Background and Aims: The purpose of this study was to identify the role of neuroticism and psychological flexibility (PF) in quality of life (QOL) and chronic fatigue (CF) in patients with Type 2 Diabetes Mellitus (T2DM). Materials and Methods: We considered the all of the patients with T2DM over aged 30 years and living in the province of Hamadan, Iran in 2014 that were referred to the Hamadan Diabetes Center. A sample size of 170 patients was selected by the simple random sampling method. The measuring tools were completed by the patients. To test assumptions, the Pearson correlation and structural equation modeling were used. Results: The results showed that the correlation coefficient between neuroticism, with CF (r=0.579; p<0.001) and QOL (r=-0.242; p<0.001), and also correlation between PF and CF (r=0.287; p<0.001) are significant. There is no significant relationship between QOL and PF (r= -0.098; p=0.203). Structural equation modeling showed that neuroticism has a direct positive effect in CF (p<0.001) and a negative effect on QOL (p<0.001), and the PF has a significant direct effect on CF (p=0.014) and an indirect effect on QOL. The CF affects negatively on the QOL (p<0.001). Conclusion: It could be concluded that neuroticism and PF play important roles in QOL and CF and with effective intervention can help patients with diabetes to improve them QOL.
If the inline PDF is not rendering correctly, you can download the PDF file here.
1. Guariguata L Whiting DR Hambleton I Beagley J Linnenkamp U Shaw J. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract 103: 137-149 2014.
2. Shaw JE Sicree RA Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 87: 4-14 2010.
3. Haghdoost AA Rezazadeh Kermani M Sadghirad B Baradaran HR. Prevalence of type 2 diabetes in the Islamic Republic of Iran: systematic review and meta-analysis. East Mediterr Health J 15: 591-599 2009.
4. Kiani J Goharifar H Moghimbeigi A Azizkhani H. Prevalence and risk factors of five most common upper extremity disorders in diabetics. Res Health Sci 14: 92-95 2014.
5. Ashwill J Droske S. Nursing care of children principles and practice. Philadelphia: W. B. Saunders Co. 2001.
6. WHO QOL Group. Development of the WHO QOL: Rationale and current status. Int J Mental Health 23:24-56 1994.
7. Kuznetsov L Long GH Griffin SJ Simmons RK. Are changes in glycaemic control associated with diabetes‐specific QOL and health status in screen‐detected type 2 diabetes patients? Four‐year follow up of the addition‐Cambridge cohort. Diabet Metab Res Rev 31: 69-75 2015.
8. Low LL Tong SF Low WY. Mixed feelings about the diagnosis of type 2 diabetes mellitus: a consequence of adjusting to health related quality of life. Coll Antropol 38: 11-20 2014.
9. Fritschi C Quinn L.Fatigue in patients with diabetes: a review. J Psychosom Res 69: 33-41 2010.
10. Rosenthal TC Majeroni BA Pretorius R Malik K. Fatigue: an overview. Am Fam Physician 78: 1173-1179 2008.
11. Ranjith G. Epidemiology of chronic fatigue syndrome. Occup Med (Lond) 55: 13-19 2005.
12. Bates DW Schmitt W Buchwald D et al. Prevalence of fatigue and CF syndrome in a primary care practice. Arch Int Med 153: 2759-2765 1993.
13. Park H Park C Quinn L Fritschi C. Glucose control and fatigue in type 2 diabetes: the mediating roles of diabetes symptoms and distress. J Adv Nurs 71: 1650- 1660 2015.
14. Wicksell RK Kanstrup M Kemani MK et al. Acceptance and commitment therapy for children and adolescents with physical health concerns. Curr Opin Psychol 2: 1-5 2015.
15. Hayes SC Strosahl KD Wilson KG. Acceptance and Commitment Therapy: The process and practice of mindful change (2nd ed.). New York: The Guilford Press 2011.
16. Hayes SC Strosahl KD Bunting K et al. What is acceptance and commitment therapy?. In A practical guide to acceptance and commitment therapy (pp. 3-29). Springer US 2004.
