The Structural Relationship of Treatment Adherence Based on Illness Perception in Patients with Psoriasis: The Mediating Role of Body Image Concern

Amir  Yousefi; Mohsen Jalali; MohammadTaghi  Badelleh Shamshuki; LeilaSadat  Azizi Ziabari

doi:10.61838/kman.jndd.3.3.10

Authors

Amir Yousefi Department of Health Psychology, Gorgan Branch, Islamic Azad University, Gorgan, Iran. Author https://orcid.org/0000-0002-9506-3308
Mohsen Jalali Assistant Professor, Department of Clinical Psychology, Faculty of Humanities and Social Sciences, Golestan University, Gorgan, Iran. Author https://orcid.org/0000-0002-1835-0776
MohammadTaghi Badelleh Shamshuki Assistant Professor, Department of Health Psychology, Psychiatry Research Center, Golestan University of Medical Sciences, Gorgan, Iran. Author https://orcid.org/0000-0001-6440-8054
LeilaSadat Azizi Ziabari Assistant Professor, Department of Nursing, Gorgan Branch, Islamic Azad University, Gorgan, Iran. Author https://orcid.org/0000-0003-4576-6141

DOI:

https://doi.org/10.61838/kman.jndd.3.3.10

Keywords:

Treatment adherence, illness perception, psoriasis, body image concern

Abstract

Purpose: The present study examines the structural relationship of treatment adherence based on illness perception in patients with psoriasis, considering the mediating role of body image concern.

Methodology: This study employs a descriptive-correlational research method based on structural modeling. The statistical population consists of patients with psoriasis in Tehran. Based on the inclusion and exclusion criteria, 250 patients with psoriasis will be selected using a purposive convenience sampling method. The data collection tools include the Ziaei Treatment Adherence Questionnaire (2009), the Littleton Body Image Concern Inventory (2005), and the Broadbent et al. Illness Perception Questionnaire (2006). Data analysis is conducted using structural regression equation modeling. The collected data are analyzed using SPSS 18 and AMOS 23 software.

Findings: The findings indicate that illness perception has a direct effect on treatment adherence in individuals with psoriasis. Additionally, body image concern has a direct effect on treatment adherence in these patients. Moreover, illness perception indirectly affects treatment adherence through the mediating role of body image concern.

Conclusion: Thus, addressing psychological and social factors can enhance adherence, improving treatment outcomes and patients’ quality of life.

Downloads

Download data is not yet available.

References

Aardoom, J. J., Loheide-Niesmann, L., Ossebaard, H. C., & Riper, H. (2020). Effectiveness of eHealth interventions in improving treatment adherence for adults with obstructive sleep apnea: meta-analytic review. Journal of medical Internet research, 22(2), e16972. https://doi.org/10.2196/16972

Adesanya, E. I., Matthewman, J., Schonmann, Y., Hayes, J. F., Henderson, A., Mathur, R., Mulick, A. R., Smith, C. H., Langan, S. M., & Mansfield, K. E. (2023). Factors associated with depression, anxiety and severe mental illness among adults with atopic eczema or psoriasis: a systematic review and meta-analysis. British Journal of Dermatology, 188(4), 460-470. https://doi.org/10.1093/bjd/ljac132

Afshari, A. (2018). Predicting medication adherence in diabetic patients based on self-compassion, emotional regulation, and spiritual well-being. Behavioral Sciences Research, 16(4), 466-475. https://doi.org/10.52547/rbs.16.4.466

Ahmadi, A. (2024). Predictors of Impulsiveness: The Roles of Sleep Quality and Body Image Dissatisfaction in Physically Disabled Adolescent Girls. Psychological Research in Individuals with Exceptional Needs, 2(2), 28-35. https://journals.kmanpub.com/index.php/prien/article/view/3343

Arıkan, F., Kartöz, F., Karakuş, Z., Altınışık, M., Özer, Z., & Korcum Şahin, A. F. (2024). Body image and social appearance anxiety in patients with cancer undergoing radiotherapy: Across-sectional study. BMC Psychol, 12(1), 363. https://doi.org/10.1186/s40359-024-01856-w

Boughdady, A. M., Ghazi, H. A., Elmawla, A., Abd Elhameed, D., & Ali, S. M. (2024). Effect of Illness Perception and Medication Adherence on Self-Care Ability of Elderly Patients with Hypothyroidism. NILES journal for Geriatric and Gerontology, 7(1), 127-151. https://doi.org/10.21608/niles.2024.320452

