Journal of Police Medicine

fa تدوین مدل ساختاری شاخص‌های سلامت سالوتوژنیک بر اساس منابع مقابله و مدیریت استرس با میانجی‌گری سبک زندگی ارتقاء‌دهنده سلامت در بیماران انتظامی مبتلا به سندرم روده تحریک‌پذیر Development of Structural Model of Salutogenic Health Indicators Based on Coping Resources and Stress Management Mediated by Health Promoting Lifestyle in Police Patients with Irritable Bowel Syndrome روان‌شناسی انتظامی Police Related Psychology پژوهشی اصيل Original Research <div style="text-align: justify;">اهداف: طیف گسترده‌ای از بیماری‌های گوارشی در نیروهای نظامی مشاهده می‌شود که تأثیرات جدی بر سلامتی ایشان دارد. بیشتر تحقیقات انجام‌شده در زمینه متغیرهای مربوط به سازگاری با سندرم روده تحریک‌پذیر، تمرکز بر دیدگاه پاتوژنیک (عوامل خطرساز مانند حوادث زندگی) بوده‌اند تا دیدگاه سالوتوژنیک (عواملی مانند کنارآمدن و سازگاری). در این پژوهش از متغیرهای مورد تأکید دیدگاه سالوتوژنیک استفاده شد تا یک مدل ساختاری برای شاخص‌های سلامت بر اساس منابع مقابله و مدیریت استرس، با میانجی‌گری سبک زندگی ارتقاءدهنده سلامت در بیماران انتظامی مبتلا به سندرم روده تحریک‌پذیر تدوین گردد. مواد و روش‌ها: این پژوهش یک طرح همبستگی از نوع مدل‌یابی معادلات ساختاری بود. جامعه آماری پژوهش، بیماران انتظامی مبتلا به سندرم روده تحریک‌پذیر که در سال ۱۳۹۸ و ۱۳۹۹ به درمانگاه گوارش و اعصاب و روان یکی از بیمارستان‌های نیروی انتظامی مراجعه کرده بودند، تعریف شد. تعداد نمونه آماری، ۲۵۰ نفر بود که به‌ صورت در دسترس از بیمارانی که با تشخیص روان‌پزشک بر اساس ملاک ROME-IV مبتلابه سندرم روده تحریک‌پذیر بودند، انتخاب شدند. ابزارهای پژوهش، مقیاس شاخص‌های سالوتوژنیک سلامت Bringsen (آلفای کرونباخ ۰/۸۱)، پرسش‌نامه مدیریت استرس Epstein (آلفای کرونباخ نسخه اصلی ۰/۸۰ ونسخه ترجمه شده ۰/۹۴)، پرسش‌نامه نیم‌رخ سبک زندگی ارتقاءدهنده سلامت Walker (آلفای کرونباخ ۰/۸۲) و پرسش‌نامه منابع مقابله با استرس Matheny (آلفای کرونباخ نسخه اصلی ۰/۸۴ تا ۰/۹۷ و نسخه ترجمه‌شده ۰/۹۴) بود. داده‌ها با استفاده از نرم‌افزارهای SPSS ۲۴ و SmartPLS-۳ با آزمون‌های همبستگی پیرسون و تحلیل مسیر معادلات ساختاری تحلیل شدند. یافته‌ها: شاخص‌های برازندگی درنتیجه آزمون مدل مفروض نشان داد که مدل ساختاری رابطه منابع مقابله و مدیریت استرس با میانجی‌گری سبک زندگی بر روی شاخص‌های سلامت از برازش مطلوبی برخوردار بود. تحلیل مسیرهای این مدل نشان داد که در مسیر مستقیم، ضریب تأثیر مدیریت استرس (۰/۱۱=λ؛ ۳/۱۱=t؛ ۰/۰۵=p)، منابع مقابله (۰/۳۷=λ؛ ۳/۰۱=t؛ ۰/۰۱=p) و سبک زندگی ارتقاءدهنده سلامت (۰/۲۰=λ؛ ۳/۱۶=t؛ ۰/۱۰=p) بر شاخص‌های سالوتوژنیک سلامت معنادار بود. در مسیر غیرمستقیم، مدل میانجی سبک زندگی میان مدیریت استرس و منابع مقابله با شاخص‌های سلامت سالوتوژنیک در سطح اطمینان ۰/۰۵ و ضریب استاندارد (۰/۱۳-۰/۱۱) معنادار بود. نتیجه‌گیری: این مطالعه نشان داد، سبک زندگی ارتقاءدهنده سلامت می‌تواند ارتباط بین منابع مقابله و مدیریت استرس با شاخص‌های سلامت سالوتوژنیک در نمونه انتخابی بیماران انتظامی مراجعه‌کننده به یکی از مراکز درمانی نیروهای انتظامی را به‌صورت مثبت و معنادار میانجی‌گری کند.</div> <div dir="ltr" style="text-align:justify"><ave<0.90) between="" correlation="" greater="" structures="" than="" the="" was=""><ave<0.90) between="" correlation="" greater="" structures="" than="" the="" was=""></ave<0.90)></ave<0.90)>Introduction ... [1]. Two approaches, pathogenic (pathological) and salutogenic (origin of health), mention factors such as risk factors and disease resistance [2]. Irritable bowel syndrome is a chronic and widespread psychosomatic disease in which psychological factors are involved [3]. ... [4-7]. More than one-third of military women have irritable bowel syndrome [8]. ... [9, 10]. The pathophysiology of this disease is not fully understood [11, 12]. ... [13]. However, as the police officers are exposed to chemical, physical, and other environmental and psychological stressors, they are prone to gastrointestinal infections, which increases the risk of irritable bowel syndrome. [14, 15]. Studies have noted the relationship between stress management variables and coping resources in adaptation to chronic diseases such as irritable bowel syndrome [16-20], but previous studies have not emphasized the salutogenic perspective on variables related to adaptation to this disease. Aim (s) Variables emphasized by salutogenic were used in this study to develop a structural model for health indicators based on coping resources and stress management, mediated by a health-promoting lifestyle in police patients with irritable bowel syndrome (IBS). Research Society, Place, and Time Police patients with IBS who were referred to the gastrointestinal and psychiatric clinic of one of the police hospitals in 2020 and 2021 were introduced as the statistical population of the study. Sampling Method and Number 250 samples were selected through convenience sampling method from patients who were diagnosed with IBS by a psychiatrist based on ROME-IV criteria. Used Devices & Materials Research tools included the Bringsen Health Salotogenic Indices