-1-4158-fa.html
Hoover, E., Holliday, V., Merullo, N., Oberdhan, D., Perrone, R. D., Rusconi, C., ... & Dahl, N. K. (2024). Pain and Health-Related Quality of Life in Autosomal Dominant Polycystic Kidney Disease: Results from a National Patient-Powered Registry. Kidney Medicine6 (5), 1-10. https://doi.org/10.1016/j.xkme.2024.100813
Hughes, M., Brown, S. L., Campbell, S., Dandy, S., & Cherry, M. G. (2021). Self-compassion and anxiety and depression in chronic physical illness populations: A systematic review. Mindfulness12 (1), 1597-1610.https://doi.org/10.1007/s12671-021-01602-y
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10 (2), 144–156.https://doi.org/10.1093/clipsy.bpg01
Kamaloddini, M.H., & Saravani, K. (2021). A comparative study of the quality of life in patients undergoing hemodialysis and kidney transplant recipients: systematic review and meta-analysis. Tehran Univ Med J, 78 (12), 853-858. (In Persian)
Kander, T. N., Lawrence, D., Fox, A., Houghton, S., & Becerra, R. (2024). Mindfulness-based interventions for preadolescent children: A comprehensive meta-analysis. Journal of school psychology102 (1), 1-10.https://doi.org/10.1016/j.jsp.2023.101261
Kearney, B. Y., & Fleischer, B. J. (1979). Development of an instrument to measure exercise of self‐care agency. Research in nursing & health2 (1), 25-34. https://doi.org/10.1002/nur.4770020105
Khanjani, S., Foroughi, A.A., Sadghi, K., & Bahrainian, S.A. (2016). Psychometric properties of Iranian version of self-compassion scale (short form). Pajoohande, 21 (5), 282-289. (In Persian) http://pajoohande.sbmu.ac.ir/article-1-2292-fa.html
Kim, H., & Cho, M. K. (2021). Factors influencing self-care behavior and treatment adherence in hemodialysis patients. International Journal of Environmental Research and Public Health18 (24), 1-10.https://doi.org/10.3390/ijerph182412934
Kim, S., Nigatu, Y., Araya, T., Assefa, Z., & Dereje, N. (2021). Health related quality of life (HRQOL) of patients with End Stage Kidney Disease (ESKD) on hemodialysis in Addis Ababa, Ethiopia: a cross-sectional study. BMC nephrology22 (1), 1-6.
Kirschner, H., Kuyken, W., Wright, K., Roberts, H., Brejcha, C., & Karl, A. (2019). Soothing your heart and feeling connected: A new experimental paradigm to study the benefits of self-compassion. Clinical Psychological Science7 (3), 545-565.
Kline, R. B. (2023). Principles and practice of structural equation modeling. Guilford publications. https://www.guilford.com/books/Principles-and-Practice-of-Structural-Equation-Modeling/Rex-Kline/9781462551910
Kotera, Y., Green, P., & Sheffield, D. (2022). Positive psychology for mental wellbeing of UK therapeutic students: relationships with engagement, motivation, resilience and self-compassion. International Journal of Mental Health and Addiction20 (3), 1611-1626. https://doi.org/10.1007/s11469-020-00466-y
Kullman, S. M., Simpson, K. M., Semenchuk, B. N., Taylor, D., & Strachan, S. M. (2024). Self-compassion, physical activity, and psychological antecedents of physical activity: A scoping review of quantitative research. Sport, Exercise, and Performance Psychology, 13 (3), 254–271. https://doi.org/10.1037/spy0000349
Lockard, A. J., Hayes, J. A., Neff, K., & Locke, B. D. (2014). Self‐compassion among college counseling center clients: An examination of clinical norms and group differences. Journal of College Counseling17(3), 249-259.https://psycnet.apa.org/doi/10.1002/j.2161-1882.2014.00061.x
López A., Sanderman R., Ranchor A. V., Schroevers M. J. (2018). Compassion for others and self-compassion: Levels, correlates, and relationship with psychological well-being. Mindfulness, 9 (1), 325–331.https://doi.org/10.1007/s12671-017-0777-z
 Mongrain M., Chin J. M., Shapira L. B. (2011). Practicing compassion increases happiness and self-esteem. Journal of Happiness Studies, 12 (6), 963–981. https://doi.org/10.1007/s10902-010-9239-1
Najafi, E., Mosavipour, S., & Sajadi Nezhad, M.S. (2023). The effectiveness of intervention program of meaning therapy on general well-being, resilience and quality of life of patients with multiple sclerosis. Rooyesh11 (12), 85-96. (In Persian)
Okubo, R., Kondo, M., Imasawa, T., Saito, C., Kai, H., Tsunoda, R., ... & Yamagata, K. (2024). Health-related quality of life in 10 years long-term survivors of chronic kidney disease: a from-J study. Journal of Renal Nutrition34 (2), 161-169. https://doi.org/10.1053/j.jrn.2023.10.001