Chen, X., Du, L., Wu, R., Xu, J., Ji, H., Zhang, Y., Zhu, X., & Zhou, L. (2020). The effects of family, society and national policy support on treatment adherence among newly diagnosed tuberculosis patients: a cross-sectional study. BMC Infectious Diseases, 20(1), 1-11. https://doi.org/10.1186/s12879-020-05354-3

Chong, Y. Y., Chien, W. T., Cheng, H. Y., Chow, K. M., Kassianos, A. P., Karekla, M., & Gloster, A. (2020). The role of illness perceptions, coping, and self-efficacy on adherence to precautionary measures for COVID-19. International journal of environmental research and public health, 17(18), 6540. https://doi.org/10.3390/ijerph17186540

Costantino, F., Bahier, L., Tarancón, L. C., Leboime, A., Vidal, F., Bessalah, L., Breban, M., & D'Agostino, M. A. (2021). COVID-19 in French patients with chronic inflammatory rheumatic diseases: clinical features, risk factors and treatment adherence. Joint Bone Spine, 88(1), 105095. https://doi.org/10.1016/j.jbspin.2020.105095

Dwi Nur, R. (2021). Jurnal-Self Awareness as a mediator for self-directed learning and goal setting on students. https://repo-dosen.ulm.ac.id/handle/123456789/21050

El Abdellati, K., De Picker, L., & Morrens, M. (2020). Antipsychotic treatment failure: a systematic review on risk factors and interventions for treatment adherence in psychosis. Frontiers in Neuroscience, 14, 531763. https://doi.org/10.3389/fnins.2020.531763

Fragoulis, G. E., Evangelatos, G., Arida, A., Bournia, V. K., Fragiadaki, K., Karamanakos, A., Kravvariti, E., Laskari, K., Panopoulos, S., Pappa, M., Tektonidou, M. G., & Sfikakis, P. P. (2020). Treatment adherence of patients with systemic rheumatic diseases in COVID-19 pandemic. Annals of the Rheumatic Diseases. https://doi.org/10.1136/annrheumdis-2020-217935

Ghasempour, H., Darzi Azadbani, M., Mirzaian, B., Sangani, A., & Shakarian, S. (2022). Modeling the effect of early maladaptive schemas on treatment adherence with the mediating role of emotional regulation and resilience in coronary heart disease patients. Nursing Education, 11(4), 13-24. https://jne.ir/article-1-1360-en.html

Hedemann, T. L., Liu, X., Kang, C. N., & Husain, M. I. (2022). Associations between psoriasis and mental illness: An update for clinicians. General Hospital Psychiatry, 75, 30-37. https://doi.org/10.1016/j.genhosppsych.2022.01.006

Hooshmandi, R., Aljaberi, M. A., Hammadi, F., & Ma, J. (2024). The Impact of Interoceptive Awareness on Pain Catastrophizing and Illness Perception. Journal of Personality and Psychosomatic Research (JPPR), 2(2), 4-10. https://doi.org/10.61838/kman.jppr.2.2.2

Kavehzadeh, A., Big Rezai, S., Nilforoushzadeh, M. A., Heydari, A., & Hosseini, S. M. (2016). Comparing body image perception in dermatology patients and healthy individuals. Skin and Beauty, 7(4), 213-219. https://journals.tums.ac.ir/jdc/article-1-5218-en.html

Kleyn, C. E., Talbot, P. S., Mehta, N. N., Sampogna, F., Bundy, C., Ashcroft, D. M., Kimball, A. B., van de Kerkhof, P. C. M., ´Griffiths, C. E. M., Valenzuela, F., van der Walt, J. M., Aberra, T., & Lluís, P. U. I. G. (2020). Psoriasis and mental health workshop report: exploring the links between psychosocial factors, psoriasis, neuroinflammation and cardiovascular disease risk. Acta dermato-venereologica, 100(1). https://doi.org/10.2340/00015555-3375

Lambert, J. L. W., Segaert, S., Ghislain, P. D., Hillary, T., Nikkels, A., Willaert, F., Lambert, J., & Speeckaert, R. (2020). Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 1). Journal of the European Academy of Dermatology and Venereology, 34(8), 1654-1665. https://doi.org/10.1111/jdv.16684

Lee, E., & Jang, M. H. (2021). The influence of body image, insight, and mental health confidence on medication adherence in young adult women with mental disorders. International journal of environmental research and public health, 18(8), 3866. https://doi.org/10.3390/ijerph18083866

