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Volume 14, Issue 1 (2022)
Iran J War Public Health 2022, 14(1): 1-7 |
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Received: 2021/12/5 | Accepted: 2022/03/3 | Published: 2022/04/9
Received: 2021/12/5 | Accepted: 2022/03/3 | Published: 2022/04/9
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Talavari E, Ehteshamzadeh P, Asgari P, Naderi F. Relationship of Core Self-evaluation with Healthy Lifestyle by Mediating Social Intimacy and Self-Control in the Veterans. Iran J War Public Health 2022; 14 (1) :1-7
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1- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
2- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran ,-
2- Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran ,
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Introduction
War, as a cause of severe psychological stress, has individual, economic, social, and cultural consequences, which have a significant impact on the relationships of members of society over many generations. One of the harmful consequences of war is the physical and mental problems of people, who were involved directly or indirectly in war, and will affect them for a long time after the war [1]. Despite the high prevalence of psychological disorders among veterans, the factors and variables affecting the quality of life, satisfaction, and health of veterans are still unknown; because, according to most experts in the field of behavioral sciences and psychology, satisfaction and lifestyle are the strongest predictors of whether or not people suffer from psychological disorders [2]. The results of numerous researches in the field of physical and psychological health of veterans show many problems in various areas of their life such as emotional distress, social isolation [3], and quality of life [4].
However, research background has shown that a health-oriented lifestyle can reduce the impact of risk factors [5]. Lifestyle can be interpreted as a set of behaviors used to meet a person's needs and embody their chosen identity in front of others [6]. A health-promoting lifestyle is an important determinant of health status. Health-based lifestyle is the process of empowering people to increase control of health-related factors and their health [7]. Health-promoting lifestyle is a combination of six dimensions including a spiritual dimension, belief in God's supreme power to maintain the mental dimension of health, a sense of responsibility for maintaining and promoting health and society, maintaining interpersonal relationships to promote the social dimension of health, stress management to prevent of physical and mental disease, doing physical activity and following a healthy diet to maintain health in daily life [8].
One of the most influential psychological phenomena associated with this lifestyle is core self-evaluation. This phenomenon affects a person's evaluation of characteristics, behaviors, satisfaction, and even a person's behavior; because they have more connections with other attributes, beliefs, and evaluations than core attributes [9]. Core self-evaluation is the evaluation of individuals regarding their values, competencies, qualifications (performance, adaptability, success, and perseverance), talents, and abilities (in life control) [10]. People with high core self-evaluation can perceive different aspects of work and life positively, seek out more positive situations, and avoid negative ones. Work is a challenge that may act as a fundamental motivating affecting positively on one's behavior from the perspective of these people [11]. In general, people with higher core self-evaluation are more motivated to perform better, they tend to choose and retain more challenging jobs and are more satisfied with their occupations and lives, they experience lower levels of stress and conflict, and are better able to adapt to change, and take advantage of opportunities [12]. Core self-evaluation includes four components that refer to individual differences in self-esteem, overall self-efficacy, control status, and emotional stability [13]. This phenomenon is related to job satisfaction [14], life satisfaction and perceived stress [15], organizational support, and perceived support [16]. In fact, what is related to behavioral well-being and health is somehow interacting with this phenomenon. Emotion control has always been seen more in people who meet more indicators of mental health.
In some studies, it has been observed that the self-control factor is the most predictor of health variance. Self-control is the ability to adapt and change oneself following the environment and the ability to change one's inner responses and stop behaving inappropriately and avoid acting on them [18]. It is also the ability to recognize and regulate desires and emotions, which is characterized by the exercise of willpower, self-discipline, and the ability to postpone pleasure or reward [19]. In this way, people with high self-control are more psychologically adaptable, have fewer psychological problems, show fewer pathological symptoms, and have higher self-esteem. These people report fewer impulse control problems and experience healthier emotional lives. Hence, self-control leads to positive outcomes such as a healthier lifestyle; while failure in self-control can mean giving in to these impulses and performing harmful behaviors [20]. Thus, failure to manage health-related behaviors can have harmful consequences. Numerous factors such as time, awareness, and insufficient resources can limit a person's ability to self-control and a health-promoting lifestyle. Social intimacy, which is defined as the capacity to communicate, is a key factor in mental health and well-being.
Intimacy is an important feature of interpersonal relationships in early adulthood. Erickson identified intimacy tasks as a key factor in the transition from adolescence to adulthood [23]. According to Burke, intimacy has been seen in close interpersonal relationships, such as relationships with close friends, parents, and spouses. One of the signs of having the ability of intimacy is the desire to participate in close, warm, communicative, and committed interactions that play an essential role in the successful and fruitful life of an adult [24].
