The Mediating Role of Emotion Regulation in the Relationship between Corona Disease Anxiety and Health-Related Quality of Life in Students

Document Type : Research Paper

Authors

Department of Psychology, Faculty of Literature and Humanities, University of Guilan, Rasht, Iran.

Abstract

The primary objective of this research was to ascertain the extent to which emotion regulation acts as a mediator between covid-19 anxiety and students' HRQoL. A descriptive cross-sectional study was conducted in Guilan province in the winter of 2021, involving 18,000 students. A total of 369 students wer​e selected at random and provided their responses voluntarily on three scales: the Health Survey Questionnaire (SF-36), the Emotion Regulation Skills Questionnaire (ERSQ), and the online-adjusted Corona Disease Anxiety Scale (CDAS). The AMOS-24 software was utilized to conduct the data processing, employing the Pearson correlation coefficient and SEM technique. A statistically significant negative relationship was observed between anxiety related to the coronavirus and both HRQoL and emotion. A good fit was obtained by the mediator model (CFI = 0.944, RMSEA = 0.074). The results of the bootstrap analysis conducted using the MACRO program of SPSS-24 software indicate that there is no significant mediating effect of emotion regulation on the relationship between corona disease anxiety and HRQoL (p = 0.1998). The findings suggest that the important role of anxiety on HRQoL be considered and therapists and those in charge of macro-health policies put on the agenda the implementation of enterprises in the face with health conditions, the issue of coping with anxiety in their outcomes.

