Structural model of health-related quality of life in diabetic patients based on mental well-being and quality of sleep mediated by self-care behaviors

Background: Diabetes has long-term complications, and therefore, affects the health of both the community and individual. Diabetes can have significant psychological effects on health and delay the recovery of the disease. Objectives: This study aimed to determine the causal model of health-related quality of life based on subjective well-being and sleep quality mediated by self-care behaviors in diabetic patients. Methods: This correlational study was conducted using the path analysis statistical method. The statistical population (n=195) included all middle-aged patients with diabetes referred to the endocrinologists of Bushehr Province, Iran, in 2019 and selected by the availability sampling method. The instrument used to collect data were questionnaires, namely a demographic form, the SF-36 Health-Related Quality of Life Questionnaire, Diabetes Self-Care Questionnaire, Pittsburgh Sleep Quality Questionnaire, and Mental Well-Being Scale. The data were analyzed in SPSS software (version 22) and Amos software (version 22) using the path analysis method. Results: The results showed that both the variables of sleep quality and mental well-being mediated by self-care had a direct and significant relationship with quality of life (P 0.001). The direct relationship between sleep quality and quality of life was not signifi- cant. However, there was a significant direct relationship between mental well-being and quality of life (P 0.001). Conclusion: It can be concluded that sleep quality and mental well-being affected the self-care that the patient selected and could predict the quality of life of diabetic patients.