Research shows that choosing a healthy lifestyle can be influenced by several factors, including age and education, social and economic capital, smoking and alcohol consumption, stress, exercise and nutrition, and personality traits and cultural experiences [25].
Since maintaining and promoting the health of the disabled and war veterans is an important issue in any society, few studies have been conducted on veterans in this field. Therefore, in this study, we seek to design appropriate interventions to improve the lifestyle of veterans by examining the factors affecting the promoting lifestyle of this group of people and its mediating factors. Since core self-evaluation alone can not predict lifestyle-related health, it is necessary to examine the role of other characteristics in this regard. Therefore, this study aimed to test the causal relationship model of core self-evaluation and health-promoting lifestyle mediated by self-control and social intimacy with a favorable fit.
Instrument & Methods
This descriptive study was carried out on 382 veterans with more than 25% disability level, who worked in the southern oilfields of Iran. 202 people working in the National Iranian Oil Companies of Setad, Karun, Marun, Gachsaran, and Masjed Soleyman in Ahvaz, Aghajari, and Gachsaran cities were selected by the census. Research instruments were as follows:
1. Core self-evaluation questionnaire: It consists of 12 articles and 4 subscales, including self-esteem, control position, self-efficacy, and emotional stability. Answers are measured by a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). The minimum and maximum scores for each subscale in this questionnaire are 3 and 15, respectively. Hashemi Sheikh Shabani et al. in the research showed acceptable reliability of the scale by investigating the internal consistency of the questionnaire items with Cronbach's alpha method and the correlation of each question with the total test score. Confirmatory factor analysis also showed that, except for one item, other items on this scale significantly were affected by the factor. The results of the convergent validity study showed that the core self-evaluation scale had a positive relationship with the self-esteem, restraint status, and generalized self-efficacy scales and a negative relationship with the nervous personality trait scale [28]. The reliability of this questionnaire in the present study was 0.79 and 0.82 by Cronbach's alpha and halving methods, respectively.
2. Health-Promoting Lifestyle Questionnaire: The English version of this questionnaire contains 52 items. This questionnaire measures health-promoting behaviors in 6 dimensions, which are answered using the 4-point Likert scale (1=never, 2=sometimes, 3=often, and 4=always and normally). Cronbach's alpha coefficient has been reported to be 0.82 and 0.64-0.91 for the instrument and sub-scales, respectively, and test-retest results showed stability for the questionnaire. Confirmatory factor analysis of the 6-factor model indicates an acceptable fit. Examining the latent structures of the measurement model has reduced the number of cases from 52 to 49 [29]. The reliability of the questionnaire in this study was calculated to be 0.93 and 0.88 by Cronbach's alpha and halving methods, respectively.
3. Social Intimacy Questionnaire: The scale consists of two sets of items, 6 of which are developed to describe the frequency of intimacy and 11 to the intensity of intimacy experienced at present. The items are scored using the 10-point Likert scale, from "very rare"=1 to "always"=10. Questions 2 and 14 are reversely scored. Miller & Lefcourt reported Cronbach's alpha coefficient in various performances of the scale, from 0.86 to 0.91. They also reported the reliability coefficient of the retest method with a time interval of more than two months and more than one month as 0.84 and 0.96, respectively [30]. Daneshvarpour et al. reported a Cronbach's alpha coefficient of 0.79 in a preliminary study [31]. The reliability of the questionnaire in this study was calculated to be 0.80 and 0.78 by Cronbach's alpha and halving methods, respectively.
4. Self-control questionnaire: This is a self-report questionnaire consisting of 24 items. These items were scored by a 5-points Likert scale from “no similarity at all”=0 to very similar=4. The scores 0-48, 48-95, and >95 indicate weak self-control, moderate self-control, and strong self-control. Tangney et al. [32] calculated the Cronbach's alpha test for the two separate samples at 0.83 and 0.85 levels, respectively. Mousavimoghadam et al. reported the significance of the convergent validity and divergent validity coefficient of the questionnaire using the Tangney et al.'s self-control questionnaire and the Material Consumption Questionnaire, respectively [33]. The reliability of this questionnaire in this study was calculated at 0.71 and 0.76, by Cronbach's alpha and halving methods, respectively.
This study was approved by the Research Ethics Committee of the Islamic Azad University, Ahvaz Branch. The questionnaires were provided to the participants after conducting the necessary administrative coordination and identifying eligible individuals through a research interface in the Labor Relations and Social Affairs Offices located in the National Company of Southern Oilfields.