Scale (Cronbach's alpha 0.81), Epstein Stress Management Questionnaire (Cronbach's original version 0.80 and translated version 0.94), Walker Health Promotion Lifestyle Profile Questionnaire (Cronbach's alpha 0.82) And the Matheny Stress Resources Questionnaire (Cronbach's alpha of the original version 0.84 to 0.97 and the translated version 0.94). Ethical Permissions This paper is taken from the Ph.D. dissertation on health psychology of the Islamic Azad University, Central Tehran Branch, code 10120709981008, and all ethical principles were observed. Finding by Text 229 participants (130 (56.8%) female and 99 people (43.2%) male) with an age range of 18-49 years with a mean of 30.27 and a standard deviation of 4.18 completely answered the questionnaires of this study. 81 people (35.4%) were single, 110 (48%) were married and 32 (14%) were divorced. Mean research variables were as follows: salutogenic health indices 33.34±9.39, health-promoting lifestyle 142.90±35.90, stress management 78.19±19.18 and sources of coping with stress 82.38 19±19.07 (Table 1). To comply with the assumptions, the assumptions of structural equation modeling including the data level, which was spaced for all variables, the normality of the data, the absence of skewed data, and linearity were examined. In this study, the hypothesized model of the relationship between stress management and coping resources as an input or independent variable mediated by a health-promoting lifestyle on salutogenic indices as a dependent or output variable in SmartPLS-3 software was investigated. Confirmatory factor analysis was used to evaluate the fit, validity, and reliability of the model for measuring the relationship between coping resources and stress management on the salutogenic index of health through lifestyle mediation. The indicators of the goodness of fit of the measured model on the salutogenic index of health that is mediated by lifestyle had suitable values (Table 2). Therefore, the data were statistically consistent with the factor structure and theoretical basis of the four latent variables of the research. The standardized factor load (λ) of all selected markers for the structures in question (higher than 0.70) were all statistically significant at the 5% error level (Table 3). These results provided sufficient evidence to confirm the one-dimensionality of the selected markers in each of the relevant structures. Therefore, it can be said that the selected markers for each of the relevant structures were selected correctly. According to the results presented in Table 3, the combined reliability (CR) of all research structures was more than 0.70 and their Cronbach's alpha coefficient was higher than 0.70. Therefore, all latent variables (constructs) of the research measurement model had good reliability. The results presented in Table 3 showed that the average variance extracted (AVE) of all research constructs was more than 0.50. Therefore, all constructs of the research measurement model had good convergent validity. Also, in general, the root means of the extracted variance for each of the structures (0.43<ave<0.90) between="" correlation="" greater="" structures="" than="" the="" was=""></ave<0.90)><ave<0.90) between="" correlation="" greater="" structures="" than="" the="" was=""></ave<0.90)> Main Comparison to the Similar Studies Consistent with other findings of this study, sources of coping with stress, including social support, trust, religion and spirituality, stress monitoring, the ability to reduce tension, a sense of dominance, physical health, ability to engage in problem-solving and organizing [27], have a direct effect on salutogenic indicators of health, including levels of mood, tension, sleep, concentration, creativity, accuracy, expression of emotions, illness, energy level, social ability, and physical function [23]. This result is also consistent with the study of Fouché et al. [3] who showed that there is a correlation between coping resources and indicators of health and adaptation to the disease in people with IBS. The Wilpart study, which showed that [16] low levels of physical coping resources (such as exercise or health-promoting activities) were associated with high levels of anxiety in people with irritable bowel syndrome, is also consistent with this study. On the other hand, the findings of this study showed that stress management [24] had a direct effect on salutogenic indicators of health which is consistent with the studies of Kamkar et al. [17] and the study of Soleimani et al. [29] which have shown that stress management is effective in reducing the severity of symptoms in patients with IBS. On the other hand, the results showed that the sources of coping with stress and stress management indirectly