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Aim and Background: Health literacy is the ability to receive, process, understand and understand health-related information and services in order to make appropriate health decisions. The health literacy for breast cancer patients plays an important role in accessing adequate diagnostic and therapeutic measures. The aim of this study was to investigate the mediating role of Pain catastrophizing in the relationship between health literacy and specific quality of life among patients with breast cancer.
Methods and Materials: The present study was a cross-sectional and correlational study in terms of method and was basic science in terms of purpose. In this cross-sectional study, 213 consecutive patients with breast cancer were selected based on the inclusive and exclusive criteria. Then, the patients completed questionnaires of Iranian version of health literacy, quality of life and Pain catastrophizing. Data were analyzed using SPSS and LISREL software by path analysis model.
Findings: All components of health literacy and specific quality of life were significantly correlated with Pain catastrophizing. Also there was a significant association between health literacy and specific quality of life. The findings showed that as far as the health literacy is Increase, the Pain catastrophizing scores significantly are also decrease.
Conclusions: It seems that Pain catastrophizing plays the mediating role between health literacy and specific quality of life among patients with breast cancer. Therefore, it is necessary to consider the relational model between these factors for development of psychological protocols and integrating those protocols in therapeutic plans for breast cancer patients.

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Aim and Background: Improving the quality of life and controlling blood glucose in patients with diabetes is one of the most important goals of interventions and health promotion programs in these patients. The purpose of this study was to develop a health model in type 2 diabetic patients based on psychological toughness, health literacy, self-efficacy and beliefs. Health is mediated by self-management behaviors and social support.
Methods and Materials: The research method is analytical and structural equations. The statistical population of this study includes all patients with type 2 diabetes referred to diabetes clinics in abadan in 1398. Random sampling method was used to select the sample. 254 patients with diabetes were selected based on inclusion and exclusion criteria. Research instruments psychological toughness questionnaire (Kobasa, 1984), health literacy questionnaire (Montazeri, 2014), tobert and glasgow self-management behaviors questionnaire (1994) and quality of life questionnaire (Bruges, 2004) and wax social support questionnaire, 1986), health beliefs questionnaire (Kartal, 2006) and the self-efficacy questionnaire (Stanford, 2001).
Findings: Findings showed that health beliefs have a direct and significant effect on the health outcomes of patients with type 2 diabetes (P≤0.001) and self-efficacy has direct and indirect effects on health outcomes (mediated by self-management behaviors) (P≤0.001). Health literacy had no direct and significant effect on the quality of life of patients with type 2 diabetes (p≥0.001). Psychological hardiness has direct and indirect effects on health outcomes (mediated by self-management behaviors) (P≤0.001) and the effect of social support on health outcomes was not significant (P≥0.001).
Conclusions: Considering the role of health beliefs and self-efficacy and persistence on health outcomes in patients with type 2 diabetes, it is recommended to use these variables in quality of life and self-care programs of this group of these patients.