Structural Model of the Effect of Spiritual Health and Social Support on Self-care Behavior of Cardiovascular Patients Concerning the Mediating Role of Psychological Capital

Heart disease affects various aspects of quality of life, including physical, emotional, social, and functional health. However, some factors can improve the quality of cardiovascular patients' personal, occupational, and social life by improving their lifestyle, one of which is the adoption of self–care behaviors by patients. Self–care is not meant to replace professional and organizational care but should be seen as a complement. It plays a crucial role in determining the extent and manner in which it is utilized. The present study aimed to test the structural relationship between spiritual health and social support with self–care behaviors by studying the mediating role of psychological capital.

The present study was correlational using a path analysis model. The study's statistical population consisted of all cardiovascular patients referred to medical centers in Qom City, Iran. Of whom 200 people were selected by convenience sampling. In determining the sample size, in modeling research, 10 to 15 people are needed for each obvious variable, and based on the available variables, 200 people were selected by purposive sampling. After randomly determining the target centers (through lottery) and obtaining the necessary permits from the university, the researchers attended the medical centers and explained the research objectives. Then, they obtained the informed consent of the sample members to participate in the research. Finally, the samples were selected, and after explaining the objectives of the study and the method of answering the questions, they were asked to answer the Psychological Capital Questionnaire (Lutans and Jensen, 2007), the Multidimensional Perceived Social Support Scale (Zimmet et al., 1988), the Spiritual Health Questionnaire (Ellison, 1983), and the European Questionnaire to complete self–care behavior in patients with heart failure (Jarasma et al., 2003). Data analysis was performed using the Pearson correlation method and path analysis model in AMOS.22 and SPSS.22 software. The significance level of the tests in this study was considered 0.05.

The results showed that social support (β=0.17, p=0.013) and spiritual health (β=0.21 and p=0.002) had a direct effect on psychological capital. Social support (β=0.19, p=0.006) and spiritual health (β=0.15 and p=0.025) had a direct effect on caring behavior. Psychological capital (β=0.17 and p=0.013) had a direct effect on caring behavior. The calculated goodness of fit indicators of the relationship between social support, mental capital, spiritual health, and self–care behaviors showed that mental capital mediated the relationship between spiritual health and social support with self–care behaviors (RMSEA=0.067, AGFI=0.98).

The results showed that perceived social support, while having a direct and significant relationship with caring behavior in cardiovascular patients, indirectly improves their caring behavior by increasing the psychological capital of these patients.