influenced salutogenic health indicators by mediating a health-promotion lifestyle. A health-promoting lifestyle is defined as a multidimensional model involving a person's perceptions and actions that begins with motivating oneself and contributes to a stronger level of health and self-fulfillment [30]. This finding is in line with the studies of Guo [18], Haji Shafiei [19], Maghtaei, Vakhshuury, and Khoshdel [14], the research of Papaefthymiou et al [31], and the study of Kang [20]. ... [32]. Several studies have shown an association between post-traumatic stress disorder (PTSD) and IBS in members of the police forces [6], which may indicate the role of stress in the military for IBS; Therefore, considering that stress is inherent in military jobs and also considering the role of acute and chronic stress in the development of IBS, the importance of training military personnel in stress management strategies and sources of coping with stress and lifestyle modification is highlighted. Limitations Due to errors in measuring self-reports, the use of self-report tools may affect the results. Another limitation of this study was convenience sampling method. Suggestions This research was a cross-sectional correlation design based on which no causal results can be obtained, so experimental designs can be used in future research. It is suggested that in future studies, the random sampling method be applied in the selection of samples. Conclusions The present study showed that a health-promoting lifestyle including spiritual growth, stress management, nutrition, physical activity, health responsibility, and interpersonal support, can positively and significantly mediate the relationship between coping resources and stress management with salutogenic indicators of health in a sample of police personnel. Clinical & Practical Tips in Police Medicine Due to the nature of the job, police personnel is highly exposed to acute and chronic stressors, to manage and adapt to IBS, training personnel in stress management techniques such as managing or reducing the source of stress, thought management, prevention and planning and practicing relaxation techniques, providing solutions to increase sources of coping with stress through spiritual exercise, social support, active coping, as well as holding courses to promote a healthy lifestyle (exercise, proper nutrition, feeling responsible for your health) along with maintaining their physical, mental and social health can be effective in optimal police personnel’s performance. Acknowledgments We thank all the people who helped us in this research. Conflict of Interest The authors state that there is no conflict of interest in the present study. Funding Sources This research had no financial support.<ave<0.90) between="" correlation="" greater="" structures="" than="" the="" was=""><ave<0.90) between="" correlation="" greater="" structures="" than="" the="" was=""> TABLES & CHARTS</ave<0.90)></ave<0.90)> </div> <div dir="ltr" style="text-align:center">Table 1) Minimum, maximum and the average of research variables</div> <table align="center" class="MsoTableGrid" dir="ltr" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Research variables</td> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Minimum</td> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Maximum</td> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Mean</td> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">The standard deviation</td> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Qualitative index</td> </tr> <tr> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">Salutogenic indicators of health</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">14</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">61</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">33.34</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">9.39</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">medium</td> </tr> <tr> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">Health-promoting lifestyle</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">54</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">206</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">142.90</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">35.90</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">High</td> </tr> <tr> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">stress management</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">29</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">123</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">78.19</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">19.18</td> <td style="border-bottom:none; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">medium</td> </tr> <tr> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">Resources