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Structural Equation Modeling of Self-Management in Patients with Hemodialysis
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Jieun Cha
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J Korean Acad Nurs 2017;47(1):14-24. Published online February 28, 2017
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DOI: https://doi.org/10.4040/jkan.2017.47.1.14
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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 on the Self-Regulation Model and resource-coping perspective.
Methods
Data were collected from 215 adults receiving hemodialysis in 17 local clinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth Hope Index and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variables were cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and structural equation modeling were performed.
Results
The hypothetical model with six paths showed a good fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-management behavior were social context (β=.84), hope and cognitive illness representation (β=.37 and β=.27) explaining 92.4% of the variance. Self-management behavior mediated the relationship between psychosocial coping resources and illness outcome.
Conclusion
This research specifies a more complete 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 emotions that each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management intervention development and assure effective clinical assessment.
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Citations
Citations to this article as recorded by  - Predictive Model of Self‐Management and Quality of Life for Patients on Hemodialysis Using Information‐Motivation‐Behavioral Skills Model: A Cross‐Sectional Study
Sung Reul Kim, Hye Young Kim, Eun Ko, No Eul Kang, Kang Sun Lee
Nursing & Health Sciences.2025;[Epub] CrossRef - Effects of self-care intervention using a mobile instant messenger on hemodialysis patient’s knowledge, self-efficacy, self-care behavior and physiological index
Yu Kyung Shin, Mi Young Kim
Journal of Korean Biological Nursing Science.2024; 26(2): 123. CrossRef - WeChat peer education on self-management behavior of hemodialysis patients
Jun Wang
International Journal of Research Studies in Management.2023;[Epub] CrossRef - Healthy life of Korean patients with chronic kidney failure undergoing hemodialysis: A situation-specific nursing theory
Jinhyang Yang, Myung-Ok Cho, Haeok Lee
Applied Nursing Research.2022; 65: 151584. CrossRef - The Effect of Nonpharmacological Integrated Care Protocols on Patients with Fatigue Undergoing Hemodialysis: A Randomized Controlled Trial
Manhua Zuo, Na Zuo, Jinrong Lin, Jing Zhuo, Xinghui Jing, Jun Tang, Liaqat Ali
Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef - Development and Effectiveness of Emotional Intelligence Promotion Program for Schizophrenia
Min Young Jung, Jeongyee Bae
Journal of Korean Academy of psychiatric and Mental Health Nursing.2022; 31(4): 505. CrossRef - Effect of Self‐Determination Theory on Knowledge, Treatment Adherence, and Self‐Management of Patients with Maintenance Hemodialysis
Rui Wu, Sifang Feng, Hongli Quan, Yun Zhang, Rong Fu, Hong Li, Mohammad Farukh Hashmi
Contrast Media & Molecular Imaging.2022;[Epub] CrossRef - Exploring demands of hemodialysis patients in Taiwan: A two-step cluster analysis
I-Chen Yu, Ji-Tseng Fang, Yun-Fang Tsai, Andrew Carl Miller
PLOS ONE.2020; 15(2): e0228259. CrossRef - Mediating Effect of Stress on the Relationship between Illness Perception and Sleep in Patients at Risk of Metabolic Syndrome
Hyun-E Yeom, Jee-Won Shin
Korean Journal of Adult Nursing.2019; 31(4): 449. CrossRef - The Impact of Physical, Psychological, Social Factors on Illness Burden of Long-term Hemodialysis Patients in South Korea
Jieun Cha
Journal of Health Informatics and Statistics.2018; 43(3): 159. CrossRef - Validity and Reliability Test of the Korean Version of the Hemodialysis Self-Management Instrument (HDSMI-K)
Jieun Cha, Jiyoung Kang
Journal of Health Informatics and Statistics.2017; 42(2): 153. CrossRef
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