مدل‌یابی ساختاری خودمراقبتی در بیماران مبتلا به بیماری عروق کرونر بر اساس روابط موضوعی و تیپ شخصیتی D: نقش میانجی موازی حمایت اجتماعی ادراک‌شده و ناگویی هیجانی

مجتبی  ربانی; رضا باقریان; حمیدرضا  نیک‌یار; حسن رضایی جمالویی

Authors

Mojtaba Rabani Department of Health Psychology, Na.C., Islamic Azad University, Najafabad, Iran Author https://orcid.org/0009-0003-1427-9356
Reza Bagherian Sararoudi Professor of Health Psychology, Department of Health psychology and Behavioral Sciences Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IRAN Author https://orcid.org/0000-0002-5965-4485
Hamidreza Nikyar Department of medicine. Clinical Research Development Center, Na.C., Islamic Azad University. Najafabad, Iran. Author https://orcid.org/0000-0001-6372-336X
Hasan Rezaei jamalouei Associate Professor Department of Health Psychology, Na.C., Islamic Azad University, Najafabad, Iran Author https://orcid.org/0000-0002-0338-0163

Keywords:

Self, care, coronary artery disease, thematic relations, personality type D, perceived social support, alexithymia, structural equation modeling

Abstract

Objective: This study aimed to test a structural model of self-care in patients with coronary artery disease based on object relations and Type D personality, with perceived social support and alexithymia as parallel mediators.

Methods and Materials: This applied, descriptive-correlational study employed partial least squares structural equation modeling. The statistical population consisted of patients with a confirmed diagnosis of coronary artery disease attending teaching hospitals affiliated with Isfahan University of Medical Sciences during the Iranian year 1403, from whom 243 patients were selected through systematic random sampling. Data were collected using the Self-Care Questionnaire, Object Relations Questionnaire, Type D Personality Scale, Multidimensional Scale of Perceived Social Support, and Toronto Alexithymia Scale. Data were analyzed using SPSS version 24 and SmartPLS version 3. Partial least squares structural equation modeling was used to examine the hypothesized structural relationships, and Sobel tests were applied to assess the significance of indirect effects. Statistical significance was set at p<0.05.

Findings: The structural model demonstrated acceptable fit (SRMR=0.060) and explained 52.5% of the variance in self-care. Type D personality negatively predicted perceived social support (β=-0.566, p<0.001) and self-care (β=-0.188, p=0.004), while positively predicting alexithymia (β=0.281, p=0.005). Object relations positively predicted perceived social support (β=0.285, p=0.003) and self-care (β=0.246, p=0.003) and negatively predicted alexithymia (β=-0.500, p<0.001). Perceived social support positively predicted self-care (β=0.257, p=0.001), whereas alexithymia negatively predicted self-care (β=-0.431, p<0.001). The specific indirect effects through both mediators were significant for Type D personality and object relations, confirming partial parallel mediation through perceived social support and alexithymia.

Conclusion: Self-care among patients with coronary artery disease is jointly influenced by personality characteristics, interpersonal representations, emotional processing capacity, and perceived social resources.

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