for coping with stress</td> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">31</td> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">124</td> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">82.38</td> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">19.07</td> <td style="border-bottom:1px solid black; width:100px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">High</td> </tr> </tbody> </table> <div dir="ltr" style="text-align:center"> Table 2) Fit indicators of the model for measuring the impact of coping resources and stress management on salutogenic health index mediated by lifestyle</div> <table align="center" class="MsoTableGrid" dir="ltr" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom:1px solid black; width:150px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Fit index</td> <td style="border-bottom:1px solid black; width:150px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">SRMR</td> <td style="border-bottom:1px solid black; width:150px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">NFI</td> <td style="border-bottom:1px solid black; width:150px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">RMS_Theta</td> </tr> <tr> <td style="border-bottom:none; width:150px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">Suggested value</td> <td style="border-bottom:none; width:150px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none"><0.10</td> <td style="border-bottom:none; width:150px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">>0.70</td> <td style="border-bottom:none; width:150px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none"><0.12</td> </tr> <tr> <td style="border-bottom:1px solid black; width:150px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">Estimated value</td> <td style="border-bottom:1px solid black; width:150px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">0.072</td> <td style="border-bottom:1px solid black; width:150px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">0.751</td> <td style="border-bottom:1px solid black; width:150px; padding:0cm 2px; text-align:center; border-top:none; border-right:none; border-left:none">0.017</td> </tr> </tbody> </table> <div dir="ltr" style="text-align:center"> Table 3) Summary of Evaluation Results of a Model for Measuring the Relationship between Coping Resources and Stress Management on Health Salutogenic Index with Lifestyle Mediation</div> <table align="center" class="MsoTableGrid" dir="ltr" style="width:471px; border-collapse:collapse; border:none" width="471"> <tbody> <tr> <td style="border-bottom:1px solid black; width:90px; padding:0cm 2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Latent variables</td> <td style="border-bottom:1px solid black; width:57px; padding:2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Marker</td> <td style="border-bottom:1px solid black; width:92px; padding:2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Standardized factor load λ</td> <td style="border-bottom:1px solid black; width:22px; padding:2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">t</td> <td style="border-bottom:1px solid black; width:22px; padding:2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">p</td> <td style="border-bottom:1px solid black; width:73px; padding:2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Combined validity (CR)</td> <td style="border-bottom:1px solid black; width:78px; padding:2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">Cronbach's alpha</td> <td style="border-bottom:1px solid black; width:37px; padding:2px; text-align:center; border-top:1px solid black; border-right:none; border-left:none">AVE</td> </tr> <tr> <td rowspan="6" style="border-bottom:1px solid black; width:90px; padding:0cm 2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">Coping Resources</td> <td style="border-bottom:none; width:57px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">AC</td> <td style="border-bottom:none; width:92px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">0.922</td> <td style="border-bottom:none; width:22px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">2.53</td> <td style="border-bottom:none; width:22px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> <td rowspan="6" style="border-bottom:1px solid black; width:73px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">0.945</td> <td rowspan="6" style="border-bottom:1px solid black; width:78px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">0.930</td> <td rowspan="6" style="border-bottom:1px solid black; width:37px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">0.740</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">SC</td> <td