A Prediction Model for the Resilience and the Quality of Life in Cancer Patients with Radiotherapy

So Yeun Jun; Hyeon Jeong Ju; Je Sang Yu; Ji Hyun Lee

doi:10.5388/aon.2015.15.4.228

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Jun, Ju, Yu, and Lee: A Prediction Model for the Resilience and the Quality of Life in Cancer Patients with Radiotherapy

Original Article

Asian Oncology Nursing 2015; 15(4): 228-238.

Published online: 31 December 2015

DOI: https://doi.org/10.5388/aon.2015.15.4.228

A Prediction Model for the Resilience and the Quality of Life in Cancer Patients with Radiotherapy

So Yeun Jun¹, Hyeon Jeong Ju², Je Sang Yu³, Ji Hyun Lee⁴

¹College of Nursing, Yonsei University, Seoul, Korea.

²Department of Nursing, Kaya University, Gimhae, Korea.

³Department of Radiation Oncology, Kosin University Gospel Hospital,Busan, Korea.

⁴College of Nursing, Kosin University, Busan, Korea.

Address reprint requests to: Ju, Hyeon Jeong. College of Nursing, Kaya University, 208 Samgye-ro, Gimhae 50830, Korea. Tel: +82-55-330-1085, Fax: +82-55-330-1142, ju1085@kaya.ac.kr

Received 11 August 2015 Revised 3 November 2015 Accepted 21 December 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was conducted to determine the factors which affect the resilience and quality of life for cancer patients with radiotheraphy.

Methods

Collecting data was conducted by self-administered questionnaire that 205 cancer patients with radiation therapy in one university hospital participated from 15th to 31st May 2015. The data analyzed by SPSS v18 and AMOS v18.

Results

This research found that the side-effect of treatments, social support, self esteem, depression, uncertainty and resilience are verified to be the variables having not only direct but indirect influence on the quality of life of patients receiving radiotheraphy. The side-effect of treatments was found to have direct influence on the quality of life of patients receiving was, and social support was found to have indirect influence on resilience through uncertainty and self esteem, and resilience was found to have direct influence on the quality of life. for cancer patients.

Conclusion

It's necessary to come up with the approaches to develop the realistic practice guideline in order to raise the quality of life of patients receiving radiotheraphy, and to lower social support, self esteem, uncertainty in order to have higher resilience.

Keywords: Resilience, Quality of Life, Adverse Effects, Social Support, Radiotherapy

Figures and Tables

Fig. 1

Path diagram for modified model.

Table 1

Descriptive Statistics of Variables

Variables	Categories	M±SD	Skewness	Kurtosis	Tolerance	VIF	Estimate	SE	CR	AVE
Side effects	Total	2.63 ± 0.78	- .03	- .57	.75	1.33
	Side effects 1	2.61 ± 0.84	.08	- .56	.37	2.74	.85	.20	.87	.69
	Side effects 2	2.59 ± 0.89	- .05	- .82	.43	2.35	.79	.29
	Side effects 3	2.60 ± 0.97	- .11	- 1.00	.45	2.20	.76	.40
Social support	Total	3.79 ± 0.74	- .31	- .41	.75	1.33
	Family support	3.77 ± 0.87	- .36	- .49	.59	1.69	.68	.41	.73	.58
	Health care provider support	3.81 ± 0.84	- .18	- .52	.50	1.98	.74	.33
Uncertainty	Total	2.81 ± 0.48	.14	.49	.60	1.68
	Ambiguity	2.95 ± 0.69	.32	.46	.41	2.46	.80	.18	.91	.78
	Complexity	2.73 ± 0.57	.34	.26	.38	2.61	.81	.11
	Lack of information	2.75 ± 0.48	- .16	- .22	.52	1.92	.58	.16
Self-esteem	Total	3.51 ± 0.53	- .05	.38	.40	2.49
	Self-esteem 1	3.55 ± 0.56	- .29	.71	.42	2.36	.68	.13	.82	.70
	Self-esteem 2	3.45 ± 0.68	- .25	.54	.58	1.71	.74	.30
Depression	Total	2.75 ± 0.71	- .08	- .12	.39	2.57
	Depression 1	2.65 ± 0.70	- .16	.42	.33	3.01	.86	.31	.85	.67
	Depression 2	2.68 ± 0.58	.42	.23	.51	1.95	.47	.14
	Depression 3	3.02 ± 0.77	.03	- .27	.49	2.04	.70	.27
Resilience	Total	3.44 ± 0.43	- .10	.46	.50	1.99
	Competent individuals	3.45 ± 0.44	- .05	.31	.26	3.80	.89	.04	.98	.96
	Acceptance of life	3.41 ± 0.46	- .23	.24	.24	4.12	.92	.03
Quality of life	Total	3.12 ± 0.67	.16	- .66	-	-
	Physical function	3.18 ± 0.75	.01	- .14	.43	2.34	.70	.29	.85	.53
	Role function	3.17 ± 0.99	.27	- .92	.42	2.36	.71	.51
	Emotion function	3.08 ± 0.94	.14	- .54	.36	2.78	.80	.32
	Social function	3.06 ± 0.93	.02	- .65	.44	2.28	.76	.38
	General health	3.89 ± 0.95	- 1.00	.78	.65	1.54	.51	.68

