Structural Relationship between Psychodynamic Conflicts and Mentalization with Quality of Life and Fasting Blood Sugar Levels in People with Diabetes: The Mediating Role of Diabetes Acceptance

Eisazadeh, Fatemeh; Rahimian-Boogar, Isaac

doi:10.30473/hpj.2025.73815.6199

Document Type : Scientific Research

Authors

¹ Postdoctoral Researcher, Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.

² Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran

10.30473/hpj.2025.73815.6199

Abstract

Objective: Diabetes is the most common chronic metabolic disease in worldwide with high financial and human costs; therefore, it was important to investigate the factors affecting the quality of life related to diabetes and fasting blood sugar levels. Therefore, the main purpose of the present study is to determine the structural relationship between psychodynamic conflicts and mentalization with quality of life and fasting blood sugar levels in people with diabetes, with the mediating role of diabetes acceptance. Method: The present study was a retrospective cross-sectional descriptive study with structural equation modeling. The statistical population was all diabetics who referred to the Iranian Diabetes Association in Tehran in the first half of 2024. Using research instruments, 511 participants were enrolled in the study based on a convenience sampling method. Based on the formula Q15 > n > Q5, the minimum sample size was calculated to be 240 people, and the maximum was 720 people. Therefore, the researchers deemed a sample size of 500 people to be appropriate. Due to the possibility of attrition, 530 questionnaires were distributed, and 523 questionnaires were completed, of which only 511 were suitable for inclusion in the study. The inclusion criteria for the study were: willingness to participate in the research, diagnosis of type 1 or type 2 diabetes, and referral to the Iranian Diabetes Association in the first half of first half of 2024. The exclusion criteria were: unwillingness to continue participating in the research and incomplete completion of questionnaires. The data were analyzed using two statistical software packages, SPSS - 26 and AMOS - 26. The research tools consisted a Fasting Blood Sugar (FBS) test, and a form for collecting demographic information. To collect data, the second edition of the Psychodynamic Conflicts Questionnaire (2020), the Revised Mentalization Questionnaire by Horvath et al. (2023), the Diabetes-Related Quality of Life Questionnaire by Burroughs et al. (2004), and the Iranian version of the Diabetes Acceptance Scale (2022) were used. Results: In this study, 511 individuals participated, with 232 (45.4%) being male and 279 (54.6%) being female. The age range of all participants was 15 to 80 years. Furthermore, 184 individuals (36%) had type 1 diabetes, and 327 individuals (64%) had type 2 diabetes. Therefore, the majority of the study sample consisted of individuals with type 2 diabetes, which seems entirely logical given its higher prevalence. Also, after collecting data and analyzing them in a descriptive and inferential form and presenting the model using statistical software, the results indicated that the proposed structural model has a good fit and the predictor and mediating variables have a significant direct (P<0/05) and indirect effect (through the mediating variable) on the criterion variables. In other words, the t-values (or critical ratios) for all direct paths were above ±1.96, indicating the significance of all direct effects of the study variables. Bootstrap results showed that all indirect paths, mediated by the diabetes acceptance variable for diabetes, were statistically significant. Conclusion: According to the results of the present study, it seems that targeting the components of psychodynamic conflicts, mentalization, and diabetes acceptance in relation to quality of life related to diabetes and fasting blood sugar levels can be effective in people with diabetes. Encouraging patients to confront their intrapsychic conflicts and enhance mentalization (as part of their treatment), along with utilizing constructive coping strategies for their mental health, can be effective in improving diabetes-related quality of life and fasting blood glucose levels. Furthermore, this approach enables diabetic patients to achieve greater acceptance of their condition, which can lead to increased engagement in the treatment process and, ultimately, improved diabetes management and control.

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Main Subjects

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Structural Relationship between Psychodynamic Conflicts and Mentalization with Quality of Life and Fasting Blood Sugar Levels in People with Diabetes: The Mediating Role of Diabetes Acceptance

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Volume 14, Issue 54September 2025Pages 129-144

Volume 14, Issue 54
September 2025
Pages 129-144