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4 "Structural equation model"
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Research Paper
A Prediction Model of Exercise Level in Patients with Ankylosing Spondylitis
Kim, Moon Ja , Lee, Eun Nam
J Korean Acad Nurs 2022;52(2):157-172.   Published online April 30, 2022
DOI: https://doi.org/10.4040/jkan.21238
AbstractAbstract PDF
Purpose
This study aimed to construct and test a hypothetical model to explain the predictive factors and causal pathways for exercise levels in patients with ankylosing spondylitis based on the self-determination theory. A conceptual framework was constructed assuming that autonomy support by health care providers would satisfy the three basic psychological needs of patients, which would increase their autonomous motivation for exercise, resulting in its initiation and continuation.
Methods
This cross-sectional study included 221 patients with ankylosing spondylitis who were visiting rheumatology clinics in two tertiary hospitals. Health Care Climate Questionnaire-exercise regularly, Basic Psychological Needs Satisfaction scale, Behavior Regulation in Exercise Questionnaire-2, and exercise level were used to collect data.
Results
The fitness of the hypothetical model met the recommended level (χ2/df ≤ 3, SRMR ≤ .08, RMSEA ≤ .08, GFI ≥ .90, AGFI ≥ .85, NFI ≥ .90, TLI ≥ .90, CFI ≥ .90). The model effect analysis revealed that autonomy support by health care providers had a positive effect on patients' autonomy, competence, relatedness, autonomous motivation, and exercise level. Competence and relatedness had positive effects on autonomous motivation and exercise level, respectively. Autonomous motivation had a positive effect on exercise level.
Conclusion
The predictive factors of exercise level in patients with ankylosing spondylitis were autonomous motivation, health care providers' autonomy support, competence, and relatedness. Considering these factors, we recommend the development of an effective program for improving exercise levels in these patients.
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Original Articles
Structural Equation Model of Health-Related Quality of Life in School Age Children with Asthma
Yunsoo Kim, Ho Ran Park
J Korean Acad Nurs 2018;48(1):96-108.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.1.96
AbstractAbstract PDF
Abstract Purpose

This study aimed to construct and test a hypothetical model of the quality of life of school-age children with asthma based on the health-related quality of life model by Wilson and Cleary.

Methods

Data were collected from 205 pairs of pediatric outpatients diagnosed with asthma and their parents in Seoul and Gyeonggi-do from July 2016 to April 2017. The exogenous variables were asthma knowledge, number of accompanying allergic diseases, and social support. The endogenous variables were asthma self-efficacy, asthma symptom control, perceived health status, parental quality of life, and children's quality of life. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed.

Results

Eighteen of the twenty-four hypotheses selected for the hypothetical model were attentive and supported statistically. Quality of life was explained by asthma self-efficacy, asthma symptom control, perceived health, parental quality of life, and asthma knowledge with 83.5%.

Conclusion

Strategies for promoting self-efficacy and enforcing asthma knowledge will be helpful for the improvement of health-related quality of life with school-aged asthmatic children.

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Development of Structural Equation Model for Causal Relationships Among the Risk Factors of Arteriosclerosis
Hyun Soo Oh, Wha Sook Seo
Journal of Korean Academy of Nursing 1999;29(6):1192-1207.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1192
AbstractAbstract PDF

The purpose of this study was to clarify the dynamic relationships among risk factors of arteriosclerosis and to develop and examine a model which could explain this relationship clearly. Data were collected from medical records of 400 male clients who visited a university hospital located in Inchon for physical examinations, from May 1996 to December 1996. Data were analyzed using the LISREL (Linear Structural Relationship) 8 program. To test the fitness of the hypothesized model, chi-square, RMSR (root mean square residual), GFI (goodness of fit index), CN (critical number) and Q-plot were used. Most of the fitness measurements, except the chi-square showed that the hypothesized model complimented the real data. According to the results, there were trends that obesity and hyperlipidemia were prevalent in heavier smokers, higher alcohol intakers, and groups who excercised less. Also, hypertension was more prevalent in older age, higher alcohol intaker, and higher serum lipid level groups. In contrast to the hypothesis, alcohol intake did not significantly affect serum lipid levels. This might be due to the serum lipid measurements (total cholesterol and trigryceride) used in this study to estimate hyperlipidemia. The direct effect of smoking on hypertension was not significant. However, the total effect of smoking on the hypertension was significant since indirect effects of smoking on hypertension, such as obesity and hyperlipidemia, were significant. The total effect of obesity on hypertension was significant since the indirect effect of obesity on hypertension via hyperlipidemia was significant, although the direct effect of smoking on hypertension was not significant. The degree of explaining hyperlipidemia with smoking, exercise, and obesity was high (60%), however, the degree of explaining obesity with age, smoking, alcohol intake, and exercise was very low (7%). On the basis of these results, high risk factors of arteriosclerosis such as hypertension, hyperlipidemia, or obesity are either directly or indirectly correlated each other. Therefore, it is difficult to predict outcomes for increasing or decreasing the risk factors by simply modulating a factor. Smoking, alcohol, and exercise both directly and indirectly affected major risk factors of arteriosclerosis. Therefore, correcting these variables is required to decrease risk factors. Finally, the relationship among other risk factors which have been known to be related with arteriosclerosis (diet, stress or hereditary) should be clarified in further studies.

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A Structural Equation Model on Sexual Function in Women with Gynecologic Cancer
Nami Chun
J Korean Acad Nurs 2008;38(5):639-648.   Published online October 30, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.5.639
AbstractAbstract PDF
Purpose

This study was designed to construct and test a structural equation model on sexual function in women with gynecologic cancer.

Methods

The model was constructed and tested under the hypotheses that women's physical changes in sexual function after gynecologic cancer treatment did not automatically lead to sexual dysfunctions. Women's psychosocial factors were considered to be mediating variables. Two hundred twelve women with cervical, ovarian, and endometrial cancer were recruited and asked to complete a survey on their physical factors, psychosocial factors and sexual function. Data was analyzed using SPSS WIN 12.0 and Amos WIN 5.0.

Results

Predictors of sexual function in the final model were sexual attitude affected by physical distress and couple's age, sexual information affected by physical distress and couple's age, depression affected by physical distress, and marital intimacy affected by physical distress. Tumor stage and time since last treatment directly affected women's sexual function without any mediating psychosocial variables. However, body image did not affect women's sexual function.

Conclusion

Nursing professionals should develop a tailored educational program integrating both physical and psychosocial aspects, and apply it to women and their spouses in order to promote sexual function in women with gynecologic cancer.

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