Structural model for quality of life of patients with chronic cardiovascular disease in Korea.
BACKGROUND
Health promotion among those with chronic illness has been proposed as a strategy to contain health care cost and enhance quality of life (QOL), but little research has been done in Korea on QOL focused on health promotion of patients with chronic cardiovascular disease (CCVD).


OBJECTIVE
This study was designed to estimate a structural model to represent the QOL of patients with CCVD, on the basis of a literature review and Pender's health promotion model (HPM).


METHODS
Data were collected by questionnaire from 436 patients with CCVD in a university hospital in Seoul from August 2001 to July 2002. Data analysis included descriptive statistics and covariance structural analysis.


RESULTS
As the fit of the hypothetical model to the data was only moderate, it was modified by excluding 10 paths and including free parameters. The modified model with path showed a good fit to the empirical data (chi = 508.12, p = .001, GFI = .95, AGFI = .93, NFI = .98, NNFI = .98, RMSEA = .04). Health-promoting behavior (HPB) and self-efficacy were found to have a significant direct effect on QOL. Health perception, self-esteem, perceived barriers to action, and preference were found to have indirect effects on QOL. The variables of this model explain 63% of the variance in QOL.


CONCLUSIONS
The modified model is considered appropriate to explain and predict QOL of patients with CCVD. Therefore, it can effectively be used as a reference model for further studies and to suggest directions in nursing practice.
Han
Kuem Sun
KS
College of Nursing, Korea University, Seoul, Korea. hksun@korea.ac.kr
Lee
Sook Ja
SJ
Park
Eun Sook
ES
Park
Young-Joo
YJ
Cheol
Kang Hyun
KH
D001294:Attitude to Health; D002318:Cardiovascular Diseases; D002908:Chronic Disease; D015438:Health Behavior; D006785:Hospitals, University; D006801:Humans; D007723:Korea; D008961:Models, Structural; D017060:Patient Satisfaction; D011788:Quality of Life; D012649:Self Concept; D020377:Self Efficacy; D011795:Surveys and Questionnaires