Keywords


منابع
اصغری‌مقدم، م. ع.، و فقیهی، س. (1382). اعتبار و پایایی پرسشنامۀ زمینه‌یابی سلامت (فرم کوتاه 36 سؤالی) در دو نمونۀ ایرانی. دانشور رفتار. 10(1)، 10-1. https://cpap.shahed.ac.ir/article_2770.html
علی‌پور، ا.، قدمی، ا.، علی‌پور، ز.، و عبداله‌زاده، ح. (1398). اعتباریابی مقدماتی مقیاس اضطراب بیماری کرونا (CDAS) در نمونۀ ایرانی. فصلنامۀ روان‌شناسی سلامت. 8(4)، 175-163. https://doi.org/10.30473/hpj.2020.52023.4756
عینی، س.، عبادی، م.، و ترابی، ن. (1399). تدوین مدل اضطراب کرونا در دانشجویان براساس حس انسجام و تاب‌آوری: نقش میانجی حمایت اجتماعی ادراک‌شده. فرهنگ مشاوره و روان‌درمانی. 11(43)، 32-1. https://doi.org/10.22054/qccpc.2020.51656.2376
رضائی، س.، ثامنی، آ.، و زبردست، ع. (1399). تأثیر قرنطینۀ خانگی ناشی از پاندمی بیماری کووید-19 بر استرس والدین و رابطۀ آن با اضطراب و افسردگی کودکان گیلانی. مجلۀ روان‌پزشکی و روان‌شناسی بالینی ایران. 26(3)، 293-280. http://dx.doi.org/10.32598/ijpcp.26.3402.1
زبردست، ع.، بشارت، م. ع.، پورحسین، ر.، بهرامی احسان، ه‍.، و پورشریفی، ح. (1394). مقایسۀ اثربخشی درمان روابط بین‌شخصی و مدیریت هیجانی در کاهش وزن زنان چاق و دارای اضافه‌وزن. فصلنامۀ روان‌شناسی سلامت. 4(15)، 74-49. https://hpj.journals.pnu.ac.ir/article_1986.html
زبردست، ع.، رضائی، س.، و شریف‌نیا، م. (1400). نقش میانجی خودشفقت‌ورزی در رابطۀ میان حمایت اجتماعی ادراک‌شده و تأثیر رویداد قرنطینۀ اجباری خانگی مبتلایان به کووید- 19. پژوهش‌های کاربردی روان‌شناختی. 12(2)، 228-211.  https://doi.org/10.22059/japr.2021.319681.643770
References
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: a meta-analytic review. Clinical Psychology Review, 30, 217-237. http://dx.doi.org/10.1016/j.cpr.2009.11.004
Alinia, C., Yaghmaei, S., Zahir Abdullah, F., Ahmadi, A., Samadi, N., Pourteimour, S., … & Pirooz, B. (2021). The health-related quality of life in Iranian patients with COVID-19. BMC Infectious Diseases, 21, 459. https://doi.org/10.1186/s12879-021-06246-w
Alipour, A., Ghadami, A., Alipour, Z., & Abdollahzadeh, H. (2020). Preliminary validation of the Corona Disease Anxiety Scale (CDAS) in the Iranian sample. Health Psychology8(32), 163-175. https://doi.org/10.30473/hpj.2020.52023.4756 (In Persian)
Andrea, S., Rafaela, C., Klein, M.F., & Sousa, C.T. (2016). Relationship among stress, depression, cardiovascular and metabolic changes and physical exercise. Fisioterapia em Movimento, 29, 23–36. https://doi.org/10.1590/0103-5150.029.001.AO02
Arab-Zozani, M., Hashemi, F., Safari, H., Yousefi, M., & Ameri, H. (2020). Health-related quality of life and its associated factors in COVID-19 patients. Osong Public Health and Research Perspectives, 11(5), 296-302. https://doi.org/10.24171/j.phrp.2020.11.5.05
Asghari Moghaddam, M., & Faghihi, S. (2003). Validity of the SF-36 Health Survey Questionnaire in Two Iranian Samples. Clinical Psychology and Personality1(1), 1-10. https://cpap.shahed.ac.ir/article_2770.html?lang=en (In Persian)
Bajema, K. L., Oster, A. M., & McGovern, O. L. (2020). Persons evaluated for 2019 novel Coronavirus —United States. Morbidity and Mortality Weekly Report, 16(6), 166-170. https://stacks.cdc.gov/view/cdc/84956
Berking, M., & Znoj, H. (2008). Development and validation of a self-report measure for the assessment of emotion-regulation skills. Journal of Psychiatric, Psychology and Psychotherapy, 56, 141–152. https://doi.org/10.1024/1661-4747.56.2.141
Blanco, I., Boemo, T., & Sanchez-Lopez, A. (2022). The role of cognitive biases and emotion regulation strategies when facing major stressors: ecological evidence during the COVID-19 lockdown of 2020 using a novel online cognitive bias assessment. JMIR Mental Health, 30961, 1-29. https://doi.org/10.2196/30961
Chen, X., Xu, Q., Lin, H., Zhu, J., Chen, Y., Zhao, Q., Fu, C., & Wang, N. (2021). Quality of life during the epidemic of COVID-19 and its associated factors among enterprise workers in East China. BMC Public Health, 21, 1370. https://doi.org/10.1186/s12889-021-11414-3
Eyni, S., Ebadi, M., & Torabi, N. (2020). Developing a model of corona anxiety in students based on optimism and resilience: the mediating role of the perceived social support. Ebnesina - IRIAF Health Administration, 22(1), 17-29. https://doi.org/10.22054/qccpc.2020.51656.2376 (In Persian)
Franceschini, C., Musetti, A., Zenesini, C., Palagini, L., Scarpelli, S., Quattropani, M. C., ... & Castelnuovo, G. (2020). Poor sleep quality and its consequences on mental health during the COVID-19 lockdown in Italy. Frontiers Psychology, 11, 574475. https://doi.org/10.3389/fpsyg.2020.574475
Kim, J. H., Shim, Y., Choi1, I., & Choi, E. (2022). The Role of coping strategies in maintaining well-being during the COVID-19 outbreak in South Korea. Social Psychological and Personality Science, 13(1), 320–332. https://doi.org/10.1177/1948550621990595
Kline, R. (2016). Principles and practice of structural equation modeling (4th ed., pp. 64-96). New York, NY: Guilford.
Laslo‐Roth, R., George‐Levi, S., & Margalit, M. (2020). Social participation and posttraumatic growth: The serial mediation of hope, social support, and reappraisal. Journal of Community Psychology, 50, 47–63. https://doi.org/10.1002/jcop.22490