style="border-bottom:none; width:92px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">0.860</td> <td style="border-bottom:none; width:22px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">3.27</td> <td style="border-bottom:none; width:22px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">ST</td> <td style="border-bottom:none; width:92px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">0.807</td> <td style="border-bottom:none; width:22px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">3.56</td> <td style="border-bottom:none; width:22px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">TC</td> <td style="border-bottom:none; width:92px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">0.891</td> <td style="border-bottom:none; width:22px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">2.46</td> <td style="border-bottom:none; width:22px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">TR</td> <td style="border-bottom:none; width:92px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">0.832</td> <td style="border-bottom:none; width:22px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">2.68</td> <td style="border-bottom:none; width:22px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> <tr> <td style="border-bottom:1px solid black; width:57px; padding:2px; height:5px; text-align:center; border-top:none; border-right:none; border-left:none">WC</td> <td style="border-bottom:1px solid black; width:92px; padding:2px; height:5px; text-align:center; border-top:none; border-right:none; border-left:none">0.892</td> <td style="border-bottom:1px solid black; width:22px; padding:2px; height:5px; text-align:center; border-top:none; border-right:none; border-left:none">3.58</td> <td style="border-bottom:1px solid black; width:22px; padding:2px; height:5px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> <tr> <td rowspan="4" style="border-bottom:1px solid black; width:90px; padding:0cm 2px; height:15px; text-align:center; border-top:none; border-right:none; border-left:none">stress management ESMI</td> <td style="border-bottom:none; width:57px; padding:2px; height:15px; text-align:center; border-top:none; border-right:none; border-left:none">RLX</td> <td style="border-bottom:none; width:92px; padding:2px; height:15px; text-align:center; border-top:none; border-right:none; border-left:none">0.935</td> <td style="border-bottom:none; width:22px; padding:2px; height:15px; text-align:center; border-top:none; border-right:none; border-left:none">2.63</td> <td style="border-bottom:none; width:22px; padding:2px; height:15px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> <td rowspan="4" style="border-bottom:1px solid black; width:73px; padding:2px; height:15px; text-align:center; border-top:none; border-right:none; border-left:none">0.843</td> <td rowspan="4" style="border-bottom:1px solid black; width:78px; padding:2px; height:15px; text-align:center; border-top:none; border-right:none; border-left:none">0.763</td> <td rowspan="4" style="border-bottom:1px solid black; width:37px; padding:2px; height:15px; text-align:center; border-top:none; border-right:none; border-left:none">0.592</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:18px; text-align:center; border-top:none; border-right:none; border-left:none">MA</td> <td style="border-bottom:none; width:92px; padding:2px; height:18px; text-align:center; border-top:none; border-right:none; border-left:none">0.848</td> <td style="border-bottom:none; width:22px; padding:2px; height:18px; text-align:center; border-top:none; border-right:none; border-left:none">2.05</td> <td style="border-bottom:none; width:22px; padding:2px; height:18px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">MNG</td> <td style="border-bottom:none; width:92px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">0.942</td> <td style="border-bottom:none; width:22px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">3.15</td> <td style="border-bottom:none; width:22px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> <tr> <td style="border-bottom:1px solid black; width:57px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">TT</td> <td style="border-bottom:1px solid black; width:92px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">0.920</td> <td style="border-bottom:1px solid black; width:22px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">4.61</td> <td style="border-bottom:1px solid black; width:22px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> <tr> <td rowspan="6" style="border-bottom:1px solid black; width:90px; padding:0cm 2px; height:10px; text-align:center; border-top:none; border-right:none; border-left:none">life style HPLP II</td> <td