암환자의 심리사회 적응 구조모형
저자
발행사항
공주 : 공주대학교 대학원, 2017
학위논문사항
학위논문(박사)-- 공주대학교 대학원 : 간호학과 2017. 8
발행연도
2017
작성언어
한국어
발행국(도시)
충청남도
기타서명
Structural Model of Psychosocial Adjustment for Cancer Patients
형태사항
vi, 108장 : 삽도 ; 26 cm
일반주기명
지도교수:김희경
참고문헌 : p. 74-85
소장기관
Amid the recent increase of the cancer incidence, the survival rate of the cancer patients has been increased due to the developments of the science and medical technology. However, they experience the fear and the anxiety once they are diagnosed. Also, they suffer from psychological and social difficulties as well as physical pains during the treatment. The patients spend the painful time psychosocially on the repeated treatments and progressions for a long time during the treatment courses. It is necessary to accept the changed situation and to participate in the treatments actively together with continuous management of their health. Therefore, this study aims to provide the basic data to develop the nursing interventions for self-initiated healthy lives by adjustment to the psychological society.
In this study, the structural model was described and validated to understand the degree of the cancer patients’ adjustment to the psychological society and to estimate the factors to affect the adjustment to the psychological society directly and indirectly based on Kim In Ja’s theory (1997) which combined with Roy’s adjustment theory and proposition of stress-evaluation-countermeasure by Lazarus and Folkman.
The measurement variables consisted of three external ones including symptom experience, social support, and depression, and six internal ones including uncertainty, overcome, self-esteem, problem oriented countermeasure, emotional oriented countermeasure, and adjustment to the psychological society.
The study subjects were the cancer patients who were diagnosed as gastrointestinal cancer, breast cancer, pulmonological cancer, genitourinary cancer, and so on as the inpatients or outpatients in the general hospitals in D City. The data collection was performed by self-reported survey form from November 20, 2016 to February 10, 2017, and 200 data were analyzed out of 220. Data analysis was performed with SPSS Win 23.0 by descriptive analysis per demography and study variables. Applicability of hypothesis model and its test were performed using Amos 23.0 program.
The study results are as follows.
1. Upon the fit analysis of the hypothetical model, overall fit index of the model was = 300.52(p<.001), /df= 2.76, GFI .86, RMSEA .09, NFI .83, CFI .88, NNFI(TLI) .83, AGFI .86, PNFI .59, demonstrating the necessity of the amended model.
2. To enhance the fit level of the hypothetical model, the amended model supporting 11 paths as a whole was finalized by deleting the paths if the value between the measured errors is smaller by amended index measurement.
3. Upon the fit analysis validation of the amended model, the results showed with =121.07(p<.001), /df=2.24, GFI=.93, RMSEA .08, NFI .90, CFI .94, NNFI(TLI) .90, AGFI .86, PNFI .54 suggesting the better amended model than the hypothetical model.
4. According to the validation results of the amended model, statistically significant variables on the uncertainty of the cancer patients were social support and depression, demonstrating 55.1% explanatory power of uncertainty to the cancer patients by these variables. Statistically significant variables on overcome were social support, depression, and uncertainty, demonstrating 40.3% explanatory power of overcome to the cancer patients by these variables. Statistically significant variables on self-esteem were social support, depression, and overcome, demonstrating 44.1% explanatory power of self-esteem to the cancer patients by these variables. Statistically significant variables on problem oriented countermeasure were social support, and self-esteem, demonstrating 32.2% explanatory power of problem oriented countermeasure to the cancer patients by these variables. Statistically significant variables on adjustment to the psychological society were symptom experience and uncertainty, demonstrating 41.0% explanatory power of adjustment to the psychological society to the cancer patients by these variables.
In conclusion, symptom experience and uncertainty were found to be the crucial factors to affect the cancer patients’ adjustment to the psychological society. Using these results, it should be prepared to develop symptom relieving programs, objective treatment directions, potential symptoms and nursing interventional program on the information to lower the experiences of symptoms. To lower the uncertainty, it should be prepared to develop the programs of adjustment to the psychological society by self-support meeting of the cancer patients who were in common to have counseling and treatments on the progression and treatment plans after diagnosis of their cancers.
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