Lenzo, V., Quattropani, M. C., Musetti, A., Zenesini, C., Freda, M. F., Lemmo, D., ... & Feranceschini, C. (2020). Resilience contributes to low emotional impact of the COVID 19 outbreak among the general population in Italy. Frontiers Psychology, 11, 576485. https://doi.org/10.3389/fpsyg.2020.576485
Meyers, L. S., Gamst, G., & Guarino, A. J. (2012). Applied Multivariate Research: Design and Interpretation. SAGE Publications.
Montazeri, A., Goshtasebi, A., Vahdaninia, M., & Gandek, B. (2005). The short form Health Survey (SF-36): Translation and validation study of the Iranian version. Quality of Life Research, 14, 875-82. https://doi.org/10.1007/s11136-004-1014-5
Mueller, O. (1996). Basic Principles of Structural Equation Modeling. New York: Springer Verlag.
Nayak, P., Kumaran, S. D., Babu, A. S., Maiya, A. G., & Solomon, J. M. (2019). Levels of physical activity and quality of life among community dwelling adults with stroke in a developing country. European Journal of Physiotherapy, 23(3), 165–70. https://doi.org/10.1080/21679169.2019.1663927
Nguyen, H. C., Nguyen, M. H., Do, B. N., Tran, C. Q., Nguyen, T. T. P., Pham, K. M., … & Duong, T. V. (2020). People with suspected COVID-19 symptoms were more likely depressed and had lower health-related quality of life: the potential benefit of health literacy. Journal of Clinical Medicine, 9(4), 965. https://doi.org/10.3390/jcm9040965
O'Connor, D., Thayer, F., & Vedhara, V. (2021). Stress and Health: A Review of Psychobiological Processes. Annual Review of Psychology, 72(1), 663-688. https://doi.org/10.1146/annurev-psych-062520-122331
Panayiotou, G., Panteli, M., & Leonidou, C. (2021). Coping with the invisible enemy: The role of emotion regulation and awareness in quality of life during the COVID-19 pandemic. Journal of Contextual Behavioral Science, 19, 17–27. https://doi.org/10.1016/j.jcbs.2020.11.002
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879-91. https://doi.org/10.3758/BRM.40.3.879
Qi, M., Li, P., Moyle, W., Weeks, B., & Jones, C. (2020). Physical activity, health-related quality of life, and stress among the Chinese adult population during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 17(18), 6494. https://doi.org/10.3390/ijerph17186494
Rezaei, S., Sameni Toosarvandani, A., & Zebardast, A. (2020). Effect of COVID-19-induced home quarantine on parental stress and its relationship with anxiety and depression among children in Guilan Province. Iranian Journal of Psychiatry and Clinical Psychology, 26(3), 280-293. http://dx.doi.org/10.32598/ijpcp.26.3402.1 (In Persian)
Sardella, A., Lenzo, V., Bonanno, G. A., Basile, G., & Quattropani, M. C. (2021). Expressive flexibility and dispositional optimism contribute to the elderly’s resilience and health-related quality of life during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 18(4), 1698. https://doi.org/10.3390/ijerph18041698
Teo, T., & Noyes, J. (2014). Explaining the intention to use technology among pre-service teachers: A multi-group analysis of the unified theory of acceptance and use of technology. Interactive Learning Environments. 22(1), 51-66. https://doi.org/10.1080/10494820.2011.641674
Wang, X., Lei, S., Le, S., Yang, Y., Zhang, B., Yao, W., … & Cheng, S. (2020). Bidirectional influence of the COVID-19 pandemic lockdowns on health behaviors and quality of life among Chinese adults. International Journal of Environmental Research and Public Health, 17(15), 5575. https://doi.org/10.3390/ijerph17155575
Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-Item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483. https://pubmed.ncbi.nlm.nih.gov/1593914/
West, S. G., Finch, J. F., & Curran, P. J. (1995). Structural equations withnon-normal variables: Problems and remedies. In R. H. Hoyle (Ed.), Structural equation modeling: Issues and applications (pp. 56-75). Newbury Park, CA: Sage.
Wu, C., Cheng, J., Zou, J., Duan, L., & Campbell, J. E. (2021). Health-related quality of life of hospitalized COVID-19 survivors: An initial exploration in Nanning city, China. Social Science & Medicine, 274, 113748. https://doi.org/10.1016/j.socscimed.2021.113748
Zebardast, A., Besharat, M. A., Purhosein, R., Bahrami Ehsan, E., & Pursharifi, H. (2015). Comparing the Effects of Interpersonal Therapy and Regulation of Emotion on the Reduction of Weight in Obese Women. Journal of Guilan University of Medical Sciences, 24(94), 36-47. https://journal.gums.ac.ir/article-1-993-en.html (In Persian)
Zebardast, A., Rezaei, S., & Sharifnia, M. (2021). The mediating role of self-compassion in the relationship between perceived social support and the impact of home quarantine for patients with Covid-19. Journal of Applied Psychological Research12(2), 211-228. https://doi.org/10.22059/japr.2021.319681.643770 (In Persian)
Zhou, F., Liu, X., Shao, L., Zhang, R., Wei, Y., Li, J., … & Hong, X. (2020). Perceived social support and its impact on psychological status and quality of life of medical staffs after outbreak of SARSCoV-2 pneumonia: a cross-sectional study. Retrieved from: SSRN | ID: ppcovidwho-515. https://doi.org/10.2139/ssrn.3541127