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Vol. 13 No. 1 (2026)

June 2026

Structural Equation Modeling of the Association Between Psychological Hardiness and Quality of Life in Heart Failure Patients: The Mediating Role of Self-Efficacy

  • Amir Khojaste kashani
  • Sara Sanatnegar
  • Esmail Shirdel-Havar

International Journal of Applied Behavioral Sciences, Vol. 13 No. 1 (2026), 1 June 2026 , Page 31-40
https://doi.org/10.22037/ijabs.v13i1.49136 Published: 2026-06-01

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Abstract

Background and Aim: Heart failure is a prevalent chronic condition that is frequently associated with reduced quality of life. Psychological hardiness may play a protective role in improving quality of life among patients with heart failure, potentially through mechanisms such as self-efficacy. The present study aimed to examine the relationships among psychological hardiness, self-efficacy, and quality of life in patients with heart failure.

Materials and Methods: This descriptive cross sectional study used a correlational design and structural equation modeling. The sample consisted of 298 patients with heart failure who were recruited through convenience sampling from the cardiology department of Farabi Social Security Hospital in Mashhad, Iran. Data were collected using the Minnesota Living with Heart Failure Questionnaire (MLHFQ; 21 items; Rector, 1984), the General Self Efficacy Scale (10 items; Schwarzer et al.), and the Ahvaz Hardiness Questionnaire (1998). Descriptive statistics and correlations were calculated using SPSS, and structural equation modeling was performed with LISREL. Statistical significance was set at p < 0.05.

Results: The results of structural equation modeling indicated that self-efficacy significantly mediated the relationship between psychological hardiness and quality of life in patients with heart failure (β = 0.55, p < 0.05). In addition, psychological hardiness had a direct and significant positive association with quality of life (p < 0.05). Model fit indices suggested an acceptable model fit (RMSEA = 0.077; GFI = 0.92).

Conclusion: Psychological hardiness contributes to improved quality of life in patients with heart failure both directly and indirectly through self-efficacy. These findings underscore the potential value of interventions aimed at strengthening hardiness and self-efficacy to enhance patient well-being.

Keywords:
  • Psychological Hardiness, Self Efficacy, Quality of Life, Heart Failure, Structural Equation Modeling
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How to Cite

Khojaste kashani, A., Sanatnegar, S., & Shirdel-Havar, E. (2026). Structural Equation Modeling of the Association Between Psychological Hardiness and Quality of Life in Heart Failure Patients: The Mediating Role of Self-Efficacy. International Journal of Applied Behavioral Sciences, 13(1), 31–40. https://doi.org/10.22037/ijabs.v13i1.49136
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