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Parisa Janjani1 
, Khodamorad Momeni2 , Amir Shini3 , Sarira Daniali4 , Mohammad Reza Majzoobi5 , Parisa Nosrati *6
, Khodamorad Momeni2 , Amir Shini3 , Sarira Daniali4 , Mohammad Reza Majzoobi5 , Parisa Nosrati *6
1- Cardiovascular Research Center, Health Policy and Promotion Institute, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
2- Department of Psychology, Faculty of Social Sciences, Razi University, Kermanshah, Iran.
3- Department of Speech Therapy, School of Rehabilitation Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.
4- Cardiovascular Research Center, Health Policy and Promotion Institute, Imam Ali Hospital,Kermanshah University of Medical Sciences, Kermanshah, Iran
5- Institute of Psychology, Siegen University, Westphalia, Germany
6- Cardiovascular Research Center, Health Policy and Promotion Institute, Imam Ali Hospital,Kermanshah University of Medical Sciences, Kermanshah, Iran ,parisanosrati77@yahoo.com
2- Department of Psychology, Faculty of Social Sciences, Razi University, Kermanshah, Iran.
3- Department of Speech Therapy, School of Rehabilitation Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.
4- Cardiovascular Research Center, Health Policy and Promotion Institute, Imam Ali Hospital,Kermanshah University of Medical Sciences, Kermanshah, Iran
5- Institute of Psychology, Siegen University, Westphalia, Germany
6- Cardiovascular Research Center, Health Policy and Promotion Institute, Imam Ali Hospital,Kermanshah University of Medical Sciences, Kermanshah, Iran ,
Abstract: (31 Views)
Objectives: Cardiovascular diseases are among the leading causes of mortality in older adults, and treatment adherence plays a critical role in managing and improving these conditions. Psychological factors such as perceived social support and self-compassion may significantly influence adherence levels. Coping strategies, as psychological mechanisms, may mediate this relationship. Therefore, the present study was conducted to examine the relationship between perceived social support and self-compassion with treatment adherence, mediated by coping strategies, in older adults with cardiovascular disease.
Materials and Methods: This descriptive-correlational study employed structural equation modeling (SEM). The study population included older adults with stable coronary artery disease referred to Imam Ali Hospital in kermanshah in 2024, from which 242 participants were selected as the sample through convenience sampling. Research instruments included the Multidimensional Scale of Perceived Social Support (Zimet et al., 1988), the Self-Compassion Scale–Short Form (Raes et al., 2011), the Coping Inventory for Stressful Situations–Short Form (Endler & Parker, 1990), and the Treatment Adherence Questionnaire (Modanloo, 2013). After obtaining ethical approvals, trained interviewers collected data from eligible participants while ensuring confidentiality and adherence to ethical standards. Data analysis was conducted using SPSS version 26 and AMOS version 24.
Results: Path analysis revealed that perceived social support (β=0.19, p<0.001) and self-compassion (β=0.38, p<0.001) had significant direct effects on treatment adherence. Perceived social support was positively associated with problem-focused coping (β=0.43, p<0.001) and negatively associated with emotion-focused (β=−0.40, p<0.001) and avoidance coping strategies (β=−0.26, p<0.001). Similarly, self-compassion was positively related to problem-focused coping (β=0.34, p<0.001) and negatively related to emotion-focused (β=−0.45, p<0.001) and avoidance coping (β=−0.68, p<0.001). In the final model, problem-focused coping positively predicted treatment adherence (β=0.10, p<0.001), while emotion-focused (β=−0.31, p<0.001) and avoidance coping (β=−0.46, p<0.001) had significant negative effects. Sobel’s test confirmed the mediating role of coping strategies in the relationship between perceived social support and self-compassion with treatment adherence, with significant indirect paths via problem-focused (z=3.18, p<0.001), emotion-focused (z=2.21, p<0.001), and avoidance coping (z=2.05, p<0.001) for perceived social support, and via problem-focused (z=2.57, p<0.001), emotion-focused (z=1.96, p<0.001), and avoidance coping (z=2.01, p<0.001) for self-compassion.
Conclusion: The findings underscore the importance of perceived social support and self-compassion in promoting treatment adherence among older adults with cardiovascular disease. These effects are both direct and mediated through coping strategies. Problem-focused coping emerged as a positive mediator, while emotion-focused and avoidance coping acted as negative mediators. These results highlight the need to address psychological and social dimensions in treatment planning and support the development of psychotherapeutic and educational interventions aimed at improving adherence in this clinical population.
Materials and Methods: This descriptive-correlational study employed structural equation modeling (SEM). The study population included older adults with stable coronary artery disease referred to Imam Ali Hospital in kermanshah in 2024, from which 242 participants were selected as the sample through convenience sampling. Research instruments included the Multidimensional Scale of Perceived Social Support (Zimet et al., 1988), the Self-Compassion Scale–Short Form (Raes et al., 2011), the Coping Inventory for Stressful Situations–Short Form (Endler & Parker, 1990), and the Treatment Adherence Questionnaire (Modanloo, 2013). After obtaining ethical approvals, trained interviewers collected data from eligible participants while ensuring confidentiality and adherence to ethical standards. Data analysis was conducted using SPSS version 26 and AMOS version 24.
Results: Path analysis revealed that perceived social support (β=0.19, p<0.001) and self-compassion (β=0.38, p<0.001) had significant direct effects on treatment adherence. Perceived social support was positively associated with problem-focused coping (β=0.43, p<0.001) and negatively associated with emotion-focused (β=−0.40, p<0.001) and avoidance coping strategies (β=−0.26, p<0.001). Similarly, self-compassion was positively related to problem-focused coping (β=0.34, p<0.001) and negatively related to emotion-focused (β=−0.45, p<0.001) and avoidance coping (β=−0.68, p<0.001). In the final model, problem-focused coping positively predicted treatment adherence (β=0.10, p<0.001), while emotion-focused (β=−0.31, p<0.001) and avoidance coping (β=−0.46, p<0.001) had significant negative effects. Sobel’s test confirmed the mediating role of coping strategies in the relationship between perceived social support and self-compassion with treatment adherence, with significant indirect paths via problem-focused (z=3.18, p<0.001), emotion-focused (z=2.21, p<0.001), and avoidance coping (z=2.05, p<0.001) for perceived social support, and via problem-focused (z=2.57, p<0.001), emotion-focused (z=1.96, p<0.001), and avoidance coping (z=2.01, p<0.001) for self-compassion.
Conclusion: The findings underscore the importance of perceived social support and self-compassion in promoting treatment adherence among older adults with cardiovascular disease. These effects are both direct and mediated through coping strategies. Problem-focused coping emerged as a positive mediator, while emotion-focused and avoidance coping acted as negative mediators. These results highlight the need to address psychological and social dimensions in treatment planning and support the development of psychotherapeutic and educational interventions aimed at improving adherence in this clinical population.
Keywords: Coping Skills, Social Support, Self-Compassion, Treatment Adherence, Cardiovascular Disease, Aged
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