Mediation Effect of Adaptation on the Quality of Life in Patients with Gastric Cancer Undergoing Gastrectomy: A Structure Equation Model

Purpose: This study aimed to develop a model for estimating the quality of life mediated by adaptation to changes experienced after stomach cancer diagnosis and surgery in patients with gastrectomy and to verify the model based on the Cancer Survivor Adaptation Model by Naus et al. (2009) and literature reviews. Methods: Data was collected from 297 gastric cancer patients who underwent a gastrectomy at an outpatient clinic of two university hospitals in Daegu city from May to August, 2016. The exogenous variables were perceived gastrointestinal symptoms, self-efficacy, anxiety, social support, and spiritual well-being. The endogenous variables were adaptation and quality of life, and adaptation was the mediating variable. For data analysis, structural equation modeling was performed using IBM SPSS 21.0 and AMOS 18.0. Results: The fitness parameters of the final model showed a reasonable fit to the data. Based on R-2, the exogenous variables explained 73.9% of the quality of life of stomach cancer patients who underwent surgery, through the mediation of adaptation; adaptation alone explained 73.5% of quality of life. Adaptation of stomach cancer patients with gastrectomy was a factor that strongly influenced their quality of life. Conclusion: It is important for gastric cancer patients with gastrectomy to adapt well to changes after surgery in order to improve the quality of life. Nursing interventions to aid successful adaptation would ultimately exert positive influences and improve the patients' quality of life. (C) 2019 Korean Society of Nursing Science, Published by Elsevier Korea LLC.