رابطه سبک‌های دلبستگی و حس انسجام با استرس ادراک‌شده در سالمندان مقیم سرای سالمندان در دوران شیوع بیماری کرونا: نقش میانجی هوش معنوی

The spread of Coronavirus is an important challenge for health care systems in Iran. Attachment styles, self-coherence and spiritual intelligence are the variables that can have a significant impact on mental health and quality of life in the elderly during the outbreak of Coronavirus. Therefore, the current study aimed to investigate the mediating role of spiritual intelligence in the relationship between attachment styles and self-coherence with perceived stress during the outbreak of coronavirus in the elderly. This was a correlational study of path analysis type. The statistical population included all the elderly living in nursing homes in Sanandaj in 2021, among whom 270 (146 men and 124 women) people were selected using convenience sampling method. Data were collected using Collins’s adult attachment styles, Antonovsky’s sense of cohesion, Cohen et al.’s perceived stress, and King’s spiritual intelligence Scales. The results of path analysis revealed that the hypothetical model has a good fit in the sample of this study. As such, secure and avoidant attachment styles had an indirect relationship with perceived stress through spiritual intelligence, and sense of cohesion indicated an indirect relationship with perceived stress through spiritual intelligence (P<0.05). The findings emphasize the importance of the relationship between attachment styles and a sense of cohesion with respect to the mediating role of spiritual intelligence in providing psychological assistance for the elderly in order to manage their perceived stress.
References
Antonovsky, A. (1993). The structure and properties of the sense of coherence scale. Social Science & Medicine, 36(6), 725-733. https://doi.org/10.1016/0277-9536(93)90033-Z
Askary, M., Asgary, P., & Sangani, A. (2019). Relationship of spiritual intelligence, perceived stress and flexibility of action with psychological well-being in the elderly. Iranian Journal of Psychiatric Nursing, 7(3), 15-21. [Persian] http://ijpn.ir/article-1-1263-fa.html
Aziziaram, S., & Basharpoor, S. (2020). The Role of rumination, emotion regulation and responsiveness to stress in predicting of Corona Anxiety (COVID-19) among nurses. Quarterly Journal of Nursing Management, 3(9), 9-18. [Persian] http://ijnv.ir/article-1-729-fa.html
Bagheri, L., Safouraei, S., & Safouraei, M, M. (2021). The Resilience prediction of patients with Corona Disease based on life expectancy, religious coping style, spiritual intelligence and self-compassion. Quran and Medicine, 5(4), 1-10. [Persian] http://quranmed.com/article-1-426-fa.html  
Barni, D., Danioni, F., Canzi, E., Ferrari, L., Ranierr, S., Lanz, M., Iafrate, R., Regalia, C., & Rosnati, R. (2020). Facing the COVID-19 pandemic: The role of sense of coherence. Frontiers in Psychology, 11, 578440. https://doi.org/10.3389/fpsyg.2020.578440
Baumel, A., & Berant, E. (2015). The Role of attachment styles in malicious envy. Journal of Research in Personality, 55, 1– 9.  https://doi.org/10.1016/j.jrp.2014.11.001
Behroozi, N., Shahani yeylag, M., & Pourseyed, SM. (2013). Relationship between perfectionism, perceived stress and social support with academic burnout. Journal of Culture Strategy, 5(20), 83-102. [Persian]  http://www.jsfc.ir/article_43841.html 
Bermejo-Martins, E., Luis, E. O., Fernández-Berrocal, P., Martínez, M., & Sarrionandia, A. (2021). The Role of emotional intelligence and self-care in the stress perception during COVID-19 outbreak: An intercultural moderated mediation analysis. Personality and Individual Differences, 177(1), 1-9. https://doi.org/10.1016/j.paid.2021.110679
Bogolyubova, O., Fernandez, A. S. M., Lopez, B. T., & Portelli, P. (2021). Traumatic impact of the COVID-19 pandemic in an international sample: Contribution of fatalism to psychological distress and behavior change. European Journal of Trauma & Dissociation, 5(2), 1-7. https://doi.org/10.1016/j.ejtd.2021.100219
Bowlby, J. (1980). Attachment and loss.Vol. 3. loss. New York: Basic Books.
