quality of life

Objective: Musculoskeletal diseases are among the most common and costly illnesses across all age groups and various communities, leading to disability, incapacity, early retirement, and job loss. The present study aimed to develop a structural model of quality of life based on resilience with the mediation of perceived stress in women with rheumatoid arthritis. Methods: The research method was descriptive-survey with a structural equation modeling design. The statistical population included women with rheumatoid arthritis in the city of Isfahan. The women with rheumatoid arthritis referred to medical centers in Isfahan had at least one year of disease history. Data were collected using the Varni-Kazisnki and Keller Quality of Life Questionnaire (1996), the Connor-Davidson Resilience Scale, Antonovsky’s Sense of Coherence Questionnaire (1993), Cohen, Kamarck, and Mermelstein’s Perceived Stress Questionnaire (1983), and the Gratz and Roemer Emotion Regulation Difficulty Scale (2004). Data were analyzed using structural equation modeling and Amos26 software. Findings: The results showed that the direct effect of resilience on the quality of life of patients with rheumatoid arthritis was significant (β = 0.25; P < 0.01). The indirect effect of resilience through the mediation of perceived stress on the quality of life of patients with rheumatoid arthritis was significant (β = 0.16; P < 0.01). Additionally, the total effect of resilience through the mediation of perceived stress on quality of life was significant (β = 0.41; P < 0.01). Conclusion: It can be concluded that the structural model of quality of life based on resilience with the mediation of perceived stress was well-fitted, and perceived stress played a mediating role in the relationship between quality of life and resilience in women with rheumatoid arthritis.

Objective: The aim of the present study was to explain the structural model of quality of life based on early maladaptive schemas and the mediating role of self-care in women with type 2 diabetes. Methods: This research is classified as descriptive-correlational using structural equation modeling. The statistical population included all women with type 2 diabetes in Tehran who visited healthcare centers during 2021. The sample comprised 350 women with type 2 diabetes in Tehran in 2021, selected through convenience sampling based on inclusion and exclusion criteria. Data were collected using the World Health Organization Quality of Life Brief Questionnaire, the Young Schema Questionnaire-Short Form, and the Diabetes Self-Care Activities Questionnaire. Data were analyzed using structural equation modeling and Pearson correlation statistical methods with SPSS.22 and AMOS.22 software. Findings: The results showed the fit indices were PCFI=0.655, PNFI=0.661, CMIN/DF=2.90, RMSEA=0.089, IFI=0.917, CFI=0.914, and GFI=0.903, indicating a good fit of the proposed model with the data. The highest coefficient (-0.47) was attributed to the pathway from the domain of impaired autonomy and performance to quality of life. Conclusion: The coefficient of determination for the quality of marital relationship variable in the proposed structural model was 0.889, indicating that exogenous variables could predict 89% of the variations in quality of life, which is a strong prediction.

Objective: The present study aimed to design an educational package based on Motivational Interviewing, Acceptance and Commitment Therapy, and Compassion-Focused Therapy and evaluate its effectiveness on alexithymia and quality of life in patients with Multiple Sclerosis (MS) in Tehran. Method: This study employed a quasi-experimental design with a control group and pre-test, post-test, and follow-up assessments. Forty women with MS, who visited the MS Association in Tehran Province from October to February 2021, were selected based on research criteria through purposive sampling and were randomly assigned to two groups (using a random number table). After random assignment, one of the groups was randomly designated as the experimental group, receiving the researcher-developed integrative treatment package, and the other as the control group (n=20). The data collection tools included a demographic information questionnaire, the Toronto Alexithymia Scale (Bagby, Taylor, & Parker, 1994), and the Multiple Sclerosis Quality of Life-54 Instrument (Ware et al., 1988). Data were collected at three stages: baseline, post-intervention, and three-month follow-up. The research hypotheses were analyzed using repeated measures ANOVA and Bonferroni post hoc tests. Findings: The results of this study indicated that the educational package based on Motivational Interviewing, Acceptance and Commitment Therapy, and Compassion-Focused Therapy significantly improved alexithymia (F=24.31, P<0.001) and quality of life (F=22.67, P<0.001) in women with MS. Conclusion: It can be concluded that the educational package based on Motivational Interviewing, Acceptance and Commitment Therapy, and Compassion-Focused Therapy is effective in improving alexithymia and quality of life in women with MS.

Objective: This study aimed to compare the effectiveness of resilience training and acceptance and commitment group training on improving quality of life in male students from divorced families, while controlling for age at the time of parental divorce and the duration since the divorce. Methods and Materials: This quasi-experimental study was conducted on 90 male students in grades 5 to 9 from Kouhchenar County, whose parents were divorced. Participants were selected using convenience sampling from six schools with the highest prevalence of students from divorced families and were randomly assigned to three groups: resilience training (n = 30), acceptance and commitment training (n = 30), and control (n = 30). The interventions included ten 50-minute weekly sessions based on Kruger’s (2006) resilience protocol and eight weekly sessions based on Hayes and Rose’s (2008) ACT protocol. All participants completed the WHOQOL-BREF before the intervention, immediately after, and at a one-month follow-up. Data were analyzed using repeated measures ANOVA and MANCOVA while adjusting for confounding variables. Findings: Significant improvements were observed in all four domains of quality of life—physical health, psychological health, social relationships, and environmental health—in both intervention groups across time (p < 0.001). The time × group interaction effect was also significant for all components (p < 0.001). Between-subjects analysis showed significant differences in posttest mean scores among the three groups (p < 0.001), and Bonferroni post hoc comparisons confirmed that both experimental groups outperformed the control group (p < 0.001), with the ACT group showing significantly greater improvements than the resilience group in all domains (p < 0.001). Conclusion: Both resilience training and ACT-based group training effectively enhanced the quality of life of students from divorced families; however, ACT demonstrated superior and more sustained improvements. These findings highlight the potential of ACT as a preferred school-based intervention for adolescents coping with familial disruption.