{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T14:30:52Z","timestamp":1778509852891,"version":"3.51.4"},"reference-count":0,"publisher":"Knowledge E DMCC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJPS"],"abstract":"<jats:p>Objective: Psychological and behavioral factors play a critical role in diabetes management. This study investigates the structural relationships among the informational-motivational-behavioral skills (IMB) and acceptance and commitment processes with self-management, treatment adherence, and Glycated hemoglobin (HbA1c) levels in diabetic patients, with distress as a mediator.\r\nMethod: A cross-sectional study was conducted with 321 patients with type 2 diabetes patients referred to health centers in Jiroft, Iran. Data were collected using the Diabetes Self-Management Questionnaire-Revised (DSMQ-R), the IMB-based Diabetic Self-Management Scale (IMB-DSMS), the Diabetes Distress Scale (DDS-17), the Diabetes Acceptance and Action Scale-Revised (DAAS-R), and the Diabetes Mellitus Treatment Adherence Scale (DMTAS). Structural equation modeling (SEM) was employed using LISREL-8.8 for analysis.\r\nResults: Acceptance and commitment were positively associated with IMB skills (\u03b2 = 0.34, P &lt; 0.001), self-management (\u03b2 = 0.51, P &lt; 0.001), and treatment adherence (t = 8.19, \u03b2 = 0.55), while negatively associated with distress (\u03b2 = -0.24, P &lt; 0.001). IMB skills were associated with increased self-management (\u03b2 = 0.43, P &lt; 0.001) and adherence (\u03b2 = 0.46, P &lt; 0.001), and also negatively associated with distress (\u03b2 = -0.40, P &lt; 0.001). Distress was also negatively associated with self-management (\u03b2 = -0.22, P &lt; 0.001) and adherence (\u03b2 = -0.29, P &lt; 0.001), and positively associated with HbA1c levels (\u03b2 = 0.19, P &lt; 0.001). Bootstrap results confirmed distress as a mediator between IMB skills, acceptance, and commitment, and self-management\/adherence (P &lt; 0.05). The model showed excellent fit (RMSEA = 0.046, \u03c7\u00b2\/df = 2.51).\r\nConclusion: This cross-sectional study tested a structural model integrating acceptance-commitment and IMB frameworks. Findings highlight associations among psychological flexibility, IMB skills, reduced distress, and improved self-management. These relationships inform potential intervention targets. Longitudinal and experimental studies are required to evaluate causal effects and clinical implementation.<\/jats:p>","DOI":"10.18502\/ijps.v21i2.21221","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T09:51:31Z","timestamp":1776246691000},"source":"Crossref","is-referenced-by-count":0,"title":["Structural Effect of Informational-Motivational-Behavioral Skills and Acceptance-Commitment in Self-Management, Adherence, and HbA1c in Diabetes: The Mediating Role of Distress"],"prefix":"10.18502","author":[{"given":"Zahra Heidari","family":"Archandani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac Rahimian-","family":"Boogar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"7770","published-online":{"date-parts":[[2026,4,13]]},"container-title":["Iranian Journal of Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/publish.kne-publishing.com\/index.php\/IJPS\/article\/download\/21221\/19711","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/publish.kne-publishing.com\/index.php\/IJPS\/article\/download\/21221\/19711","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T13:47:39Z","timestamp":1778507259000},"score":1,"resource":{"primary":{"URL":"https:\/\/publish.kne-publishing.com\/index.php\/IJPS\/article\/view\/21221"},"secondary":[{"URL":"https:\/\/ijps.tums.ac.ir\/index.php\/ijps\/article\/view\/4447","label":"UNIVERSITY"}]},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":0,"URL":"https:\/\/doi.org\/10.18502\/ijps.v21i2.21221","relation":{},"ISSN":["1735-4587","2008-2215"],"issn-type":[{"value":"1735-4587","type":"electronic"},{"value":"2008-2215","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,13]]}}}