17. Bond FW Hayes SC Baer RA et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological inflexibility and experiential avoidance. Behav Ther 42: 676-688 2011.
18. Kashdan TB Rottenberg J. Psychological flexibility as a fundamental aspect of health. Clin Psychol Rev 30: 865-878 2010.
19. Hayes SC Luoma JB Bond FW Masuda A Lillis J. Acceptance and commitment therapy: Model processes and outcomes. Behav Res Ther 44: 1-25 2006.
20. Vowles KE McCracken LM. Acceptance and values-based action in chronic pain: a study of treatment effectiveness and process. J Consult Clin Psychol 76: 397- 407 2008.
21. Lillis J Kendra KE. Acceptance and Commitment Therapy for weight control: Model evidence and future directions. J Contextual Behav Sci 3: 1-7 2014.
22. Feinstein AB Forman EM Masuda A et al. Pain intensity psychological inflexibility and acceptance of pain as predictors of functioning in adolescents with juvenile idiopathic arthritis: a preliminary investigation. J Clin Psychol Med Settings 18: 291-298 2011.
23. McCrae RR Costa PT. Validation of the fivefactor model of personality across instruments and observers. J Pers Soc Psychol 52: 81-90 1987.
24. Lai BP Tang CS Chung TK. A prospective longitudinal study investigating neuroticism and mastery as predictors of quality of life among Chinese gynecologic cancer survivors. Qual Life Res 19: 931-941 2010.
25. Uliaszek AA Zinbarg RE Mineka S et al. The role of neuroticism and extraversion in the stress-anxiety and stress-depression relationships. Anxiety Stress Coping 23: 363-381 2010.
26. Dubayova T Nagyova I Havlikova E et al. Neuroticism and extraversion in association with quality of life in patients with Parkinson’s disease. Qual Life Res 18: 33-42 2009.
27. Poppe C Petrovic M Vogelaers D Crombez G. Cognitive behavior therapy in patients with chronic fatigue syndrome: of The role illness acceptance and neuroticism. J Psychosom Res 74: 367-372 2013.
28. Paulus DJ Vanwoerden S Norton PJ Sharp C. From neuroticism to anxiety: Examining unique contributions of three transdiagnostic vulnerability factors. Personality and Individual Differences 94: 38-43 2016.
29. Ware Jr JE Sherbourne CD. The MOS 36- item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care 30: 473-483 1992.
30. Montazeri A Goshtasebi A Vahdaninia M Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual Life Res 14: 875-882 2005.
31. Nazari F Shahreza MS Shaygannejad V Valiani M. Comparing the effects of reflexology and relaxation on fatigue in women with multiple sclerosis. Iran J Nurs Midwifery Res 20: 200 2015.
32. Eysenck HJ. Manual of the Eysenck personality scales (EPS Adult) 1991.
33. Alexopoulos DS Kalaitzidis I. Psychometric properties of eysenck personality questionnaire-revised (EPQ-R) short scale in greece. Personal Individ Diff 37: 1205-1220 2004.
34. Hayes SC Pistorello J Levin ME. Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist 40: 976-1002 2012.
35. Palladino CL Ange B Richardson DS et al. Measuring psychological flexibility in medical students and residents: a psychometric analysis. Med Educ Online 18: 20932 2013.
36. Gloster AT Klotsche J Chaker S Hummel KV Hoyer J. Assessing psychological flexibility: What does it add above and beyond existing constructs? Psychol Assess 23: 970-982 2011.
37. Abasi E Fti L Molodi R Zarabi H. Psychometric properties of Persian Version of Acceptance and Action Questionnaire-II. Scientific Journal Management System 2: 65-80 2013.
38. Trompetter HR Ten Klooster PM Schreurs KM et al. Measuring values and committed action with the Engaged Living Scale (ELS): Psychometric evaluation in a nonclinical sample and a chronic pain sample. Psychol Assess 25: 1235-1246 2013.
