The Relationship between Adult Attachment Styles and Adherence to Treatment in Patients with Chronic Disease: The Mediating Role of Resilience

One of the main challenges in treating chronic disease is patients' adherence to treatment instructions. The aim of this study was to determine the mediating role of resilience in the relationship between attachment styles and treatment adherence in patients with chronic disease. The research design was descriptive-correlational. The statistical population included all patients with diabetes and hypertension in Guilan province in ۲۰۲۰. A sample of ۳۹۹ people were selected by purposive sampling method. Data were collected through the Collins and Reed's Adult Attachment Scale (RAAS), the Connor-Davidson Resilience Scale(CD-RISC), and the Modanloo Adherence to Treatment Questionnaire. Data processing was performed using path analysis technique in AMOS-۲۴ software setting and bootstrap analysis in Macro program of Preacher and Hayes (۲۰۰۸). There was a significant direct relationship between adherence to treatment with resilience and secure and avoidant attachment style(p<۰.۰۱). However, there was no relationship between adherence to treatment and ambivalent attachment(p>۰.۰۵). The fit of the mediator model was improved after deleting the two non-significant paths and it was obtained a good fit by releasing the covariance error between the ambivalent attachment and the secure and avoidant attachment (CFI=۱.۰۰, RMSEA=۰.۰۸۶). Bootstrap analysis revealed that resilience mediates the associations between endogenous and exogenous variables. The coefficient of determination in the final model demonstrated that all exogenous and mediating variables predict ۲۱% of the changes in the adherence to treatment. Resilience and attachment pattern are important in patients' adherence to the treatment procedure and it is suggested that skills and strategies for coping with the disease stress and increasing the capacity to adaptive coping to life-threatening conditions be included in the treatment program of patients with chronic diseases.

Keywords:

Adherence to treatment , chronic disease , resilience , attachment styles. , تبعیت از درمان , بیماری مزمن , تاب آوری , سبک های دلبستگی.