Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Health Education and Promotion Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Qual Life Res. 2019 Aug;28(8):2183-2193. doi: 10.1007/s11136-019-02183-z. Epub 2019 Apr 29.
Type 2 diabetes is a major public health issue particularly in the elderly. Religion may affect the Health Related Quality of Life (HRQoL) in such patients, mediated by factors such as religious coping and social support. This study aimed to investigate the impact of religiosity on medication adherence and HRQoL.
793 adults (> 65 years old, 45% females) were recruited from 4 diabetes care centers and followed for 1 year. Duke University Religion Index, Spiritual Coping Strategies, Multidimensional Perceived Social Support, Medication Adherence Report Scale, WHOQOL-BREF and Diabetes-specific Quality of Life Questionnaire Module were used for assessment, as well as HbA1c and fasting blood glucose level. Using structural equation modeling, the potential paths were tested between religiosity, medication adherence and HRQoL; social support, religious coping and medication adherence served as the mediators.
Religious coping and social support were recognized as the significant mediators between religiosity and medication adherence (CFI = 0.983, TLI = 0.985, and RMSEA = 0.021). The relationships between religiosity and HRQoL were considerably mediated by social support, religious coping and medication adherence and these variables explained 12% and 33% of variances of generic and specific HRQoL, respectively. There was no significant direct effect of religiosity on HRQoL. HbA1c and fasting blood glucose level were successfully loaded on the latent construct of medication adherence (factor loading = 0.51 and 0.44, respectively).
The impact of religiosity on medication adherence and HRQoL occurs through the mediators such as religious coping and social support. Therefore, to improve the adherence to treatment and quality of life, interventions may be designed based on these mediators.
2 型糖尿病是一个主要的公共卫生问题，尤其是在老年人中。宗教可能会通过宗教应对和社会支持等因素影响这些患者的健康相关生活质量（HRQoL）。本研究旨在探讨宗教信仰对药物依从性和 HRQoL 的影响。
从 4 个糖尿病护理中心招募了 793 名年龄>65 岁的成年人（45%为女性），并对他们进行了为期 1 年的随访。使用杜克大学宗教指数、精神应对策略、多维感知社会支持、药物依从性报告量表、世界卫生组织生活质量量表简表和糖尿病特定生活质量问卷模块进行评估，同时还评估了 HbA1c 和空腹血糖水平。使用结构方程模型，测试了宗教信仰、药物依从性和 HRQoL 之间的潜在路径；社会支持、宗教应对和药物依从性作为中介。
宗教应对和社会支持被认为是宗教信仰与药物依从性之间的重要中介（CFI=0.983，TLI=0.985，RMSEA=0.021）。宗教信仰与 HRQoL 之间的关系主要通过社会支持、宗教应对和药物依从性来介导，这些变量分别解释了通用和特定 HRQoL 方差的 12%和 33%。宗教信仰对 HRQoL 没有显著的直接影响。HbA1c 和空腹血糖水平成功地加载到药物依从性的潜在构念上（因子负荷分别为 0.51 和 0.44）。
宗教信仰对药物依从性和 HRQoL 的影响是通过宗教应对和社会支持等中介因素产生的。因此，为了提高治疗依从性和生活质量，可以根据这些中介因素设计干预措施。