Çerkez, Y. (2017). The effect of attachment styles on perfectionism in romantic relationships. Eurasia Journal of Mathematics, Science and Technology Education, 13(10), 6923-6931. https://doi.org/10.12973/ejmste/78539
Cherniak, AD., Mikulincer, M., Shaver, PR., & Granqvist, P. (2020). Attachment theory and religion. Current Opinion in Psychology, 40, 126-130. https://doi.org/10.1016/j.copsyc.2020.08.020
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385-396. https://doi.org/10.2307/2136404
Collins, N. L. (1996). Working models of attachment: Implications for explanation, emotion, and behavior. Journal of Personality and Social Psychology, 71(4), 810–832. https://doi.org/10.1037/0022-3514.71.4.810
Conway, C. C., Naragon-Gainey, K., & Harris, M. T. (2021). The Structure of distress tolerance and neighboring emotion regulation abilities. Assessment, 28(4), 1050-1064. https://doi.org/10.1177%2F1073191120954914
Di Blasi, M., Gullo, S., Mancinelli, E., Freda, M. F., Esposito, G., Gelo, O. C. G., & Coco, G. L. (2021). Psychological distress associated with the COVID-19 lockdown: A two-wave network analysis. Journal of Affective Disorders, 284, 18-26. https://doi.org/10.1016/j.jad.2021.02.016
Duan, L., & Zhu, G. (2020). Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry, 7(4), 300-302. https://doi.org/10.1016/S2215-0366(20)30073-0
Dymecka, J., Gerymski, R., & Machnik-Czerwik, A. (2021). How does stress affect our life satisfaction during COVID-19 pandemic? Moderated mediation analysis of sense of coherence and fear of coronavirus. Psychology, Health & Medicine, 1-9. https://dx.doi.org/10.3389%2Ffpsyt.2021.712103
Eindor-Abarbanel, A., Naftali, T., Ruhimovich, N., Shitrit, A., Sklerovsky-Benjaminov, F., Konikoff, F., & Broide, E. (2020). Important relation between self-efficacy, sense of coherence, illness perceptions, depressionand anxiety in patients with inflammatory bowel disease. Frontline Gastroenterology, 35(3), 3-7. http://dx.doi.org/10.1136/flgastro-2020-101412
Eyni, S., Hashemi, Z., & Tagavi, R. (2019). Elderly perceived stress: The Predictive role of spiritual well-being, coping strategies, and sense of cohesion. Journal of Gerontology, 4(3), 25-34. [Persian] http://joge.ir/article-1-353-fa.html
Falgares, G., Marchetti, D., De Santis, S., Carrozzino, D., Kopala-Sibley, D. C., Fulcheri, M., & Verrocchio, M. C. (2017). Attachment styles and suicide-related behaviors in adolescence: The mediating role of self-criticism and dependency. Frontiers in Psychiatry, 36(8), 1-9. https://doi.org/10.3389/fpsyt.2017.00036
Farhadi, M., Mohagheghi, H., & Nesai Moghadam, B. (2020). The Relationship between attachment styles and student interpersonal problems: The role of mediating emotional intelligence. Razi Journal of Medical Sciences, 27(1), 73-84. [Persian] http://rjms.iums.ac.ir/article-1-5660-fa.html
Fearon, R., Pasco, B.K., Marian, J., Van, I., Marinus, H., Lapsley, A., Marie, R., & Glenn, I. (2010). This significance of insecure attachment and disorganized in the development of children externalizing behavior. Child Development, 81(2), 435-456. https://doi.org/10.1111/j.1467-8624.2009.01405.x
Feeney, JA., & Fitzgerald, J. (2022). Autonomy connection tensions, stress and attachment; The case of COVID-19. Current Opinion in Psychology, 43: 18-23. https://doi.org/10.1016/j.copsyc.2021.05.004
Flesia, L., Monaro, M., Mazza, C., Fietta, V., Colicino, E., Segatto, B., & Roma, P. (2020). Predicting perceived stress related to the Covid-19 outbreak through stable psychological traits and machine learning models. Journal of Clinical Medicine, 9(10), 3350. https://doi.org/10.3390/jcm9103350
Hashemi, Z., & Eyni, S. (2019). Perceived stress in the elderly: The role of spiritual intelligence, self-compassion, and psychological hardiness, Journal of Aging Psychology, 5(4), 289-299. [Persian]  https://dx.doi.org/10.22126/jap.2020.4836.1381
Huremović, D. (2019). Psychiatry of pandemics: a mental health response to infection outbreak. Springer. https://doi.org/10.1007/978-3-030-15346-5
Jafari, A., & Hesampour, F. (2017). Predicting life satisfaction based on spiritual intelligence and psychological capital in older people. Iranian Journal of Ageing, 12(1), 90-103. [Persian]  http://dx.doi.org/10.21859/sija-120190
Jones-Bitton, A., Best, C., MacTavish, J., Fleming, S., & Hoy, S. (2020). Stress, anxiety, depression, and resilience in Canadian farmers. Social Psychiatry and Psychiatric Epidemiology, 55, 229-236. https://doi.org/10.1007/s00127-019-01738-2
King, D. B. (2009). Rethinking claims of spiritual intelligence: A definition, model, and measure. Unpublished Master’s Thesis, Trent University, Peterborough, Ontario, Canada.
