Stressful Life Events and Health-related Quality of Life Among Diabetic Patients: The mediating role health-promoting behaviors and self-management behaviors

Diabetes is a non-communicable disease that affects the physical, mental, and emotional aspects of life. The present study aimed to assess the mediating role of health-promoting behaviors and self-management behaviors in the relationship between stressful life events and health-related quality of life in diabetic patients.

The present study was conducted based on a descriptive-correlational design. The statistical population of the study consisted of all diabetic patients aged 25-75 years who were referred to the Diabetes Clinic of Zabol from January to March 2016 (n=550). The sample consisted of 400 patients who were selected via the convenience sampling method. They completed the life stressful events questionnaire, health-promoting lifestyle profile, diabetes self-management questionnaire, and diabetic patient’s health-related quality of life questionnaire. Data were analyzed in SPSS (version 22) and LISREL 8.8 statistical software using structural equation modeling.

Based on the results, the direct path of stressful events to health-promoting behaviors and self-management behaviors was negative and significant (P<0.01); moreover, it was negative and non-significant to the health-related quality of life (P<0.01). The direct path of health-promoting behaviors and self-management behaviors to health-related quality of life was positive and significant (P<0.01). In addition, it was found that the indirect relationship between stressful events and health-related quality of life was mediated by health-promoting behaviors and self-management behaviors (P<0.01).

These findings indicate that health-promoting behaviors and self-management behaviors can play a significant indirect role in reducing the negative effects of stressful events on health-related quality of life. Strengthening positive psychological characteristics and reducing risky constructs, such as stress and its perception, as well as the development of intervention programs and their application, can help improve the health-related quality of life among diabetic patients.