Li, F., Zhang, Y. L., Chen, X., Zhang, J. Y., Fu, L., Chai, B., & Chen, H. X. (2023). Mental stress affects the occurrence and development of psoriasis through neuroendocrine-immune regulation: a narrative review. International Journal of Dermatology and Venereology, 6(02), 87-95. https://doi.org/10.1097/JD9.0000000000000317

Lippincott, C. K., Perry, A., Munk, E., Maltas, G., & Shah, M. (2022). Tuberculosis treatment adherence in the era of COVID-19. BMC Infectious Diseases, 22(1), 800. https://doi.org/10.1186/s12879-022-07787-4

Oliveira-Kumakura, A. R. D. S., Bezutti, L. M., Silva, J. L. G., & Gasparino, R. C. (2019). Functional and self-care capacity of people with multiple sclerosis. Revista latino-americana de enfermagem, 27. https://doi.org/10.1590/1518-8345.3068.3183

Pan, J., Hu, B., Wu, L., & Li, Y. (2021). The effect of social support on treatment adherence in hypertension in China. Patient Preference and Adherence, 1953-1961. https://doi.org/10.2147/PPA.S325793

Pour Asmail Niazi, M., Farshbaf Mani Safat, F., Khademi, A., & Mashgi, S. (2021). The mediating role of coping strategies in the relationship between illness perception, perceived social support, and treatment adherence in cardiovascular patients. Nursing Psychology, 9(6), 98-108. https://ijpn.ir/browse.php?a_code=A-10-1922-1&sid=1&slc_lang=en

Quinto, R. M., De Vincenzo, F., Graceffa, D., Bonifati, C., Innamorati, M., & Iani, L. (2022). The relationship between alexithymia and mental health is fully mediated by anxiety and depression in patients with psoriasis. International journal of environmental research and public health, 19(6), 3649. https://doi.org/10.3390/ijerph19063649

Rasha Abed, H., Dhyaaldian, S. M. A., Merriam Ghadhanfar, A., Mohammed Wafqan, H., Abeer Ameen, B., Muneam Hussein, A., Safa, K. H., Zahraa Tariq, S., Huda Takleef, A., Bahaa Aldin Fawzi, S., & Shaker Holh, S. (2022). Psychometric Evaluation of the Brief Illness Perception Questionnaire among Iraqi Patients with Type II Diabetes. International Journal of Body, Mind and Culture, 9(2), 77-86. https://doi.org/10.22122/ijbmc.v9i2.400

Sampasa-Kanyinga, H., Hamilton, H. A., Willmore, J., & Chaput, J. P. (2017). Perceptions and attitudes about body weight and adherence to the physical activity recommendation among adolescents: the moderating role of body mass index. Public Health, 146, 75-83. https://doi.org/10.1016/j.puhe.2017.01.002

Sofia, S. A., Lysaker, P. H., Smith, E., Celesia, B. M., & Dimaggio, G. (2018). Therapy adherence and emotional awareness and regulation in persons with human immunodeficiency virus. The Journal of Nervous and Mental Disease, 206(12), 925-930. https://doi.org/10.1097/NMD.0000000000000901

Tarighi, S., & Kiani, Q. (2017). Predicting treatment adherence in type 2 diabetic patients based on emotional regulation, anxiety disorders, sleep issues, and social performance. 6th Congress of the Iranian Psychological Association, Tehran.

van den Brink, F., Vollmann, M., Smeets, M. A., Hessen, D. J., & Woertman, L. (2018). Relationships between body image, sexual satisfaction, and relationship quality in romantic couples. Journal of Family Psychology, 32(4), 466. https://doi.org/10.1037/fam0000407

Wagnew, F., Gray, D., Tsheten, T., Kelly, M., Clements, A. C., & Alene, K. A. (2023). Effectiveness of nutritional support to improve treatment adherence in patients with tuberculosis: a systematic review. Nutrition Reviews. https://doi.org/10.1093/nutrit/nuad120

Werner, M. C. F., Wirgenes, K. V., Shadrin, A., Lunding, S. H., Rødevand, L., Hjell, G., Ormerod, M. B. E. G., Haram, M., Agartz, I., Djurovic, S., Melle, I., Aukrust, P., Ueland, T., Andreassen, O. A., & Steen, N. E. (2022). Immune marker levels in severe mental disorders: associations with polygenic risk scores of related mental phenotypes and psoriasis. Translational psychiatry, 12(1), 38. https://doi.org/10.1038/s41398-022-01811-6

Yew, W. J. (2019). Relationship between Body Image Satisfaction and Physical Activity Adherence among College Students Tunku Abdul Rahman University College]. https://eprints.tarc.edu.my/14528/