Maher Institute Inc Iranian Journal of Neurodevelopmental Disorders 3115-848X 4 2025 09 13 Developing a Hope Model Based on Cognitive Emotion Regulation Mediated by Spiritual Well-being in Patients with Heart Failure in Kermanshah and Its Effectiveness on Pain Tolerance Developing a Hope Model Based on Cognitive Emotion Regulation Mediated by Spiritual Well-being in Patients with Heart Failure in Kermanshah and Its Effectiveness on Pain Tolerance 1 10 EN Journal Article 2025 03 09 <p><strong>Purpose: </strong>This study aimed to develop and validate a hope model based on cognitive emotion regulation with the mediating role of spiritual well-being in patients with heart failure, and to examine its effectiveness on increasing pain tolerance.</p> <p><strong>Methods and Materials: </strong>This research was conducted in two phases. The first phase utilized a descriptive-correlational design to assess the relationships between cognitive emotion regulation, spiritual well-being, and hope among 270 heart failure patients in Kermanshah, Iran, selected via Cochran’s formula. In the second phase, a quasi-experimental design with pre-test–post-test and control group was employed. Thirty participants with low hope and spiritual well-being and high pain levels were selected and randomly assigned to an experimental group (receiving a structured hope-based educational program) or a control group. Data were collected using standardized questionnaires: Snyder’s Hope Scale, the Cognitive Emotion Regulation Questionnaire (CERQ), the Spiritual Well-Being Scale, and the McGill Pain Questionnaire. Data analysis was conducted using structural equation modeling (SEM) and ANCOVA through AMOS and SPSS version 23.</p> <p><strong>Findings: </strong>The results revealed significant positive correlations among all key variables. Structural equation modeling confirmed the proposed model: cognitive emotion regulation significantly predicted hope both directly and indirectly through the mediating role of spiritual well-being. Model fit indices (e.g., χ²/df = 2.42, RMSEA = 0.068, CFI = 0.943) indicated good model fit. The ANCOVA results showed a significant group effect (F = 286.49, p &lt; .001) of the hope-based intervention on increasing pain tolerance. Paired t-tests revealed a significant reduction in post-test pain scores in the experimental group compared to the control group.</p> <p><strong>Conclusion: </strong>The study supports the effectiveness of a hope-based educational intervention grounded in cognitive and spiritual frameworks for enhancing psychological resilience and pain tolerance in patients with heart failure. The validated model offers a useful framework for designing future therapeutic interventions.</p> https://www.maherpub.com/index.php/jndd/article/download/536/422