Raes, F., Pommier, E., Neff, K. D., & Van Gucht, D. (2011). Construction and factorial validation of a short form of the self‐compassion scale. Clinical psychology & psychotherapy18 (3), 250-255. https://doi.org/10.1002/cpp.702
Rezvani, S. R., Abolghasemi, S., & Farhangi, A. (2023). Presenting the model of self-care behaviors of pregnant women based on health literacy and mindfulness with the mediation of a health-oriented lifestyle. Journal of Applied Family Therapy3 (5), 176-195. (In Persian) https://doi.org/10.22034/aftj.2022.340540.1558
Rock, L. Y., Tajudeen, F. P., & Chung, Y. W. (2024). Usage and impact of the internet-of-things-based smart home technology: a quality-of-life perspective. Universal Access in the Information Society23 (1), 345-364. https://doi.org/10.1007/s10209-022-00937-
Seid, S. S., Amendoeira, J., & Ferreira, M. R. (2023). Self-Care and Quality of Life Among Adult Patients with Heart Failure: Scoping Review. SAGE Open Nursing9 (1), 1-10. https://doi.org/10.1177/23779608231193719
Shen, Y., Chen, Y., Huang, S., Yao, X., Kanwar, Y. S., & Zhan, M. (2022). The Association between Symptoms of Depression and Anxiety, Quality of Life, and Diabetic Kidney Disease among Chinese Adults: A Cross-Sectional Study. International journal of environmental research and public health20 (1), 475-485. https://doi.org/10.3390/ijerph20010475
Shirazian, S., Smaldone, A. M., Jacobson, A. M., Fazzari, M. J., & Weinger, K. (2023). Improving quality of life and self-care for patients on hemodialysis using cognitive behavioral strategies: A randomized controlled pilot trial. Plos one18 (5), 1-10.
Sirois, F. M., Molnar, D. S., & Hirsch, J. K. (2015). Self-compassion, stress, and coping in the context of chronic illness. Self and Identity14 (3), 334-347.https://doi.org/10.1080/15298868.2014.996249
Skinner, C. M., & Kuijer, R. G. (2024). Self-compassion and health-related quality of life in individuals with endometriosis. Psychology & Health, 1 (2), 1-18.
Soleymany, E., & Sarifi, P. (2023). The Role of Self-Compassion, Emotion Regulation, and Corona Anxiety in Predicting the Self-Care Behaviors of Family Members of People with Covid-19. Health Psychology11 (44), 121-136.  (In Persian)
Tamannaeifar, M., Mansourinik, A., & Malekzadeh Kashani, F. (2024). Relationship between Insecure Attachment Style and Quality of Life in Chronic Pain Patients: The Mediating Role of Alexithymia and Moderating of Resilience. Health Psychology13 (50), 45-62. (In Persian)https://doi.org/10.30473/hpj.2024.68731.5868
Terry, M. L., & Leary, M. R. (2011). Self-compassion, self-regulation, and health. Self and identity10 (3), 352-362.https://doi.org/10.1080/15298868.2011.558404
Van Dam N. T., Sheppard S. C., Forsyth J. P., Earleywine M. (2011). Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders, 25 (1), 123–130. https://doi.org/10.1016/j.janxdis.2010.08.011
Veisi, S., Kashefi, F., & Imani, S. (2024). Fittness the Causal-Structural Relationships of Successful Intelligence with Wisdom with the Mediation of Musical Intelligence in Piano Players. Social Psychology Research14 (54), 1-14. (In Persian)
Vo, A. K., Somani, B. K., Ulvik, Ø., Beisland, C., Seitz, C., & Juliebø-Jones, P. (2024). Measuring quality of life in patients with kidney stone disease: is it the future in endourology?. Current Opinion in Urology34 (2), 91-97. https://doi.org/10.1097/MOU.0000000000001138
Walach, H., Buchheld, N., Buttenmüller, V., Kleinknecht, N., & Schmidt, S. (2006). Measuring mindfulness—the Freiburg mindfulness inventory (FMI). Personality and individual differences40 (8), 1543-1555. https://doi.org/10.1016/j.paid.2005.11.025
World Health Organization. (2004). The world health organization quality of life (WHOQOL)-BREF (No. WHO/HIS/HSI Rev. 2012.02). World Health Organization.
Yang, C. W., Harris, D. C., Luyckx, V. A., Nangaku, M., Hou, F. F., Garcia, G. G., ... & Tonelli, M. (2020). Global case studies for chronic kidney disease/end-stage kidney disease care. Kidney international supplements10 (1), 24-48. https://doi.org/10.1016/j.kisu.2019.11.010
Zhang, L., Zou, L., & Zhou, L. (2024). Effectiveness of psychoeducational interventions on psychological distress and health-related quality of life among patients with maintenance hemodialysis: a systematic review and meta-analysis. Renal Failure46 (1), 1-10. https://doi.org/10.1080/0886022X.2024.2331613