style="border-bottom:none; width:57px; padding:2px; height:10px; text-align:center; border-top:none; border-right:none; border-left:none">HR</td> <td style="border-bottom:none; width:92px; padding:2px; height:10px; text-align:center; border-top:none; border-right:none; border-left:none">0.751</td> <td style="border-bottom:none; width:22px; padding:2px; height:10px; text-align:center; border-top:none; border-right:none; border-left:none">4.62</td> <td style="border-bottom:none; width:22px; padding:2px; height:10px; text-align:center; border-top:none; border-right:none; border-left:none">0.02</td> <td rowspan="6" style="border-bottom:1px solid black; width:73px; padding:2px; height:10px; text-align:center; border-top:none; border-right:none; border-left:none">0.722</td> <td rowspan="6" style="border-bottom:1px solid black; width:78px; padding:2px; height:10px; text-align:center; border-top:none; border-right:none; border-left:none">0.712</td> <td rowspan="6" style="border-bottom:1px solid black; width:37px; padding:2px; height:10px; text-align:center; border-top:none; border-right:none; border-left:none">0.501</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">IPR</td> <td style="border-bottom:none; width:92px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">0.802</td> <td style="border-bottom:none; width:22px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">4.48</td> <td style="border-bottom:none; width:22px; padding:2px; height:8px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">N</td> <td style="border-bottom:none; width:92px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">0.844</td> <td style="border-bottom:none; width:22px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">1.96</td> <td style="border-bottom:none; width:22px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">SA</td> <td style="border-bottom:none; width:92px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">0.709</td> <td style="border-bottom:none; width:22px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">2.68</td> <td style="border-bottom:none; width:22px; padding:2px; height:7px; text-align:center; border-top:none; border-right:none; border-left:none">0.05</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">SAC</td> <td style="border-bottom:none; width:92px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">0.780</td> <td style="border-bottom:none; width:22px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">2.94</td> <td style="border-bottom:none; width:22px; padding:2px; height:9px; text-align:center; border-top:none; border-right:none; border-left:none">0.02</td> </tr> <tr> <td style="border-bottom:1px solid black; width:57px; padding:2px; height:5px; text-align:center; border-top:none; border-right:none; border-left:none">SM</td> <td style="border-bottom:1px solid black; width:92px; padding:2px; height:5px; text-align:center; border-top:none; border-right:none; border-left:none">0.722</td> <td style="border-bottom:1px solid black; width:22px; padding:2px; height:5px; text-align:center; border-top:none; border-right:none; border-left:none">2.30</td> <td style="border-bottom:1px solid black; width:22px; padding:2px; height:5px; text-align:center; border-top:none; border-right:none; border-left:none">0.02</td> </tr> <tr> <td rowspan="2" style="border-bottom:1px solid black; width:90px; padding:0cm 2px; height:35px; text-align:center; border-top:none; border-right:none; border-left:none">Salutogenic index of health Salu</td> <td style="border-bottom:none; width:57px; padding:2px; height:35px; text-align:center; border-top:none; border-right:none; border-left:none">IAF</td> <td style="border-bottom:none; width:92px; padding:2px; height:35px; text-align:center; border-top:none; border-right:none; border-left:none">0.898</td> <td style="border-bottom:none; width:22px; padding:2px; height:35px; text-align:center; border-top:none; border-right:none; border-left:none">2.29</td> <td style="border-bottom:none; width:22px; padding:2px; height:35px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> <td rowspan="2" style="border-bottom:1px solid black; width:73px; padding:2px; height:35px; text-align:center; border-top:none; border-right:none; border-left:none">0.896</td> <td rowspan="2" style="border-bottom:1px solid black; width:78px; padding:2px; height:35px; text-align:center; border-top:none; border-right:none; border-left:none">0.768</td> <td rowspan="2" style="border-bottom:1px solid black; width:37px; padding:2px; height:35px; text-align:center; border-top:none; border-right:none; border-left:none">0.812</td> </tr> <tr> <td style="border-bottom:none; width:57px; padding:2px; height:24px; text-align:center; border-top:none; border-right:none; border-left:none">IPC</td> <td style="border-bottom:none; width:92px; padding:2px; height:24px; text-align:center; border-top:none; border-right:none; border-left:none">0.904</td> <td