First, descriptive statistical methods such as mean, standard deviation, and Pearson correlations were performed. More complex analyzes were then used to evaluate the hypothetical model through path analysis. In this model, the information is in the form of covariance or correlation matrices, and a set of regression equations is compiled between the variables. The Structural Equation Model (SEM) is used to evaluate the hypothetical model. Several indicators will be used to evaluate and compare the overall suitability of the SEM model including Chi-square (χ2) and value p<050; the ratio of squares to degrees of freedom; Goodness Fit Index (GFI); Adjusted Goodness Fit Index (AGFI); Comparative Fitness Index (CFI); Incremental fitness index (IFI); Bentler-Bount Index or Softened Fitness Index (NFI); Tucker-Louise Index (TLI), the Root of Mean Squared Error of Approximation (RMSEA). The intermediate relationships of the final model were also tested using bootstrap. Data were analyzed using SPSS 24 and AMOS 18 software. An acceptable level of significance for confirming or rejecting the hypotheses was considered p<0.05.
Findings
Education level status of the subjects included diploma and lower (n=58), associate (n=39), bachelor (n=50), master and doctorate (n=55). Also, 198, 4, 82, and 120 subjects were married, single, operational staff, and headquarters members. The mean±standard deviation of age, work experience, percentage of injuries of participants were 54.49±4.39, 30.25±6.74, and 34.65±12.82, respectively.
Descriptive findings included mean, standard deviation, minimum, and maximum scores related to the variables of this study for the subjects have been described in Table 1.
There was a significant and positive correlation between the variables (p<0.05; Table 2).
Table 1) Results of scores obtained from 4 questionnaires (n=202)
Table 2) Results of correlation matrix between research variables in the subjects (n=202)
The results of skewness and elongation of each of the research variables to investigate the normality of distribution showed that the skewness values for the variables are in the range of -3 and +3 and the elongation values were in the range of -10 and +10. Therefore, the normal distribution of the variables was confirmed.
To evaluate the univariate output data, the z score of each person in each variable was calculated using SPSS software. The results showed that the data of subject number 34 were equal to 3.4 standard deviations higher or lower than the mean, which was considered as univariate outliers. Therefore, this subject's scores were removed from the analyzed data. The Mahalanobis distance was also calculated for the exogenous variables of the model to examine multivariate outlier data. The lowest and highest values of Mahalanobis distance were 0.063 and 19.76, respectively. Given that the critical chi-square at the level of p=0.05 was equal to 5.99 and the maximum distance of Mahalanobis was 19.76 and 3 subjects were more than chi-square; therefore, they were removed from the data set as multivariate outliers. Since in the model estimation step, the proposed observation had a good fit and all the paths were meaningful, therefore as a result, without any modification, the fit of the model was confirmed. The proposed model of this study with the path coefficients has been shown in Figure 1.
Figure 1) Output of the proposed model along with the standard coefficients of the paths
The results of the Chi-square (χ2=2.92), relative chi-square (χ2/df=2.92), Goodness Fit Index (GFI=0.963), Adjusted Goodness Fit Index (AGFI=0.933), Comparative Fitness Index (CFI=0.926), Incremental fitness index (IFI=0.928), Tucker-Louise Index (TLI=0.909), and the Root of Mean Squared Error of Approximation (RMSEA=0.07) indicated a good fit of the modified model. Therefore, the modified model had a good fit and all path coefficients related to the proposed model were significant (p<0.05).
The bootstrap method was used to investigate the intermediate relationships between research variables. The result of Bootstrap for the indirect effect of core self-evaluation on a health-promoting lifestyle through social intimacy was 0.138. The lower and upper limits of the confidence interval were calculated as 0.092 and 0.21, respectively. The significance level was 0.004, and the number of Bootstrap resampling was 2000. Since zero is outside the confidence interval, the indirect effect was significant, and the proposed model was approved. In addition, the result of Bootstrap for the indirect effect of core self-evaluation on a health-promoting lifestyle through self-control was 0.12. The lower limit of the confidence interval was calculated at 0.062, and the upper limit was calculated at 0.19. The significance level was 0.012, and the number of Bootstrap re-sampling was 2000. Since zero is outside the confidence interval, the indirect effect was significant, and the proposed model was approved.
