Development of a Predictive Model of Psychosocial Adjustment to Illness Based on Health-Promoting Lifestyle with the Mediating Role of Illness Perception in Female Patients with Systemic Lupus Erythematosus
Keywords:
Illness perception, psychosocial adjustment, health-promoting lifestyle, systemic lupus erythematosus, female patientsAbstract
Objective: This study aimed to determine the mediating role of illness perception in the relationship between health-promoting lifestyle and psychosocial adjustment to illness among female patients with systemic lupus erythematosus.
Materials and Methods: The present study was a descriptive-correlational study using a structural equation modeling design. The statistical population included all female patients with systemic lupus erythematosus who referred to hospitals affiliated with Islamic Azad University in Tehran, including Bou-Ali, Farhikhtegan, and Amir-Al-Momenin hospitals, as well as the Lupus Association, during the first six months of 2025. Based on the inclusion criteria, 280 participants were selected through purposive sampling. Data were collected using the Psychosocial Adjustment to Illness Scale developed by Derogatis (1986), the Health-Promoting Lifestyle Profile developed by Walker (1990), and the Brief Illness Perception Questionnaire developed by Broadbent et al. (2006). Data were analyzed using regression analysis and structural equation modeling through SPSS and PLS software at a significance level of 0.05.
Findings: The inferential findings showed that health-promoting lifestyle had a significant relationship with psychosocial adjustment to illness in female patients with systemic lupus erythematosus. In addition, illness perception was significantly associated with psychosocial adjustment to illness. The results of structural equation modeling confirmed the mediating role of illness perception in the relationship between health-promoting lifestyle and psychosocial adjustment to illness. Accordingly, the indirect path from health-promoting lifestyle to psychosocial adjustment through illness perception was statistically significant, indicating that patients’ cognitive appraisal of their illness plays an important explanatory role in how health-related lifestyle behaviors affect psychosocial adaptation.
Conclusion: The findings highlight the importance of mediating cognitive processes in adaptation to chronic illness and indicate that promoting health-related behaviors alone may not be sufficient. Interventions for women with systemic lupus erythematosus should also focus on modifying patients’ illness perceptions and cognitive interpretations in order to improve psychosocial adjustment.
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