위암 수술 환자의 삶의 질 구조 모형 : 적응 매개효과 검정을 중심으로

Other Titles
A Structure Equation Model of Quality of Life in Gastric Cancer Patients Underwent Gastrectomy:An Examination of the Mediating Effect of Adaptation
Authors
이경은
Issue Date
2016-12
Awarded Date
2017
Abstract
The purpose of this study was to develop a model for estimating the quality of life mediated by adaptation in gastric cancer patients that underwent a gastrectomy and to verify the model based on the Cancer Survivor Adaptation Model by Naus et al (2009) and literature reviews. The exogenous variables were experience gastrointestinal symptoms, self-efficacy, anxiety, social support, and spiritual well-being factors. The endogenous variables were adaptation and quality of life, and the adaptation was the mediating variable. Data was collected for 320 gastric cancer patients that underwent a gastrectomy at an outpatient clinic of A and B university hospitals in D city from May to August, 2016. A total of 297 subjects were analyzed and 27 subjects who had outlier value were excluded. IBM SPSS 21.0 and AMOS 18.0 programs were used to analyze descriptive statistics, correlation of main variables, multicollinearity, confirmatory factor analysis, efficiency of the hypothesis model, and calculate the path coefficient of direct and indirect effects of factors affecting adaptation and quality of life of subjects. The results of this study were as follows. 1. The final modified model showed goodness of fit index: =212.11 (p<.001), /df=2.91, RMR=.03, RMSEA=.08, GFI=.92, AGFI=.86, NFI=.91, TLI=.91, CFI=.94. 2. Of the 11 hypothesis put forth, all were supported by the hypothesized model. The explanatory variables which were experience gastrointestinal symptoms, self-efficacy, anxiety, social support, and spiritual well-being factors had statistically significant effects on the quality of life in gastric cancer patients that underwent a gastrectomy. These explanatory variables demonstrated 73.9% of total explained variance of quality of life mediated by adaptation. The adaptation demonstrated 72.7% of total explained variance of quality of life. Those that experienced gastrointestinal symptoms, anxiety, and social support directly influenced and indirectly influenced through the mediation of adaptation on the quality of life of gastric cancer patients that underwent a gastrectomy. Self-efficacy and spiritual well-being indirectly influenced the mediation of adaptation on the quality of life of gastric cancer patients that underwent a gastrectomy. 3. The explanatory variables which were gastrointestinal symptoms, self-efficacy, anxiety, social support, and spiritual well-being factors had statistically significant effects on adaptation in gastric cancer patients that underwent a gastrectomy. These variables demonstrated 73.9% of total explained variance. In conclusion, it is important for gastric cancer patients with gastrectomy to adapt well to the change after surgery in order to improve the quality of life.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/12928
Appears in Collections:
3. 학위논문 > 2. College of Nursing (간호대학) > 박사
Full Text
http://dcollection.kmu.ac.kr/jsp/common/DcLoOrgPer.jsp?sItemId=000000091100
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