Discussion
Therefore, this study aimed to investigate the relationship of core self-evaluations with a health-promoting lifestyle by mediating social intimacy and self-control in the veterans of the National Iranian South Oil Company. The findings showed a significant effect of core self-evaluation on the social intimacy and the self-control attributes of the veterans. In addition, core self-evaluation had a significant effect on health-promoting lifestyles. Social intimacy and self-control had a significant effect on the health-promoting lifestyle of the subjects. There was a causal relationship between core self-evaluation and the health-promoting lifestyle of the veterans through social intimacy and self-control. Montakhab Yegane & Arshadi [17] found that people with higher core self-evaluation focused on the positive aspects of their occupation and life. In this regard, Saeedi et al. [21] reported a positive significant relationship between self-control with health. Mosavimoghadam et al. [22], showed a positive significant relationship between self-control with the mental health of the female and male students. Montakhab Yegane et al. [27] also showed that core self-evaluation has a moderating role in the relationship between moral character, psychological well-being, and job stress. To explain the results of the research, it can be said that the new health model shows that health is a responsibility of all individuals and communities. Therefore, the determinants of health do not depend only on medical and public health services, but also include several factors of personal and environmental factors. Thus, the new approach to public health consistently emphasizes the promotion of health, which has an important place in the policy of the World Health Organization. Creating supportive environments, strengthening social functioning, reorienting health services, and developing individual skills include giving individuals the opportunity to learn self-care and living skills through health-promoting behaviors. Pender et al. [34] showed that health-promoting behaviors are part of daily life activities that include a set of personal happiness, values, and well-being [35]. According to the health promotion approach, people should be empowered to take responsibility for their health and adopt a healthy lifestyle [36]. Lifestyle correction is essential to maintain and promote health. Improving a health promoting is aimed to empower people to improve their lifestyles. They also have more control over their health to enjoy overall health and continue a healthy life [37]. People with desirable core self-evaluation can adapt to external barriers and experience desirable emotions and attitudes. In contrast, people with poor core self-evaluation believe that their actions are futile or that they can do little to correct the unfavorable conditions. Therefore, they are prone to experiencing negative emotions and feelings. People with high core self-esteem are positive, confident, effective, efficient, and adaptable people who believe in their power of action and value and respect themselves. Finally, staff and veterans with higher core self-evaluation have higher mental health and better lifestyles.
Self-control training as one of the components of emotional intelligence promotes the level of mental health and lifestyle of veterans. To explain this finding, we can refer to the stressful conditions of the employed veterans in the oil-rich areas of the south. Therefore, self-control training in this group of employed people with special problems is one of the skills increasing their level of mental health and lifestyle in the face of stressors; so that having high self-control skills can have a positive effect on their quality of life and improve their lifestyle.
Today, establishing positive and sincere relationships is essential in the workplace and profession. Communication is the only and most effective way that can deepen intimacy, if people are good communicators, all aspects of their lives will improve [38]. Social intimacy is a person's desire to have supportive and loving communication without losing herself/himself. Intimacy requires the exchange of deep communication and feelings that allow people to become more emotionally close and share their most private issues. The deep intimacy that people experience in their relationships depends on their ability to build effective relationships and control their thoughts and emotions. The ability to have intimate relationships with others increases self-control, empathy, sociability, and self-satisfaction in relationships. Intimate relationships are also a key factor in the mental health of adults [39]. Therefore, it can be expected that the mental health and lifestyle of people will increase by increasing social intimacy. The key to developing healthy communities with healthy people is to develop the right lifestyle. A deep understanding of interpersonal relationships in their social context leads to the development of effective approaches to health promotion. Macro-national policies have a fundamental impact on the life of individuals, their relationships, and the capacity building of societies for sustainable development. Promoting a healthy lifestyle is an extension of the continuous movement toward individual and social empowerment in the field of providing, maintaining, and promoting health. According to the research findings, with the increase of pivotal self-evaluation in the veterans, their social intimacy and self-control have improved, which leads to an increase in their health-promoting lifestyle; therefore, the necessary grounds for improving the quality of life and health-related lifestyle in veterans should be provided. In this regard, the level of health in the veteran’s lives can be improved using providing proper training. Also increased the quality of life among the veterans by providing the necessary infrastructure.
The limitations of this research were the lack of research background to make a comparison, and limited research community to veterans working in oil-rich areas of the south. It is suggested to conduct this research on a larger scale and for all Iranians. It is suggested that the lifestyle changes in veterans be examined in longitudinal studies and that other variable affecting their health be evaluated and measured. It is also recommended to provide training programs for health-promoting lifestyles among employees with difficult working and physical conditions to raise their awareness about their lifestyle and level of health and provide strategies promoting health and preventing physical and mental illness.
Conclusion
Social intimacy and self-control can play a mediating role in the relationship between core self-evaluation and a health-promoting lifestyle among employed veterans in the oil companies in southern Iran.
Acknowledgments: The authors thank all those who helped us in this research and all the veterans working in the oil-rich areas of the south, which are the pride of Iran.
Ethical permission: This study was approved by the Research Ethics Committee with the ID IR.IAU.AHVAZ.REC.1399.078.
Conflict of interest: No cases were reported by the authors.