style="border-bottom:none; width:22px; padding:2px; height:24px; text-align:center; border-top:none; border-right:none; border-left:none">2.98</td> <td style="border-bottom:none; width:22px; padding:2px; height:24px; text-align:center; border-top:none; border-right:none; border-left:none">0.01</td> </tr> </tbody> </table> <div dir="ltr" style="text-align:center"> Figure 1) Model for measuring resource coping and stress management on salutogenic health index mediated by lifestyle <img alt="" src="./files/site1/images/image-20220531113223-1.png" style="width:707px; height:441px" > Table 4) Summary of evaluation results of structural model of coping resources and stress management on salutogenic health index mediated by lifestyle <table align="center" class="MsoTableGrid" style="width:455px; border-collapse:collapse; border:none" width="455"> <tbody> <tr> <td colspan="2" style="border-bottom:1px solid black; width:154px; padding:0cm 2px 0cm 2px; border-top:1px solid black; border-right:none; border-left:none">Latent variable</td> <td colspan="2" style="border-bottom:1px solid black; width:65px; padding:0cm 2px 0cm 2px; border-top:1px solid black; border-right:none; border-left:none">Direct effect</td> <td colspan="2" style="border-bottom:1px solid black; width:58px; padding:0cm 2px 0cm 2px; border-top:1px solid black; border-right:none; border-left:none">Indirect effect</td> <td colspan="2" style="border-bottom:1px solid black; width:55px; padding:0cm 2px 0cm 2px; border-top:1px solid black; border-right:none; border-left:none">Total effect</td> <td rowspan="2" style="border-bottom:1px solid black; width:41px; padding:0cm 2px 0cm 2px; border-top:1px solid black; border-right:none; border-left:none">f²</td> <td rowspan="2" style="border-bottom:1px solid black; width:41px; padding:0cm 2px 0cm 2px; border-top:1px solid black; border-right:none; border-left:none">R²</td> <td rowspan="2" style="border-bottom:1px solid black; width:41px; padding:0cm 2px 0cm 2px; border-top:1px solid black; border-right:none; border-left:none">Q²</td> </tr> <tr> <td style="border-bottom:1px solid black; width:75px; padding:0cm 2px 0cm 2px; height:2px; border-top:none; border-right:none; border-left:none">Endogenous</td> <td style="border-bottom:1px solid black; width:79px; padding:0cm 2px 0cm 2px; height:2px; border-top:none; border-right:none; border-left:none">Exogenous</td> <td style="border-bottom:1px solid black; width:37px; padding:0cm 2px 0cm 2px; height:2px; border-top:none; border-right:none; border-left:none">λ</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:2px; border-top:none; border-right:none; border-left:none">p</td> <td style="border-bottom:1px solid black; width:30px; padding:0cm 2px 0cm 2px; height:2px; border-top:none; border-right:none; border-left:none">λ</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:2px; border-top:none; border-right:none; border-left:none">P</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:2px; border-top:none; border-right:none; border-left:none">λ</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:2px; border-top:none; border-right:none; border-left:none">p</td> </tr> <tr> <td rowspan="3" style="border-bottom:1px solid black; width:75px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">Salutogenic index of health</td> <td style="border-bottom:none; width:79px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">Coping Resources</td> <td style="border-bottom:none; width:37px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">0.37</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">0.01</td> <td style="border-bottom:none; width:30px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">0.11</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">0.05</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">0.48</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">0.01</td> <td style="border-bottom:none; width:41px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">0.23</td> <td rowspan="3" style="border-bottom:1px solid black; width:41px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">0.20</td> <td rowspan="3" style="border-bottom:1px solid black; width:41px; padding:0cm 2px 0cm 2px; height:10px; border-top:none; border-right:none; border-left:none">0.36</td> </tr> <tr> <td style="border-bottom:none; width:79px; padding:0cm 2px 0cm 2px; height:19px; border-top:none; border-right:none; border-left:none">stress management</td> <td style="border-bottom:none; width:37px; padding:0cm 2px 0cm 2px; height:19px; border-top:none; border-right:none; border-left:none">0.11</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:19px; border-top:none; border-right:none; border-left:none">0.05</td> <td