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The role of religious coping and social support on medication adherence and quality of life among the elderly with type 2 diabetes

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Abstract

Purpose

Type 2 diabetes is a major public health issue particularly in the elderly. Religion may affect the Health Related Quality of Life (HRQoL) in such patients, mediated by factors such as religious coping and social support. This study aimed to investigate the impact of religiosity on medication adherence and HRQoL.

Methods

793 adults (> 65 years old, 45% females) were recruited from 4 diabetes care centers and followed for 1 year. Duke University Religion Index, Spiritual Coping Strategies, Multidimensional Perceived Social Support, Medication Adherence Report Scale, WHOQOL-BREF and Diabetes-specific Quality of Life Questionnaire Module were used for assessment, as well as HbA1c and fasting blood glucose level. Using structural equation modeling, the potential paths were tested between religiosity, medication adherence and HRQoL; social support, religious coping and medication adherence served as the mediators.

Results

Religious coping and social support were recognized as the significant mediators between religiosity and medication adherence (CFI = 0.983, TLI = 0.985, and RMSEA = 0.021). The relationships between religiosity and HRQoL were considerably mediated by social support, religious coping and medication adherence and these variables explained 12% and 33% of variances of generic and specific HRQoL, respectively. There was no significant direct effect of religiosity on HRQoL. HbA1c and fasting blood glucose level were successfully loaded on the latent construct of medication adherence (factor loading = 0.51 and 0.44, respectively).

Conclusions

The impact of religiosity on medication adherence and HRQoL occurs through the mediators such as religious coping and social support. Therefore, to improve the adherence to treatment and quality of life, interventions may be designed based on these mediators.

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Acknowledgements

The authors would like to thank the managers and staff at the diabetes care centers for providing the facilities for data collection. This research received no specific Grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

    Mohsen Saffari

  2. Health Education and Promotion Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran

    Mohsen Saffari

  3. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong

    Chung-Ying Lin

  4. School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW, Australia

    Hui Chen

  5. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahonar Blvd, 3419759811, Qazvin, Iran

    Amir H. Pakpour

  6. Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden

    Amir H. Pakpour

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  1. Mohsen Saffari
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Correspondence to Amir H. Pakpour.

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The study was approved by the Ethics Committee of the Qazvin University of Medical Sciences. All procedures involving human participants were in accordance with the ethical standards of the institutional and/or national research ethics committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Saffari, M., Lin, CY., Chen, H. et al. The role of religious coping and social support on medication adherence and quality of life among the elderly with type 2 diabetes. Qual Life Res 28, 2183–2193 (2019). https://doi.org/10.1007/s11136-019-02183-z

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