A Structural Model to Explain Quality of Life Based on Early Maladaptive Schemas and the Mediating Role of Self-Care in Female Patients with Type 2 Diabetes

Abstract

Objective: The objective of this study was to propose a structural model explaining the quality of life based on early maladaptive schemas and the mediating role of self-care in female patients with type 2 diabetes.

Methods: This descriptive-correlational study employed structural equation modeling. The statistical population included all female patients with type 2 diabetes in Tehran who visited medical centers in 2021. The sample consisted of 250 female patients with type 2 diabetes from Tehran in 2021, selected through convenience sampling based on inclusion and exclusion criteria. Data were collected using the short form of the World Health Organization Quality of Life Questionnaire (WHO, 1996), the short form of the Young Schema Questionnaire (Young, 1998), and the Diabetes Self-Care Activities Questionnaire (Toobert et al., 2000). Data analysis was conducted using structural equation modeling and Pearson correlation methods with SPSS.22 and AMOS.22 software.

Findings: Fit indices indicated a good fit of the proposed model with the data: PCFI = 0.655, PNFI = 0.661, CMIN/DF = 2.90, RMSEA = 0.089, IFI = 0.917, CFI = 0.914, GFI = 0.903. The highest coefficient (-0.47) was related to the pathway from the domain of impaired autonomy and performance to quality of life. The determination coefficient for the marital relationship quality variable in the proposed structural model was 0.889, indicating that exogenous variables could predict 89% of the changes in quality of life, which is considered strong.

Conclusion: It can be concluded that the structural model explaining quality of life based on early maladaptive schemas and the mediating role of self-care in female patients with type 2 diabetes was well-fitted.