Kline, R. B. (2016). Principles and practice of structural equation modeling (4th Ed.). New York: The Guilford Press.
Krantz, G., & Ostergren, P. O. (2004). Does it make sense in a coherent way? Determinants of sense of coherence in Swedish women 40 to 50 years of age. International Journal of Behavioral Medicine, 11(1), 18-26. https://doi.org/10.1207/s15327558ijbm1101_3
Mahammadzadeh, A., Poursharifi, H., & Alipour, A. (2010). Validation of sense of coherence (SOC) 13-item scale in Iranian sample. Procedia Social and Behavioral Sciences, 5, 1451–1455. https://doi.org/10.1016/j.sbspro.2010.07.306
Mehra, A., Rani, S., Sahoo, S., Parveen, S., Singh, A. P., Chakrabarti, S., & Grover, S. (2020). A crisis for elderly with mental disorders: Relapse of symptoms due to heightened anxiety due to COVID-19. Asian Journal of Psychiatry, 51, 1-3. https://dx.doi.org/10.1016%2Fj.ajp.2020.102114
Meng, H., Xu, Y., Dai, J., Zhang, Y., Liu, B., & Yang, H. (2020). The Psychological effect of COVID-19 on the elderly in China. Psychiatry Research, 289, 1-3. https://dx.doi.org/10.1016%2Fj.psychres.2020.112983 
Moccia, L., Janiri, D., Pepe, M., Dattoli, L., Molinaro, M., De Martin, V., Chieffo, D., Janiri, L., Fiorillo, A., Sani, G., & Di Nicola, M. (2020). Affective temperament, attachment style, and the psychological impact of the COVID-19 outbreak: an early report on the Italian general population. Brain, Behavior, and Immunity, 87, 75-79.  https://doi.org/10.1016/j.bbi.2020.04.048
Momeni, K., Amani, R., Janjani, P., Majzoobi, M. R., Forstmeier, S., & Nosrati, P. (2022). Attachment styles and happiness in the elderly: the mediating role of reminiscence styles. BMC Geriatrics, 22(1), 1-11. https://doi.org/10.1186/s12877-022-03053-z
Narimani, M., & Eyni, S. (2021). The Causal model of coronavirus anxiety in the elderly based on perceived stress and sense of cohesion: The mediating role of perceived social support. Aging Psychology, 7(1), 13-27. [Persian] https://10.22126/JAP.2021.6043.1494
Ng, S. M., & Hou, W. K. (2017). Contentment duration mediates the associations between anxious attachment style and psychological distress. Frontiers in Psychology, 8, 258-267. https://doi.org/10.3389/fpsyg.2017.00258
Paika, V., Ntountoulaki, E., Papaioannou, D., & Hyphantis, T. (2017). The Greek version of the sense of coherence scale (SOC-29): Psychometric properties and associations with mental illness, suicidal risk and quality of life. Journal of Psychology and Clinical Psychiatry, 7(4), 1-10. http://dx.doi.org/10.15406/jpcpy.2017.07.00449
Parkes, C. M., & Hinde, J. S. (1982). The Place of attachment in human behaviour. London: Taylor & Francis Books Ltd.
