Zhaohui Geng1, Yolanda Ogbolu, Jichuan Wang, Pamela S Hinds, Huijuan Qian, Changrong Yuan. 1. Author Affiliations: School of Nursing, Second Military Medical University, Shanghai, China (Dsr Geng and Yuan); School of Nursing, University of Maryland, Baltimore (Dr Ogbolu); Division of Biostatistics and Study Methodology, Center for Translational Science, Children's National Health System (Dr Wang); School of Medicine and Health Sciences, The George Washington University (Drs Wang and Hinds); and Department of Nursing Research and Quality Outcomes, Center for Translational Science, Children's National Health System (Dr Hinds), Washington, DC; and Orthopedics Department, Shanghai Jiaotong University Affiliated Sixth People's Hospital (Ms Qian); and School of Nursing, Fudan University, Shanghai (Dr Yuan), China.
Abstract
BACKGROUND: Better self-management control in cancer survivors would benefit their functional status, quality of life, and health service utilization. Factors such as self-efficacy, social support, and coping style are important predictors of self-management behaviors of cancer survivors; however, the impact of these factors on self-management behaviors has not yet been empirically tested in Chinese cancer survivors. OBJECTIVES: The aim of this study was to examine how self-efficacy, social support, and coping style affect specific self-management behaviors. METHODS: A secondary data analysis was completed from a cross-sectional study. A total of 764 cancer survivors were recruited in the study. Validated instruments were used to assess patients' self-efficacy, social support, and coping style. Structural equation modeling (SEM) was used to test the hypothesis. RESULTS: The SEM model fits the data very well, with root mean square error of approximation (RMSEA) of 0.034; close-fit test cannot reject the hypothesis of root mean square error of approximation of 0.05 or less, comparative fit index of 0.91, Tucker-Lewis index of 0.90, and weighted root mean square residual of 0.82. For the measurement models in the SEM, all items loaded highly on their underlying first-order factors, and the first-order factors loaded highly on their underlying second-order factors (self-efficacy and social support, respectively). The model demonstrated that self-efficacy and social support directly and indirectly, via coping style, affect 3 self-management behaviors (ie, communication, exercise, and information seeking). CONCLUSION: Our results provide evidence that self-efficacy and social support impose significant direct effects, as well as indirect effects via copying style, on the self-management of cancer survivors. IMPLICATIONS FOR PRACTICE: Our findings may help nurses to further improve their care of cancer survivors in terms of their self-management behaviors, specifically communication, exercise, and information seeking.
BACKGROUND: Better self-management control in cancer survivors would benefit their functional status, quality of life, and health service utilization. Factors such as self-efficacy, social support, and coping style are important predictors of self-management behaviors of cancer survivors; however, the impact of these factors on self-management behaviors has not yet been empirically tested in Chinese cancer survivors. OBJECTIVES: The aim of this study was to examine how self-efficacy, social support, and coping style affect specific self-management behaviors. METHODS: A secondary data analysis was completed from a cross-sectional study. A total of 764 cancer survivors were recruited in the study. Validated instruments were used to assess patients' self-efficacy, social support, and coping style. Structural equation modeling (SEM) was used to test the hypothesis. RESULTS: The SEM model fits the data very well, with root mean square error of approximation (RMSEA) of 0.034; close-fit test cannot reject the hypothesis of root mean square error of approximation of 0.05 or less, comparative fit index of 0.91, Tucker-Lewis index of 0.90, and weighted root mean square residual of 0.82. For the measurement models in the SEM, all items loaded highly on their underlying first-order factors, and the first-order factors loaded highly on their underlying second-order factors (self-efficacy and social support, respectively). The model demonstrated that self-efficacy and social support directly and indirectly, via coping style, affect 3 self-management behaviors (ie, communication, exercise, and information seeking). CONCLUSION: Our results provide evidence that self-efficacy and social support impose significant direct effects, as well as indirect effects via copying style, on the self-management of cancer survivors. IMPLICATIONS FOR PRACTICE: Our findings may help nurses to further improve their care of cancer survivors in terms of their self-management behaviors, specifically communication, exercise, and information seeking.
Authors: Raffaella Calati; Fang Fang; Elizabeth Mostofsky; Qing Shen; Valentina Elisabetta Di Mattei; Jesus Garcia-Foncillas; Enrique Baca-Garcia; Andrea Cipriani; Philippe Courtet Journal: BMJ Open Date: 2018-08-10 Impact factor: 2.692