style="border-bottom:none; width:30px; padding:0cm 2px 0cm 2px; height:19px; border-top:none; border-right:none; border-left:none">0.13</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:19px; border-top:none; border-right:none; border-left:none">0.01</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:19px; border-top:none; border-right:none; border-left:none">0.24</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:19px; border-top:none; border-right:none; border-left:none">0.01</td> <td style="border-bottom:none; width:41px; padding:0cm 2px 0cm 2px; height:19px; border-top:none; border-right:none; border-left:none">0.08</td> </tr> <tr> <td style="border-bottom:1px solid black; width:79px; padding:0cm 2px 0cm 2px; height:17px; border-top:none; border-right:none; border-left:none">life style</td> <td style="border-bottom:1px solid black; width:37px; padding:0cm 2px 0cm 2px; height:17px; border-top:none; border-right:none; border-left:none">0.20</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:17px; border-top:none; border-right:none; border-left:none">0.01</td> <td style="border-bottom:1px solid black; width:30px; padding:0cm 2px 0cm 2px; height:17px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:17px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:17px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:17px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:1px solid black; width:41px; padding:0cm 2px 0cm 2px; height:17px; border-top:none; border-right:none; border-left:none"></td> </tr> <tr> <td rowspan="2" style="border-bottom:1px solid black; width:75px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">life style</td> <td style="border-bottom:none; width:79px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">Coping Resources</td> <td style="border-bottom:none; width:37px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">0.15</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">0.01</td> <td style="border-bottom:none; width:30px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:none; width:28px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:none; width:41px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">0.24</td> <td rowspan="2" style="border-bottom:1px solid black; width:41px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">0.35</td> <td rowspan="2" style="border-bottom:1px solid black; width:41px; padding:0cm 2px 0cm 2px; height:11px; border-top:none; border-right:none; border-left:none">0.31</td> </tr> <tr> <td style="border-bottom:1px solid black; width:79px; padding:0cm 2px 0cm 2px; height:4px; border-top:none; border-right:none; border-left:none">stress management</td> <td style="border-bottom:1px solid black; width:37px; padding:0cm 2px 0cm 2px; height:4px; border-top:none; border-right:none; border-left:none">0.18</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:4px; border-top:none; border-right:none; border-left:none">0.01</td> <td style="border-bottom:1px solid black; width:30px; padding:0cm 2px 0cm 2px; height:4px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:4px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:4px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:1px solid black; width:28px; padding:0cm 2px 0cm 2px; height:4px; border-top:none; border-right:none; border-left:none">-</td> <td style="border-bottom:1px solid black; width:41px; padding:0cm 2px 0cm 2px; height:4px; border-top:none; border-right:none; border-left:none">0.15</td> </tr> </tbody> </table>  </div> سندرم روده تحریک‌پذیر,منابع مقابله,خود مدیریتی,شاخص‌های سلامت,ارتقای سلامت,سبک زندگی, Irritable Bowel Syndrome,Coping Resources,Self-Management,Health Status Indicators,Health Promotion,Life Style, 1 13 http://jpmed.ir/browse.php?a_code=A-10-1103-3&slc_lang=fa&sid=1 Leila Safadel لیلا صفادل lil.sd1397@gmail.com 100319475328460012952 100319475328460012952 Yes Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran گروه روان‌شناسی، واحد تهران مرکزی، دانشگاه آزاد اسلامی، تهران، ایران Farhad Jomehry فرهاد جمهری farhadjomehri@yahoo.com 100319475328460012953 100319475328460012953 No Department of Psychology, Faculty of Psychology & Educational Sciences, Alameh Tabatabaee University, Tehran, Iran گروه روان‌شناسی، دانشکده روان‌شناسی و علوم تربیتی، دانشگاه علامه طباطبائی، تهران، ایران Susan Emamipoor سوزان امامی پور emamipursd@yahoo.com 100319475328460012954 100319475328460012954 No Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran گروه روان‌شناسی، واحد تهران مرکزی، دانشگاه آزاد اسلامی، تهران، ایران Omid Rezaei امید رضایی Dr-omid-rezaee@yahoo.com 100319475328460012955 100319475328460012955 No Department Of Psychiatry, University Of Social Welfare & Rehabilitation Sciences, Tehran, Iran گروه روان‌پزشکی، دانشگاه علوم توانبخشی و سلامت اجتماعی، تهران، ایران