39. Neuser NJ. Examining the factors of mindfulness: a confirmatory factor analysis of the five facet mindfulness questionnaire. School of Professional Psychology Thesis 128 2010. Accessed at http://commons.pacificu.edu/spp/128
40. Park T Reilly-Spong M Gross CR. Mindfulness: a systematic review of instruments to measure an emergent patient-reported outcome (PRO). Qual Life Res 22: 2639-2659 2013.
41. Gillanders DT Bolderston H Bond FW et al. The development and initial validation of the Cognitive Fusion Questionnaire. Behav Ther 45: 83-101 2014.
42. Hooper D Coughlan J Mullen M. Structural equation modelling: Guidelines for determining model fit. The Electronic Journal of Business Research Methods 6: 53-60 2008.
43. Kiani J Habibi Z Tajziehchi A Moghimbeigi A Dehghan A Azizkhani H. Association between serum uric acid level and diabetic peripheral neuropathy (A case control study). Caspian J Intern Med 5: 17-21 2014.
44. Kiani J Moghimbeigi A Azizkhani H Kosarifard S. The prevalence and associated risk factors of peripheral diabetic neuropathy in Hamedan Iran. Arch Iran Med 16: 17-19 2013.
45. Lahey BB. Public health significance of neuroticism. Am Psychol 64: 241-256 2009.
46. Valero S Sáez-Francàs N Calvo N et al. The role of neuroticism perfectionism and depression in CF syndrome. A structural equation modeling approach. Compr Psychiatry 54: 1061-1067 2013.
47. Calderwood C. The role of trait neuroticism in predicting subjective fatigue states (MSc dissertation Georgia Institute of Technology) 2009. Accessed at: https://smartech.gatech.edu/bitstream/handle/1853/31728/calderwood_charles_c_200912_mast.pdf;sequence=1
48. Nooyens AC Baan CA Spijkerman AM Verschuren WM. Type 2 diabetes and cognitive decline in middle-aged men and women the Doetinchem Cohort Study. Diabetes Care 33: 1964-1969 2010.
49. Long DM Hayes SC. Acceptance mindfulness and cognitive reappraisal as longitudinal predictors of depression and QOLin educators. Journal of Contextual Behavioral Science 3: 38-442014.
50. Moghimbeigi A Eshraghian MR Mohammad K et al. Determinants number of cigarette smoked with Iranian adolescents: A multilevel zero inflated Poisson regression model. Iran J Publ Health 38: 91-96 2009.
51. Hosseini S Moghimbeigi A Roshanaei G Momeniarbat F. Evaluation of Drug Abuse Relapse Event Rate Over Time in Frailty Model. Osong Public Health Res Perspect 5: 92-95 2014 .
52. Sáez-Francàs N Valero S Calvo N et al. Chronic fatigue syndrome and personality: A case-control study using the alternative five factor model. Psychiatry Res 216: 373-378 2014.
53. Winger A Kvarstein G Wyller VB et al. Health related quality of life in adolescents with chronic fatigue syndrome: a cross-sectional study. Health Qual Life Outcomes 13: 1 2015.
54. Kahleova H Hrachovinova T Hill M Pelikanova T. Vegetarian diet in type 2 diabetes- improvement in quality of life mood and eating behaviour. Diabet Med 30: 127-129 2013.
55. Ciarrochi J Bilich L Godsell C. Psychological flexibility as a mechanism of change in acceptance and commitment therapy. In: Assessing mindfulness and acceptance processes in clients: Illuminating the theory and practice of change. Baer R (Ed) New Harbinger Publications pp. 51-75 2010.
56. Mohammadfam I Moghimbeigi A. Evaluation of injuries among a manufacturing industry staff in Iran. J Res Health Sci 9: 7-12 2009.
57. Karimi N Moghimbeigi A Motamedzade M Roshanaei G. Evaluation of related risk factors in number of musculoskeletal disorders among carpet weavers in Iran. Saf Health Work 7: 322-325 2016.