혈액투석환자의 사회적 지지 경로분석 :자기조절모형에 기반하여
A Path Analysis of Social Support in Patients with Hemodialysis: Based on the Self-regulation Model
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목적: 이 연구의 목적은 사회적 지지(가족, 의료인, 친구/환우)와 치료에 대한 믿음, 희망, 건강상태 간의 관련성을 조사하고, 혈액투석환자의 건강상태에 직접적, 간접적 영향을 주는 변수들을 규명하고자 함이다. 방법: 건강상태 및 그와 관련된 변수들에 대한 경로모형을 설정하기 위해 자기조절모형이 사용되었다. 240명의 환자들로부터 자료를 수집하였다. 다차원적 사회적 지지 척도, 개정된 질병인식 설문지, Herth 희망 지표, Medical Outcomes Study Short Form-12를 사용하였다. 자료는 SPSS와 AMOS 프로그램을 사용하여 분석하였다. 결과: 적합한 통계치들(χ2=3.33, p=.343, GFI .995, RMSEA .021, AGFI .968)에 의해 모형은 지지되었다. 가족지지와 친구/환우 지지는 희망에 유의미하게 직접적인 영향을 보여주었고, 반면 의료인 지지는 치료에 대한 믿음에 직접적으로 영향을 주었다. 사회적지지, 치료에 대한 믿음, 희망은 직접적 그리고 간접적으로 건강상태에 영향을 주며, 변량의 28.7%를 설명하였다. 결론: 이 연구는 사회적 맥락과 결과 사이의 매개요인으로 치료에 대한 믿음과 희망을 보여주고, 사회적 지지의 영향을 입증함으로써, 사회적 지지와 건강상태 사이의 근본적인 기제를 상세히 기술하였다. 혈액투석환자의 건강을 증진시키기 위해서는 환자, 가족, 전문 의료인, 그리고 친구들 간에 협력할 필요가 있다.
Abstract
Purpose: The purpose of this study was to examine the relationship between social support (family, healthcare provider, friends/peer), treatment belief, hope, and health status in patients on hemodialysis, and to identify direct and indirect effects of the variables on patients' health status. Methods: The self-regulation model was used to establish a path model. Data were collected from 240 patients. Multidimensional Scale of Perceived Social Support, Revised Illness Perception Questionnaire, Herth Hope Index, and Medical Outcomes Study Short Form-12 were used. Data were analyzed using the SPSS and AMOS programs. Results: The model was supported by fit statistics (x2=3.33, p=.343, GFI .995, RMSEA .021, AGFI .968, NFI .986, CFI .999, TLI .993). Family and friends/peer support showed a significant direct influence on hope, while healthcare provider support directly influenced treatment belief. Social support, treatment belief, and hope directly and indirectly influenced health status, explaining 28.7% of the variance. Conclusion: These results show mechanisms underlying connections between social support and health status by demonstrating impact of social support and showing treatment belief and hope as mediators between social context and outcomes. To promote health of patients on hemodialysis, it is necessary for patient, family, healthcare professional, and friends to collaborate
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