Authors' contribution: Elahe Talavari (First author), Introduction Writer/Main Researcher/Discussion Writer (50%); Parvin Ehteshamzadeh (Second Author, Methodologist/Discussion Writer/Statistical Analyst (25%); Parviz Asgari (Thirst Author), Methodologist/Discussion Writer (15%); Naderi Farah (Forth Author), Methodologist/Discussion Writer (10%).
Financial resources: This study did not receive the support of any institution or organization.
War, as a cause of severe psychological stress, has individual, economic, social, and cultural consequences, which have a significant impact on the relationships of members of society over many generations. One of the harmful consequences of war is the physical and mental problems of people, who were involved directly or indirectly in war, and will affect them for a long time after the war [1]. Despite the high prevalence of psychological disorders among veterans, the factors and variables affecting the quality of life, satisfaction, and health of veterans are still unknown; because, according to most experts in the field of behavioral sciences and psychology, satisfaction and lifestyle are the strongest predictors of whether or not people suffer from psychological disorders [2]. The results of numerous researches in the field of physical and psychological health of veterans show many problems in various areas of their life such as emotional distress, social isolation [3], and quality of life [4].
However, research background has shown that a health-oriented lifestyle can reduce the impact of risk factors [5]. Lifestyle can be interpreted as a set of behaviors used to meet a person's needs and embody their chosen identity in front of others [6]. A health-promoting lifestyle is an important determinant of health status. Health-based lifestyle is the process of empowering people to increase control of health-related factors and their health [7]. Health-promoting lifestyle is a combination of six dimensions including a spiritual dimension, belief in God's supreme power to maintain the mental dimension of health, a sense of responsibility for maintaining and promoting health and society, maintaining interpersonal relationships to promote the social dimension of health, stress management to prevent of physical and mental disease, doing physical activity and following a healthy diet to maintain health in daily life [8].
One of the most influential psychological phenomena associated with this lifestyle is core self-evaluation. This phenomenon affects a person's evaluation of characteristics, behaviors, satisfaction, and even a person's behavior; because they have more connections with other attributes, beliefs, and evaluations than core attributes [9]. Core self-evaluation is the evaluation of individuals regarding their values, competencies, qualifications (performance, adaptability, success, and perseverance), talents, and abilities (in life control) [10]. People with high core self-evaluation can perceive different aspects of work and life positively, seek out more positive situations, and avoid negative ones. Work is a challenge that may act as a fundamental motivating affecting positively on one's behavior from the perspective of these people [11]. In general, people with higher core self-evaluation are more motivated to perform better, they tend to choose and retain more challenging jobs and are more satisfied with their occupations and lives, they experience lower levels of stress and conflict, and are better able to adapt to change, and take advantage of opportunities [12]. Core self-evaluation includes four components that refer to individual differences in self-esteem, overall self-efficacy, control status, and emotional stability [13]. This phenomenon is related to job satisfaction [14], life satisfaction and perceived stress [15], organizational support, and perceived support [16]. In fact, what is related to behavioral well-being and health is somehow interacting with this phenomenon. Emotion control has always been seen more in people who meet more indicators of mental health.
In some studies, it has been observed that the self-control factor is the most predictor of health variance. Self-control is the ability to adapt and change oneself following the environment and the ability to change one's inner responses and stop behaving inappropriately and avoid acting on them [18]. It is also the ability to recognize and regulate desires and emotions, which is characterized by the exercise of willpower, self-discipline, and the ability to postpone pleasure or reward [19]. In this way, people with high self-control are more psychologically adaptable, have fewer psychological problems, show fewer pathological symptoms, and have higher self-esteem. These people report fewer impulse control problems and experience healthier emotional lives. Hence, self-control leads to positive outcomes such as a healthier lifestyle; while failure in self-control can mean giving in to these impulses and performing harmful behaviors [20]. Thus, failure to manage health-related behaviors can have harmful consequences. Numerous factors such as time, awareness, and insufficient resources can limit a person's ability to self-control and a health-promoting lifestyle. Social intimacy, which is defined as the capacity to communicate, is a key factor in mental health and well-being.
Intimacy is an important feature of interpersonal relationships in early adulthood. Erickson identified intimacy tasks as a key factor in the transition from adolescence to adulthood [23]. According to Burke, intimacy has been seen in close interpersonal relationships, such as relationships with close friends, parents, and spouses. One of the signs of having the ability of intimacy is the desire to participate in close, warm, communicative, and committed interactions that play an essential role in the successful and fruitful life of an adult [24].
Research shows that choosing a healthy lifestyle can be influenced by several factors, including age and education, social and economic capital, smoking and alcohol consumption, stress, exercise and nutrition, and personality traits and cultural experiences [25].
