Author Affiliations: School of Nursing, Second Military Medical University, Shanghai, China (Dsr Geng and Yuan); School of Nursing, University of Maryland, Baltimore (Dr Ogbolu); Division of Biostatistics and Study Methodology, Center for Translational Science, Children's National Health System (Dr Wang); School of Medicine and Health Sciences, The George Washington University (Drs Wang and Hinds); and Department of Nursing Research and Quality Outcomes, Center for Translational Science, Children's National Health System (Dr Hinds), Washington, DC; and Orthopedics Department, Shanghai Jiaotong University Affiliated Sixth People's Hospital (Ms Qian); and School of Nursing, Fudan University, Shanghai (Dr Yuan), China.
Cancer Nurs. 2018 Sep/Oct;41(5):E1-E10. doi: 10.1097/NCC.0000000000000571.
Better self-management control in cancer survivors would benefit their functional status, quality of life, and health service utilization. Factors such as self-efficacy, social support, and coping style are important predictors of self-management behaviors of cancer survivors; however, the impact of these factors on self-management behaviors has not yet been empirically tested in Chinese cancer survivors.
The aim of this study was to examine how self-efficacy, social support, and coping style affect specific self-management behaviors.
A secondary data analysis was completed from a cross-sectional study. A total of 764 cancer survivors were recruited in the study. Validated instruments were used to assess patients' self-efficacy, social support, and coping style. Structural equation modeling (SEM) was used to test the hypothesis.
The SEM model fits the data very well, with root mean square error of approximation (RMSEA) of 0.034; close-fit test cannot reject the hypothesis of root mean square error of approximation of 0.05 or less, comparative fit index of 0.91, Tucker-Lewis index of 0.90, and weighted root mean square residual of 0.82. For the measurement models in the SEM, all items loaded highly on their underlying first-order factors, and the first-order factors loaded highly on their underlying second-order factors (self-efficacy and social support, respectively). The model demonstrated that self-efficacy and social support directly and indirectly, via coping style, affect 3 self-management behaviors (ie, communication, exercise, and information seeking).
Our results provide evidence that self-efficacy and social support impose significant direct effects, as well as indirect effects via copying style, on the self-management of cancer survivors.
Our findings may help nurses to further improve their care of cancer survivors in terms of their self-management behaviors, specifically communication, exercise, and information seeking.
提高癌症幸存者的自我管理控制能力将有益于他们的功能状态、生活质量和卫生服务利用。自我效能感、社会支持和应对方式等因素是癌症幸存者自我管理行为的重要预测因素；然而，这些因素对癌症幸存者自我管理行为的影响尚未在中国人中得到实证检验。
本研究旨在检验自我效能感、社会支持和应对方式如何影响特定的自我管理行为。
对一项横断面研究进行了二次数据分析。共有 764 名癌症幸存者参与了这项研究。使用经过验证的工具评估患者的自我效能感、社会支持和应对方式。结构方程模型（SEM）用于检验假设。
SEM 模型非常适合数据，逼近误差均方根（RMSEA）为 0.034；接近拟合检验不能拒绝逼近误差均方根小于或等于 0.05 的假设，比较拟合指数为 0.91，Tucker-Lewis 指数为 0.90，加权均方根残差为 0.82。对于 SEM 中的测量模型，所有项目都高度加载在其基础一阶因子上，一阶因子高度加载在其基础二阶因子（自我效能感和社会支持）上。该模型表明，自我效能感和社会支持直接和间接（通过应对方式）影响 3 种自我管理行为（即沟通、锻炼和信息寻求）。
我们的研究结果提供了证据，表明自我效能感和社会支持对癌症幸存者的自我管理有显著的直接影响，以及通过应对方式的间接影响。
我们的研究结果可能有助于护士进一步提高对癌症幸存者自我管理行为的护理，特别是沟通、锻炼和信息寻求。
