A CAUSAL MODEL OF HEALTH-RELATED QUALITY OF LIFE AMONG LUNG CANCER PATIENTS UNDERGOING CHEMOTHERAPY IN VIETNAM

Abstract

Health-related quality of life [HRQoL] is an important primary health outcome of chronic diseases, such as lung cancer. A model-testing, cross-sectional study was conducted to evaluate a causal model of [HRQoL] among lung cancer patients undergoing chemotherapy. Convenience sampling was used to recruit 232 persons with lung cancer receiving chemotherapy in three hospitals in the northern region of Vietnam. Data collection was carried out from April to September 2020. Research instruments included six self-report questionnaires: the Ferrans and Powers Quality of Life Index, the Memorial Symptom Assessment, the Leuven Patient Self-care during Chemotherapy, the Functional Status Questionnaire, the Social Support Survey, and the General Health Perception Scale. Reliability ranged from 0.73-0.92. Data were analyzed by using descriptive statistics and structural equation modeling.

The results revealed that the modification of the hypothesized model fit the data well (χ2 = 154.49, p =.691, df = 164, CMIN/df = .942, GFI = .942, AGFI = .918, CFI = 1.000, and RMSEA = .000). Self-care behavior, functional status, and general health perception had direct effects on [HRQoL] General health perception mediated the relationships between self-care behavior and [HRQoL], and between functional status and [HRQoL]. Symptom experience showed a negative indirect effect on [HRQoL], and social support had a positive indirect effect. In this causal relationship, social support, self-care behavior, symptom experience, functional status, and general health perception accounted for 68.0% of the variance in [HRQoL]. These findings suggest that this causal model of [HRQoL] is appropriate. The findings also suggest a new direction for the nursing profession to enhance [HRQoL] of persons with lung cancer receiving chemotherapy by improving self-care behavior, social support, general health perception, and functional status, and by reducing symptom distress.

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