Fit index: χ²=421.88, dF=149, CMIN/DF=2.83, GFI=.83, AGFI=.76, NFI=.82, TLI=.83, CFI=.87, RMR=.03, RMSEA=.09; VIF=Variance inflation factor; SE=Standard error; CR=Construct reliability; AVE=Average variance extracted.

Table 2

Correlation Matrix Table

Variables	Quality of life	Side effects	Social support	Uncertainty	Self-esteem	Depression	Resilience
Quality of life	1
Side effects	- .74	1
Social support	.38	- .28	1
Uncertainty	- .51	.36	- .42	1
Self-esteem	.39	- .27	.35	- .51	1
Depression	- .60	.46	- .43	.57	- .67	1
Resilience	.28	- .19	.33	- .33	.67	- .58	1

Table 3

Hypothetical and Modified of Standardized Regression Weights

Pathway hypothesis			Hypothetical			Modified			SMC	Result
Pathway hypothesis			Estimate	CR	p	Estimate	CR	p	SMC	Result
Quality of life	←	Resilience	0.14	2.22	.027	0.17	2.62	.009	.76	Accept
	←	Side effects	- 0.57	- 6.93	< .001	- 0.60	- 7.05	< .001		Accept
	←	Uncertainty	- 0.34	- 4.07	< .001	- 0.34	- 4.07	< .001		Accept
Resilience	←	Uncertainty	- 0.29	2.62	.009	- 0.32	2.85	.004	.90	Accept
	←	Self-esteem	1.20	5.17	< .001	1.19	5.40	< .001		Accept
	←	Depression	0.16	0.81	.416	0.13	0.75	.456		Reject
Uncertainty	←	Side effects	0.08	0.75	.453	0.10	0.91	.365	.54	Reject
Uncertainty	←	Social support	- 0.69	- 4.64	< .001	- 0.68	- 4.65	< .001	.54	Accept
Self-esteem	←	Side effects	0.11	0.88	.381	0.08	0.70	.484	.73	Reject
Self-esteem	←	Social support	0.92	5.72	< .001	0.89	5.74	< .001	.73	Accept
Depression	←	Side effects	0.24	2.16	.030	0.28	2.56	.011	.90	Accept
Depression	←	Social support	- 0.81	- 4.55	< .001	- 0.77	- 4.22	< .001	.90	Accept

CR=Critical ratio; SMC=Squared multiple correlation.

Table 4

Direct Effect, Indirect Effect, and Total Effect in Path Model

Pathway hypothesis			Direct effect (p)	Indirect effect (p)	Total effect (p)
Quality of life	←	Resilience	0.17 (.035)		0.17 (.035)
	←	Side effects	- 0.60 (.018)	- 0.01 (.909)	- 0.64 (.007)
	←	Uncertainty	- 0.34 (.015)	0.05 (.059)	- 0.29 (.018)
Resilience	←	Uncertainty	- 0.32 (.011)		- 0.32 (.011)
	←	Self-esteem	1.19 (.004)		1.19 (.004)
	←	Depression	0.13 (.390)		0.13 (.390)
Uncertainty	←	Side effects	0.10 (.540)		0.10 (.540)
Uncertainty	←	Social support	- 0.68 (.013)		- 0.68 (.013)
Self-esteem	←	Side effects	0.08 (.672)		0.08 (.672)
Self-esteem	←	Social support	0.89 (.016)		0.89 (.016)
Depression	←	Side effects	0.28 (.137)		0.28 (.137)
Depression	←	Social support	- 0.77 (.009)		- 0.77 (.009)

References

1. National Cancer Center. Accessed August 5. 2015. http://www.ncc.re.kr/webzine/201401/sub_03.jsp.

2. Choi KS, Park JA, Lee J. The effects of symptom experience and resilience on quality of life in patients with colorectal cancers. J Korean Oncol Nurs. 2012; 12:61–68.

3. Baskar R, Lee KA, Yeo R, Yeoh KW. Cancer and radiation therapy: current advances and future directions. Int J Med Sci. 2012; 9(3):193–199.

