Development of Structural Model of Salutogenic Health Indicators Based on Coping Resources and Stress Management Mediatedby Health Promoting Lifestyle in Police Patients with Irritable Bowel Syndrome

A large number of gastrointestinal diseases observed in the military may have serious effects on health. Most research on variables related to coping with irritable bowel syndrome has focused on the pathogenic perspective (risk factors such as life events) rather than the salutogenic perspective (factors such as coping and adaptation). In this study, the variables emphasized by the salutogenic perspective were used to develop a structural model for health indicators based on coping resources and stress management, mediated by a health-promoting lifestyle in police patients with irritable bowel syndrome.

This study was a correlation design of structural equation modeling. Police patients with irritable bowel syndrome were the statistical population of this study who referred to the gastrointestinal and psychiatric clinic of one of the police hospitals in 2020 and 2021. The statistical sample size was 250 people who were randomly selected from patients and were diagnosed with irritable bowel syndrome by a psychiatrist based on ROME-IV criteria. Research tools included the Bringsen Health Salutogenic Indicators Scale (Cronbach's alpha 0.81), Epstein Stress Management Questionnaire (Cronbach's original version 0.80 and translated version 0.94), Walker Health-Promoting Lifestyle Profile Questionnaire (Cronbach's alpha 0.82) and the Matheny Stress Coping Resources Questionnaire (Cronbach's alpha of the original version was 0.84 to 0.97 and the translated version was 0.94). Data were analyzed using SPSS 24 and SmartPLS-3 software by Pearson correlation test and structural equation path analysis.

Fitness indices as a result of testing the hypothetical model and the structural model showed the relationship between coping resources and stress management with lifestyle mediation on health indices which had desirable fitness. Path analysis of this model showed that in the direct path, the effect of stress management (λ=0.11; t=3.11; p=0.05), coping resources (λ=0.37; t=3.01; p=0.01) and healthpromoting lifestyle (λ=0.20; t=3.16; p=0.01) were significant on salutogenic health indices. In the indirect path, the lifestyle mediating model between stress management and coping resources with salutogenic health indicators was significant at the level of 0.05 and standard coefficient (0.11-0.13).

This study showed that a health-promoting lifestyle can positively and significantly mediate the relationship between coping resources and stress management with salutogenic health indicators in a selected sample of police patients referred to a police medical center.