Since maintaining and promoting the health of the disabled and war veterans is an important issue in any society, few studies have been conducted on veterans in this field. Therefore, in this study, we seek to design appropriate interventions to improve the lifestyle of veterans by examining the factors affecting the promoting lifestyle of this group of people and its mediating factors. Since core self-evaluation alone can not predict lifestyle-related health, it is necessary to examine the role of other characteristics in this regard. Therefore, this study aimed to test the causal relationship model of core self-evaluation and health-promoting lifestyle mediated by self-control and social intimacy with a favorable fit.
Instrument & Methods
This descriptive study was carried out on 382 veterans with more than 25% disability level, who worked in the southern oilfields of Iran. 202 people working in the National Iranian Oil Companies of Setad, Karun, Marun, Gachsaran, and Masjed Soleyman in Ahvaz, Aghajari, and Gachsaran cities were selected by the census. Research instruments were as follows:
1. Core self-evaluation questionnaire: It consists of 12 articles and 4 subscales, including self-esteem, control position, self-efficacy, and emotional stability. Answers are measured by a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). The minimum and maximum scores for each subscale in this questionnaire are 3 and 15, respectively. Hashemi Sheikh Shabani et al. in the research showed acceptable reliability of the scale by investigating the internal consistency of the questionnaire items with Cronbach's alpha method and the correlation of each question with the total test score. Confirmatory factor analysis also showed that, except for one item, other items on this scale significantly were affected by the factor. The results of the convergent validity study showed that the core self-evaluation scale had a positive relationship with the self-esteem, restraint status, and generalized self-efficacy scales and a negative relationship with the nervous personality trait scale [28]. The reliability of this questionnaire in the present study was 0.79 and 0.82 by Cronbach's alpha and halving methods, respectively.
2. Health-Promoting Lifestyle Questionnaire: The English version of this questionnaire contains 52 items. This questionnaire measures health-promoting behaviors in 6 dimensions, which are answered using the 4-point Likert scale (1=never, 2=sometimes, 3=often, and 4=always and normally). Cronbach's alpha coefficient has been reported to be 0.82 and 0.64-0.91 for the instrument and sub-scales, respectively, and test-retest results showed stability for the questionnaire. Confirmatory factor analysis of the 6-factor model indicates an acceptable fit. Examining the latent structures of the measurement model has reduced the number of cases from 52 to 49 [29]. The reliability of the questionnaire in this study was calculated to be 0.93 and 0.88 by Cronbach's alpha and halving methods, respectively.
3. Social Intimacy Questionnaire: The scale consists of two sets of items, 6 of which are developed to describe the frequency of intimacy and 11 to the intensity of intimacy experienced at present. The items are scored using the 10-point Likert scale, from "very rare"=1 to "always"=10. Questions 2 and 14 are reversely scored. Miller & Lefcourt reported Cronbach's alpha coefficient in various performances of the scale, from 0.86 to 0.91. They also reported the reliability coefficient of the retest method with a time interval of more than two months and more than one month as 0.84 and 0.96, respectively [30]. Daneshvarpour et al. reported a Cronbach's alpha coefficient of 0.79 in a preliminary study [31]. The reliability of the questionnaire in this study was calculated to be 0.80 and 0.78 by Cronbach's alpha and halving methods, respectively.
4. Self-control questionnaire: This is a self-report questionnaire consisting of 24 items. These items were scored by a 5-points Likert scale from “no similarity at all”=0 to very similar=4. The scores 0-48, 48-95, and >95 indicate weak self-control, moderate self-control, and strong self-control. Tangney et al. [32] calculated the Cronbach's alpha test for the two separate samples at 0.83 and 0.85 levels, respectively. Mousavimoghadam et al. reported the significance of the convergent validity and divergent validity coefficient of the questionnaire using the Tangney et al.'s self-control questionnaire and the Material Consumption Questionnaire, respectively [33]. The reliability of this questionnaire in this study was calculated at 0.71 and 0.76, by Cronbach's alpha and halving methods, respectively.
This study was approved by the Research Ethics Committee of the Islamic Azad University, Ahvaz Branch. The questionnaires were provided to the participants after conducting the necessary administrative coordination and identifying eligible individuals through a research interface in the Labor Relations and Social Affairs Offices located in the National Company of Southern Oilfields.
First, descriptive statistical methods such as mean, standard deviation, and Pearson correlations were performed. More complex analyzes were then used to evaluate the hypothetical model through path analysis. In this model, the information is in the form of covariance or correlation matrices, and a set of regression equations is compiled between the variables. The Structural Equation Model (SEM) is used to evaluate the hypothetical model. Several indicators will be used to evaluate and compare the overall suitability of the SEM model including Chi-square (χ2) and value p<050; the ratio of squares to degrees of freedom; Goodness Fit Index (GFI); Adjusted Goodness Fit Index (AGFI); Comparative Fitness Index (CFI); Incremental fitness index (IFI); Bentler-Bount Index or Softened Fitness Index (NFI); Tucker-Louise Index (TLI), the Root of Mean Squared Error of Approximation (RMSEA). The intermediate relationships of the final model were also tested using bootstrap. Data were analyzed using SPSS 24 and AMOS 18 software. An acceptable level of significance for confirming or rejecting the hypotheses was considered p<0.05.
