Abstract
Purpose Understanding the activities of daily living (ADL) of cancer patients at the end-of-life stage may help healthcare providers develop interventions for preserving physical function and enhance patient’s dignity in an everyday care context. This study aims to develop and test a causal effect model of physical function in terminal cancer patients.Methods A total of 238 terminal cancer patients were recruited from two hospitals in South Korea. The data were collected using a structured questionnaire including demographics, visual analogue scale for pain, Functional Assessment of Chronic Illness Therapy-Fatigue, and Katz index of independence in ADL. The collected data were analyzed using SPSS WIN 25.0 and AMOS 23.0 programs for structural equation modeling procedures. Results The model showed a good fit to the data (χ2/df=2.08, GFI=0.932, NFI=0.966, TLI=0.971, CFI=0.982, AGFI=0.874, RMSEA=0.067). Physical function of patients with terminal cancer was positively influenced by regular exercise and negatively influenced by hospitalization, fatigue, and pain, explaining 35.1% of the variance. In this study, regular exercise improved participants’ ADL level directly and indirectly either by reducing fatigue or decreasing fatigue through controlling pain. Pain did not affect ADL directly but decreased ADL level indirectly through fatigue as a mediator.Conclusion Based on these results, in order to minimizing the problems of physical function in terminal cancer patients, interventions that reduce pain and fatigue and provide regular exercise are required. Particularly, hospitalized patients are susceptible to a decrease in physical function, so regular physical function evaluations may be considered.
A structural equation modeling approach to understanding physical function of terminal cancer patients
