This study aimed to identify variables influencing the health-related quality of life (HRQOL) of older women after bilateral total knee replacement in order to establish a structural model and design an intervention strategy to improve the patient's HRQOL.
In this research, a hypothetical model...
This study aimed to identify variables influencing the health-related quality of life (HRQOL) of older women after bilateral total knee replacement in order to establish a structural model and design an intervention strategy to improve the patient's HRQOL.
In this research, a hypothetical model that involves factors influencing the HRQOL of bilateral total knee replacement in older women was constructed based on the conceptual model of patient outcome in HRQOL by Wilson and Cleary(1995), and its suitability was tested verifying the relationship among relevant variables. The hypothetical model involving various paths of these variables has been established and verified.
The data were collected from July 1, 2017 to April 6, 2018;,- a total of 193 women,- who had been diagnosed with osteoarthritis and were aged older than 65, and who were within 13 weeks to 12 months after a bilateral total knee replacement, were recruited at a hospital in Chungcheongbuk-do.
Analysis was performed using SPSS version 22.0 and the SmartPLS 3.2.4 program.
The results are as follows:
1. Predictive relevance of the exogenous variables showed the predictive relevance of the functional status (Q2=.73), physical health-related quality of life (Q2=.60), mental health-related quality of life (Q2=.58), symptoms status (Q2=.33), health perceptions (Q2=.26).
2. Predicting accuracy of the exogenous variables showed that the predictive accuracy of the functional status (75%) was high: those of the physical health -related quality of life (64%), mental health-related quality of life (63%) and symptoms status (54%) were moderate and that of health perception (28%) was low.
3. The standardized root mean square residual(SRMR) of the model fit indices for the hypothetical model was .04.
4. The effect size of the hypothetical model of this study was found to be the largest (f2=.49, p<.001) on the path from symptoms status to functional status, followed by that from self-efficacy to the symptom status (f2=.47, p<.001), indicating a significant effect of these two pathways.
5. The testing results of causality hypotheses revealed that 25 hypotheses were supported.
In conclusion, The major variables that influence the physical HRQOL of older women after bilateral total knee replacement are symptoms status, health perception, functional status, and self-efficacy in that order, whereas the major variables influencing the mental HRQOL were symptoms status, health perception, and social support, which were in the mentioned order. We found that the most significant factor in the physical and mental HRQOL of older women after bilateral total knee replacement was symptoms status, which has a direct effect-on functional status and was influenced directly by self-efficacy, fear of falling, duration of the post-operative period, and social support, thus affecting the-related physical and mental HRQOL. Therefore, in order to improve the quality of life related to the physical and mental health of older women with bilateral knee replacement, nursing intervention strategies are needed to reduce symptoms and functional status and fear of falling and to increase health perceptions and self-efficacy and social support.
This study aimed to identify variables influencing the health-related quality of life (HRQOL) of older women after bilateral total knee replacement in order to establish a structural model and design an intervention strategy to improve the patient's HRQOL.
In this research, a hypothetical model that involves factors influencing the HRQOL of bilateral total knee replacement in older women was constructed based on the conceptual model of patient outcome in HRQOL by Wilson and Cleary(1995), and its suitability was tested verifying the relationship among relevant variables. The hypothetical model involving various paths of these variables has been established and verified.
The data were collected from July 1, 2017 to April 6, 2018;,- a total of 193 women,- who had been diagnosed with osteoarthritis and were aged older than 65, and who were within 13 weeks to 12 months after a bilateral total knee replacement, were recruited at a hospital in Chungcheongbuk-do.
Analysis was performed using SPSS version 22.0 and the SmartPLS 3.2.4 program.
The results are as follows:
1. Predictive relevance of the exogenous variables showed the predictive relevance of the functional status (Q2=.73), physical health-related quality of life (Q2=.60), mental health-related quality of life (Q2=.58), symptoms status (Q2=.33), health perceptions (Q2=.26).
2. Predicting accuracy of the exogenous variables showed that the predictive accuracy of the functional status (75%) was high: those of the physical health -related quality of life (64%), mental health-related quality of life (63%) and symptoms status (54%) were moderate and that of health perception (28%) was low.
3. The standardized root mean square residual(SRMR) of the model fit indices for the hypothetical model was .04.
4. The effect size of the hypothetical model of this study was found to be the largest (f2=.49, p<.001) on the path from symptoms status to functional status, followed by that from self-efficacy to the symptom status (f2=.47, p<.001), indicating a significant effect of these two pathways.
5. The testing results of causality hypotheses revealed that 25 hypotheses were supported.
In conclusion, The major variables that influence the physical HRQOL of older women after bilateral total knee replacement are symptoms status, health perception, functional status, and self-efficacy in that order, whereas the major variables influencing the mental HRQOL were symptoms status, health perception, and social support, which were in the mentioned order. We found that the most significant factor in the physical and mental HRQOL of older women after bilateral total knee replacement was symptoms status, which has a direct effect-on functional status and was influenced directly by self-efficacy, fear of falling, duration of the post-operative period, and social support, thus affecting the-related physical and mental HRQOL. Therefore, in order to improve the quality of life related to the physical and mental health of older women with bilateral knee replacement, nursing intervention strategies are needed to reduce symptoms and functional status and fear of falling and to increase health perceptions and self-efficacy and social support.
주제어
#Total knee replacement Health-related quality of life Older women Symptoms Self-efficacy
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