Findings
Education level status of the subjects included diploma and lower (n=58), associate (n=39), bachelor (n=50), master and doctorate (n=55). Also, 198, 4, 82, and 120 subjects were married, single, operational staff, and headquarters members. The mean±standard deviation of age, work experience, percentage of injuries of participants were 54.49±4.39, 30.25±6.74, and 34.65±12.82, respectively.
Descriptive findings included mean, standard deviation, minimum, and maximum scores related to the variables of this study for the subjects have been described in Table 1.
There was a significant and positive correlation between the variables (p<0.05; Table 2).
Table 1) Results of scores obtained from 4 questionnaires (n=202)
Table 2) Results of correlation matrix between research variables in the subjects (n=202)
The results of skewness and elongation of each of the research variables to investigate the normality of distribution showed that the skewness values for the variables are in the range of -3 and +3 and the elongation values were in the range of -10 and +10. Therefore, the normal distribution of the variables was confirmed.
To evaluate the univariate output data, the z score of each person in each variable was calculated using SPSS software. The results showed that the data of subject number 34 were equal to 3.4 standard deviations higher or lower than the mean, which was considered as univariate outliers. Therefore, this subject's scores were removed from the analyzed data. The Mahalanobis distance was also calculated for the exogenous variables of the model to examine multivariate outlier data. The lowest and highest values of Mahalanobis distance were 0.063 and 19.76, respectively. Given that the critical chi-square at the level of p=0.05 was equal to 5.99 and the maximum distance of Mahalanobis was 19.76 and 3 subjects were more than chi-square; therefore, they were removed from the data set as multivariate outliers. Since in the model estimation step, the proposed observation had a good fit and all the paths were meaningful, therefore as a result, without any modification, the fit of the model was confirmed. The proposed model of this study with the path coefficients has been shown in Figure 1.
Figure 1) Output of the proposed model along with the standard coefficients of the paths
The results of the Chi-square (χ2=2.92), relative chi-square (χ2/df=2.92), Goodness Fit Index (GFI=0.963), Adjusted Goodness Fit Index (AGFI=0.933), Comparative Fitness Index (CFI=0.926), Incremental fitness index (IFI=0.928), Tucker-Louise Index (TLI=0.909), and the Root of Mean Squared Error of Approximation (RMSEA=0.07) indicated a good fit of the modified model. Therefore, the modified model had a good fit and all path coefficients related to the proposed model were significant (p<0.05).
The bootstrap method was used to investigate the intermediate relationships between research variables. The result of Bootstrap for the indirect effect of core self-evaluation on a health-promoting lifestyle through social intimacy was 0.138. The lower and upper limits of the confidence interval were calculated as 0.092 and 0.21, respectively. The significance level was 0.004, and the number of Bootstrap resampling was 2000. Since zero is outside the confidence interval, the indirect effect was significant, and the proposed model was approved. In addition, the result of Bootstrap for the indirect effect of core self-evaluation on a health-promoting lifestyle through self-control was 0.12. The lower limit of the confidence interval was calculated at 0.062, and the upper limit was calculated at 0.19. The significance level was 0.012, and the number of Bootstrap re-sampling was 2000. Since zero is outside the confidence interval, the indirect effect was significant, and the proposed model was approved.
