Structural Model of Diabetic Patients' Self-Care Based on Depression and Mindfulness: The Mediating Role of Health-Based Lifestyle

The World Health Organization estimates that more than 346 million people have diabetes worldwide. This value will probably be more than double by 2030 without intervention. Diabetic patients not only require blood glucose control but also prevention of complications as well as physical and mental rehabilitation. Therefore, this study aimed to test the causal model of self-care based on depression and mindfulness through a healthy lifestyle in diabetic patients.

The statistical population consisted of all middle-aged patients with diabetes referred to endocrinologists in Tehran, Iran during 1977. In total, 195 cases were selected by convenience sampling. The patients were asked to complete the questionnaires of depression, mindfulness, health-promoting lifestyle, and diabetes self-care. Data were analyzed in Amos software using the path analysis method.

The results showed that depression and mindfulness had an indirect and significant relationship with self-care through a health-centered lifestyle. Moreover, there was no significant relationship between depression and self-care. However, a significant direct relationship was observed between mindfulness and self-care. In other words, mindfulness was associated with self-care behaviors due to its direct effect on a health-centered lifestyle; however, depression affected self-care through a health-centered lifestyle.

Given that both depression and mindfulness affect the lifestyle of the patient, they can predict the self-management behaviors of diabetic patients through their impact on the patient's lifestyle.