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KMID : 0806120170470010014
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대한간호학회지
2017 Volume.47 No. 1 p.14 ~ p.24
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Structural Equation Modeling of Self-Management in Patients with Hemodialysis
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Cha Ji-Eun
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Abstract
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Purpose: The purpose of this study was to construct and test a hypothetical model of self-management in patients with hemodialysis based onthe Self-Regulation Model and resource-coping perspective.
Methods: Data were collected from 215 adults receiving hemodialysis in 17 localclinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth HopeIndex and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variableswere cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlationanalysis, factor analysis, and structural equation modeling were performed.
Results: The hypothetical model with six paths showed agood fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-managementbehavior were social context (β=.84), hope and cognitive illness representation (β=.37 and β=.27) explaining 92.4% of the variance. Self-managementbehavior mediated the relationship between psychosocial coping resources and illness outcome.
Conclusion: This research specifies a morecomplete spectrum of the self-management process. It is important to recognize the array of clinical resources available to support patients’self-management. Healthcare providers can facilitate self-management through collaborative care and understanding the ideas and emotionsthat each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management interventiondevelopment and assure effective clinical assessment.
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KEYWORD
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Renal dialysis, Chronic disease, Health resources, Self-control, Health behavior
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