Discussion
Therefore, this study aimed to investigate the relationship of core self-evaluations with a health-promoting lifestyle by mediating social intimacy and self-control in the veterans of the National Iranian South Oil Company. The findings showed a significant effect of core self-evaluation on the social intimacy and the self-control attributes of the veterans. In addition, core self-evaluation had a significant effect on health-promoting lifestyles. Social intimacy and self-control had a significant effect on the health-promoting lifestyle of the subjects. There was a causal relationship between core self-evaluation and the health-promoting lifestyle of the veterans through social intimacy and self-control. Montakhab Yegane & Arshadi [17] found that people with higher core self-evaluation focused on the positive aspects of their occupation and life. In this regard, Saeedi et al. [21] reported a positive significant relationship between self-control with health. Mosavimoghadam et al. [22], showed a positive significant relationship between self-control with the mental health of the female and male students. Montakhab Yegane et al. [27] also showed that core self-evaluation has a moderating role in the relationship between moral character, psychological well-being, and job stress. To explain the results of the research, it can be said that the new health model shows that health is a responsibility of all individuals and communities. Therefore, the determinants of health do not depend only on medical and public health services, but also include several factors of personal and environmental factors. Thus, the new approach to public health consistently emphasizes the promotion of health, which has an important place in the policy of the World Health Organization. Creating supportive environments, strengthening social functioning, reorienting health services, and developing individual skills include giving individuals the opportunity to learn self-care and living skills through health-promoting behaviors. Pender et al. [34] showed that health-promoting behaviors are part of daily life activities that include a set of personal happiness, values, and well-being [35]. According to the health promotion approach, people should be empowered to take responsibility for their health and adopt a healthy lifestyle [36]. Lifestyle correction is essential to maintain and promote health. Improving a health promoting is aimed to empower people to improve their lifestyles. They also have more control over their health to enjoy overall health and continue a healthy life [37]. People with desirable core self-evaluation can adapt to external barriers and experience desirable emotions and attitudes. In contrast, people with poor core self-evaluation believe that their actions are futile or that they can do little to correct the unfavorable conditions. Therefore, they are prone to experiencing negative emotions and feelings. People with high core self-esteem are positive, confident, effective, efficient, and adaptable people who believe in their power of action and value and respect themselves. Finally, staff and veterans with higher core self-evaluation have higher mental health and better lifestyles.
Self-control training as one of the components of emotional intelligence promotes the level of mental health and lifestyle of veterans. To explain this finding, we can refer to the stressful conditions of the employed veterans in the oil-rich areas of the south. Therefore, self-control training in this group of employed people with special problems is one of the skills increasing their level of mental health and lifestyle in the face of stressors; so that having high self-control skills can have a positive effect on their quality of life and improve their lifestyle.
Today, establishing positive and sincere relationships is essential in the workplace and profession. Communication is the only and most effective way that can deepen intimacy, if people are good communicators, all aspects of their lives will improve [38]. Social intimacy is a person's desire to have supportive and loving communication without losing herself/himself. Intimacy requires the exchange of deep communication and feelings that allow people to become more emotionally close and share their most private issues. The deep intimacy that people experience in their relationships depends on their ability to build effective relationships and control their thoughts and emotions. The ability to have intimate relationships with others increases self-control, empathy, sociability, and self-satisfaction in relationships. Intimate relationships are also a key factor in the mental health of adults [39]. Therefore, it can be expected that the mental health and lifestyle of people will increase by increasing social intimacy. The key to developing healthy communities with healthy people is to develop the right lifestyle. A deep understanding of interpersonal relationships in their social context leads to the development of effective approaches to health promotion. Macro-national policies have a fundamental impact on the life of individuals, their relationships, and the capacity building of societies for sustainable development. Promoting a healthy lifestyle is an extension of the continuous movement toward individual and social empowerment in the field of providing, maintaining, and promoting health. According to the research findings, with the increase of pivotal self-evaluation in the veterans, their social intimacy and self-control have improved, which leads to an increase in their health-promoting lifestyle; therefore, the necessary grounds for improving the quality of life and health-related lifestyle in veterans should be provided. In this regard, the level of health in the veteran’s lives can be improved using providing proper training. Also increased the quality of life among the veterans by providing the necessary infrastructure.
The limitations of this research were the lack of research background to make a comparison, and limited research community to veterans working in oil-rich areas of the south. It is suggested to conduct this research on a larger scale and for all Iranians. It is suggested that the lifestyle changes in veterans be examined in longitudinal studies and that other variable affecting their health be evaluated and measured. It is also recommended to provide training programs for health-promoting lifestyles among employees with difficult working and physical conditions to raise their awareness about their lifestyle and level of health and provide strategies promoting health and preventing physical and mental illness.
Conclusion
Social intimacy and self-control can play a mediating role in the relationship between core self-evaluation and a health-promoting lifestyle among employed veterans in the oil companies in southern Iran.
Acknowledgments: The authors thank all those who helped us in this research and all the veterans working in the oil-rich areas of the south, which are the pride of Iran.
Ethical permission: This study was approved by the Research Ethics Committee with the ID IR.IAU.AHVAZ.REC.1399.078.
Conflict of interest: No cases were reported by the authors.
Authors' contribution: Elahe Talavari (First author), Introduction Writer/Main Researcher/Discussion Writer (50%); Parvin Ehteshamzadeh (Second Author, Methodologist/Discussion Writer/Statistical Analyst (25%); Parviz Asgari (Thirst Author), Methodologist/Discussion Writer (15%); Naderi Farah (Forth Author), Methodologist/Discussion Writer (10%).
Financial resources: This study did not receive the support of any institution or organization.
Keywords:
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