4. Kim YB, Suh CO. Evolution of radiotherapy: high-precision radiothrapy. J Korean Med Assoc. 2008; 51(7):604–611.

5. Park KS. Changes in side effects and fatigue of cancer patients receiving radiation therapy. J Korean Oncol Nurs. 2002; 2(1):72–82.

6. Ko HK, Park GJ. Effects of self-efficacy promotion program on self-efficacy, self-care behavior, and quality of life in breast cancer patients receiving radiotherapy. J Korean Oncol Nurs. 2011; 11:136–146.

7. Jeong CY, Yang JC, Shin IS, Choi Y, Yoon JS, Lee MS, et al. Psychopathology, self esteem and quality of life in cancer patients with radiotherapy. Korean J Psychosom Med. 2002; 10(2):92–100.

8. Cha K, Kim K. Impact of uncertainty on resilience in cancer patients. Asian Oncol Nurs. 2012; 12(2):139–146.

9. Shin RM, Jung WS, Oh BC, Jo JY, Kim GC, Choi TG, et al. Quality of life and its related factors of radiation therapy cancer patients. J Korean Soc Radiat Ther. 2011; 23(1):21–29.

10. Yang KS. The Structural equation model on resilience of breast cancer patients receiving chemotherapy [dissertation]. Seoul: Ewha Women Univ.;2014.

11. Lee EK. A study on factors affecting cancer patients. J Korean Acad Soc Nurs Edu. 2007; 13(1):52–58.

12. Hasse JE, Kintner EK, Monahan PO, Robb SL. The resilience in illness model, part 1: exploratory evaluation in adolescents and young adults with cancer. Cancer Nurs. 2014; 37(3):E1–E12.

13. Kim YS, Tae YS. The influencing factors on quality of life among breast cancer survivors. Asian Oncol Nurs. 2011; 11(3):221–228.

14. Jo KH, Son BK. The relationship of uncertainty, hope and quality of life in patients with breast cancer. J Korean Acad Nurs. 2004; 34(7):1184–1193.

15. Kim YS. Structural equation model on quality of life in patients with gastrectomy [dissertation]. Busan: Kosin Univ.;2014.

16. Lee JY, Choi S. Quality of life gynecological cancer patients during chemotherapy. Korean J Women Health Nurs. 2007; 13(4):290–298.

17. EORTC QLQ C30. Accessed October 16, 2015. http://www.eortc.be/qol/files/C30/QLQ-C30%20Korean.pdf.

18. Song YS. Determinants of resilience of the physically disabled at home [master's thesis]. Busan: Kosin Univ.;2003.

19. Jon BJ. Self-esteem: a test of its measurability. Yonsei Nonchong. 1974; 11:107–130.

20. Oh SM, Min KJ, Park DB. A study on the standardization of the hospital anxiety and depression scale for Koreans. J Korean Neuropsychiatr Assoc. 1999; 38(2):289–296.

21. Kim YH, Lee JH. Relationships between side effects, depression and quality of sleep in gynecological cancer patients undergoing chemotherapy. Korean J Women Health Nurs. 2010; 16(3):276–287.

22. Lee JR. Kim KS. The relationships between stigma, distress, and quality in patients with lung cancer. J Korean Oncol Nurs. 2011; 11(3):237–246.

23. Ryu YM, Yi M. The factors influencing quality of life in women with breast cancer. Asian Oncol Nurs. 2013; 13(3):121–127.

24. Park EJ. Influence factors of stress and resilience on quality of life among women with thyroid cancer [master's thesis]. Daegu: Keimyung Univ.;2013.

25. Kim HK, Lee MH. Factors influencing resilience of adult children of alcoholics among college students. J Korean Acad Nurs. 2011; 41(5):642–651.

26. Ahn JY. The influence of symptoms, uncertainty, family support on resilience in patients with breast cancer receiving chemotherapy [master's thesis]. Seoul: Seoul Univ.;2014.

27. Kim HY, So HS. A structural model for psychosocial adjustment in patients with early breast cancer. J Korean Acad Nurs. 2012; 42(1):105–115.

28. Kim YS, Kim BH. The quality of life analysis in patients with cervical cancer. Korean J Hosp Palliat Care. 2004; 7(1):8–16.

29. Jeong K, Heo J, Tae Y. Relationships among distress, family support, and health promotion behavior in breast cancer survivors. Asian Oncol Nurs. 2014; 14(3):146–154.

30. Lee MK. A study on the characteristics of cancer patients with radiotherapy and social support psychosocial status. J Radiol Sci Technol. 2004; 27(3):59–69.

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