Paules, C. I., Marston, H. D., & Fauci, A. S. (2020). Coronavirus infections-more than just the common cold. The Journal of the American Medical Association, 323(8), 707-708. https://doi.org/10.1101/2020.03.04.976662
Pearman, A., Hughes, M. L., Smith, E. L., & Neupert, S. D. (2021). Age differences in risk and resilience factors in COVID-19-related stress. Journal of Gerontology Series B, 76(2), e38-e44. https://doi.org/10.1093/geronb/gbaa120
Preuss, H., Capito, K., van Eickels, R. L., Zemp, M., & Kolar, D. R. (2021). Cognitive reappraisal and self-compassion as emotion regulation strategies for parents during COVID-19: An online randomized controlled trial. Internet Interventions, 24, 1-12. https://doi.org/10.1016/j.invent.2021.100388
Raghib, M., Siadat, A., Hakiminya, B., & Ahmadi, J. (2010). The validation of king’s spiritual intelligence scale (SISRI-24) among students at university of Isfahan. Journal of Psychological Achievements, 17(1), 141-164. [Persian]
Ralph, P., Magyar-Russell, G., Dilella, N., & Matter, S. (2014). Sense of coherence: big five correlates, spirituality, and incremental. Journal of Personality Psychology, 2(1), 1-9. https://doi.org/10.5114/cipp.2014.43096
Rekha, P., & Laxmi, S. (2008). Spirituality and elderly. Journal of Wellbeing, 1(1), 34-38.
Rohani, C., Khanjari, S., Abedi, H.A., Oskouie, F., & Langius-Eklöf, A. (2010). Health index, sense of coherence scale, brief religious coping scale and spiritual perspective scale: Psychometric properties. Journal of Advanced Nursing, 66 (12), 2796-2806. https://doi.org/10.1111/j.1365-2648.2010.05409.x
Sandberg, J., Bradford, A., & Brown, A. (2015). Differentiating between attachment styles and behaviors and their association with marital quality. Family Process, 56(2), 518-531.https://doi.org/10.1111/famp.12186
Schäfer, S. K., Sopp, M. R., Schanz, C. G., Staginnus, M., Göritz, A. S., & Michael, T. (2020). Impact of Covid-19 on public mental health and the buffering effect of sense of coherence. Psychotherapy and Psychosomatics, 89(6), 386–392. https://doi.org/10.1159/000510752
Segal, S., Sharabany, R., & Maaravi, Y. (2021). Policymakers as safe havens: The relationship between adult attachment style, COVID-19 fear, and regulation compliance. Personality and Individual Differences, 177, 110832. https://doi.org/10.1016/j.paid.2021.110832
Sherkat, M., Kalantari, M., Azarbayejani, M., & Abedi, M. R. (2020). The effects of education on spiritual intelligence on students' psychological wellbeing, anxiety, depression, and spiritual intelligence. Journal of Psychological Sciences, 19(88), 483-493. [Persian] http://psychologicalscience.ir/article-1-682-fa.html
Szcześniak, M., & Strochalska, K. (2020). Temperament and sense of coherence: Emotional intelligence as a mediator. International journal of environmental research and public health, 17(1), 219. https://doi.org/10.3390/ijerph17010219
Von Humboldt, S., Leal, I., & Pimenta, F. (2015). Sense of coherence, sociodemographic, lifestyle, and health-related factors in older adults' subjective well-being. International Journal of Gerontology, 9(1), 15-19. https://doi.org/10.1016/j.ijge.2014.01.007
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C.S, & Ho, R. C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus Disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health, 17(5), 1729. https://doi.org/10.3390/ijerph17051729
Wijekoon, C. N., Amaratunge, H., de Silva, Y., Senanayake, S., Jayawardane, P., & Senarath, U. (2017). Emotional intelligence and academic performance of medical undergraduates: a cross-sectional study in a selected university in Sri Lanka. BMC Medical Education, 17(1), 1-11. https://doi.org/10.1186/s12909-017-1018-9
Zandifar, A., Badrfam, R., Yazdani, SH., Arzaghi, S. M., Rahimi, F., Ghasemi, S., Khamisabadi, S., Mohammadian Khonsari, N., & Qorbani, M. (2020). Prevalence and severity of depression, anxiety, stress and perceived stress in hospitalized patients with COVID-19. Journal of Diabetes & Metabolic Disorders, 19(2), 1431-1438. https://doi.org/10.1007/s40200-020-00667-1
Zhang, P., Wang, M., Wang, Y., Wang, Y., Li, T., Zeng, J., & Gong, Y. (2021). Risk factors associated with the progression of COVID-19 in elderly. Diabetes Research and Clinical Practice, 171(2), 1-10. https://doi.org/10.1016/j.diabres.2020.108550
Zohar, D. (2012). Spiritual intelligence: The ultimate intelligence. Bloomsbury publishing.