Family Stress and Physical Rehabilitation Adherence in Adolescents: The Mediating Role of Health Beliefs

Objective: The objective of this study was to examine the relationship between family stress and physical rehabilitation adherence among adolescents, with health beliefs considered as a mediating variable.Methods and Materials: This descriptive correlational study included ۳۹۹ adolescents aged ۱۲–۱۸ years who were undergoing physical rehabilitation programs in Minnesota. The sample size was determined using the Krejcie and Morgan table to ensure sufficient statistical power. Data were collected using standardized and validated instruments: the Medical Outcomes Study General Adherence Scale for adherence, the Health Belief Model Scale for health beliefs, and the Family Inventory of Life Events and Changes for family stress. Data analysis was conducted using SPSS version ۲۷ and AMOS version ۲۱. Descriptive statistics were computed, Pearson’s correlations were used to examine bivariate associations, and a structural equation model (SEM) was applied to test the hypothesized mediating role of health beliefs.Findings: Results indicated that family stress was significantly and negatively associated with physical rehabilitation adherence (r = –.۳۹, p < .۰۰۱) and health beliefs (r = –.۲۹, p < .۰۰۱). Health beliefs were positively correlated with adherence (r = .۴۷, p < .۰۰۱). Family stress had a significant negative direct effect on adherence (β = –۰.۲۶, p < .۰۰۱) and an indirect effect through health beliefs (β = –۰.۱۲, p = .۰۰۲), with a total effect of β = –۰.۳۸ (p < .۰۰۱), confirming partial mediation.Conclusion: Strengthening adolescents’ health beliefs may serve as a buffer against the adverse effects of family stress and improve rehabilitation outcomes. Objective: The objective of this study was to examine the relationship between family stress and physical rehabilitation adherence among adolescents, with health beliefs considered as a mediating variable. Methods and Materials: This descriptive correlational study included ۳۹۹ adolescents aged ۱۲–۱۸ years who were undergoing physical rehabilitation programs in Minnesota. The sample size was determined using the Krejcie and Morgan table to ensure sufficient statistical power. Data were collected using standardized and validated instruments: the Medical Outcomes Study General Adherence Scale for adherence, the Health Belief Model Scale for health beliefs, and the Family Inventory of Life Events and Changes for family stress. Data analysis was conducted using SPSS version ۲۷ and AMOS version ۲۱. Descriptive statistics were computed, Pearson’s correlations were used to examine bivariate associations, and a structural equation model (SEM) was applied to test the hypothesized mediating role of health beliefs. Findings: Results indicated that family stress was significantly and negatively associated with physical rehabilitation adherence (r = –.۳۹, p < .۰۰۱) and health beliefs (r = –.۲۹, p < .۰۰۱). Health beliefs were positively correlated with adherence (r = .۴۷, p < .۰۰۱). Family stress had a significant negative direct effect on adherence (β = –۰.۲۶, p < .۰۰۱) and an indirect effect through health beliefs (β = –۰.۱۲, p = .۰۰۲), with a total effect of β = –۰.۳۸ (p < .۰۰۱), confirming partial mediation. Conclusion: Strengthening adolescents’ health beliefs may serve as a buffer against the adverse effects of family stress and improve rehabilitation outcomes.

کلیدواژه ها:

Family stress ، health beliefs ، rehabilitation adherence ، adolescents