Document Type : Research Article
Authors
1 Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Mahdishahr, Semnan, Iran.
2 Associate Professor, Department of Clinical Psychology, Faculty of Psychology & Educational Sciences, Semnan University, Semnan, Iran.
Abstract
Introduction
Health-promoting behaviors are increasingly important to increase health and reduce diseases. On the other hand, the health of the medical staff plays an important role in improving the health of the society. Considering the limited research evidence regarding health-promoting behaviors in intern medical students, more research is needed to formulate appropriate interventions to improve psychological dimensions and health-related behaviors for them. Attachment styles play a role directly and indirectly through other protective psychological factors such as well-being on health-promoting behaviors. Attachment style influences healthy or risky behaviors by determining the interaction with health care providers and some individual characteristics. Psychological well-being is also an important factor in healthy behaviors by strengthening positive individual characteristics. Examining the relationships between attachment styles, psychological well-being and health-promoting behaviors in an integrated model among intern medical students is important. Therefore, the present study was conducted with the aim of examining the fit of the model in the relationship between attachment styles and health-promoting behaviors with the mediating factor of psychological well-being.
Method
The current study was a cross-sectional descriptive study in which structural relationships between variables were investigated using the structural equation model. The statistical population of the study included all medical students of Gilan and Qazvin provinces who completed their internship during the Corona epidemic and its subsequent strains. Among this population, 550 medical students were selected by conveniance sampling during May 2022 to February 2023. The age mean and standard deviation of the participants were 25.02 and 2.3, respectively. After obtaining written informed consent and explaining the objectives of the study to the participants, Adult Attachment Questionnaire (Hazan & Shaver, 1987), Psychological Well-Being Scale (Ryff, 1989) and Health Promotion Lifestyle Profile-II (Walker et al., 1987) were completed by the participants. In addition, the research ethical code obtained from the National Ethics Committee in Biomedical Research (ID: IR.SEMUMS.REC.1401.205) and the study was conducted in compliance with other ethical considerations, including the protection of the participants' rights, confidentiality and freedom of action in participating in the research. The descriptive statistics (mean, standard deviation, correlation, and tests of statistical presumptions) were used for data analysis with SPSS-25 software and inferential statistics (structural equation modeling) was used with LISREL 7.8 software to exmine the research hypothesis. The significance level of the data was considered as P<0.05.
Results
The findings showed that attachment styles have a direct and significant relationship with health-promoting behaviors, and psychological well-being mediates the relationship between attachment styles and health-promoting behaviors (P<0.001). According to the indices obtained in the examined model (df=ϰ^2⁄2.09, CFI=0.94, GFI=0.92, AGFI=0.91, RMSEA=0.05, NNFI=0.96, (NFI = 0.96), the model has a good fit (P<0.05). Based on the Bootstrop test, the mediating role of psychological well-being in the relationship between attachment styles and health-promoting behaviors is confirmed (P<0.05). The results of the Sobel test were also obtained to investigate the mediating role of psychological well-being in the relationship between attachment styles and health-promoting behaviors, respectively, 2.85 to 3.21, which confirmed the results of the bootstrap result.
Discussion
According to the results, attachment styles play a significant role in health-related behaviors, and psychological well-being plays a mediating role in the relationship between attachment styles and health-promoting behaviors. These results contain implications in providing and formulating appropriate interventions to promote health-related behaviors based on various attachment styles and psychological well-being. It is suggested that future researches focus on developing mixed designs (quantitative-qualitative studies) and expand these results to develop tailored interventions to promote health-related behaviors based on these factors. The strengthening secure attachment and promoting psychological well-being is necessary in order to maintain and improve health-promoting behaviors of medical students.
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