Mediation Effects of Basic Psychological Needs Between Autonomy Support from Healthcare Providers and Self-Management Among Cancer Survivors

다국어 초록 (Multilingual Abstract)

Objectives: This study examined the mediating effects of basic psychological needs between patient autonomy support from healthcare providers, and self-management among cancer survivors.
Methods: This study collected data from 148 cancer patients who had visited D hospitals in B city, Korea.
A structured questionnaire was distributed to determine patient characteristics, healthcare provider autonomy support, basic psychological needs, and self-management. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and regression analysis that implemented Baron and Kenny’s method for mediation were used for analyses.
Results: Self-management was significantly correlated with the level of healthcare provider autonomy support (r = 0.38, p < 0.001), autonomy (r = 0.40, p < 0.001), competence (r = 0.25, p = 0.002), and relatedness (r = 0.32, p < 0.001). Furthermore, autonomy (β = 0.30, p < 0.001) and relatedness (β = 0.22, p = 0.008) had partial mediating effects on the relationship between healthcare provider autonomy support and self-management (Z = 3.13, p = 0.002 and Z = 2.29, p = 0.022, respectively).
Conclusion: Autonomy and relatedness mediated the impact of healthcare provider autonomy support for self-management among cancer survivors. This suggests that strategies for enhancing autonomy and relatedness should be considered when developing self-management interventions for cancer survivor patients.

참고문헌 (Reference)

1 박애란, "자기결정성이론 기반 관상동맥중재술 환자의 건강행위 이행 구조모형" 동서간호학연구소 24 (24): 101-109, 2018

2 서영미, "자기결정성 이론에 근거한 제2형 당뇨병 환자의 자가관리행위 예측 모형" 한국간호과학회 41 (41): 491-499, 2011

3 이은하, "자기결정성 이론에 근거한 고혈압 전단계 노인의 건강행위이행 구조 모형" 기본간호학회 19 (19): 343-352, 2012

4 장선희, "암 환자의 외상 후 성장과 생의 의미가 건강증진행위에 미치는 영향" 대한종양간호학회 14 (14): 100-108, 2014

5 이은실, "부인암 환자의 생존단계별 건강증진행위, 외상 후 성장 및 삶의 질 비교" 한국성인간호학회 25 (25): 312-321, 2013

6 김혜숙, "국내 종양간호사의 암 생존간호 실무에 대한 조사연구" 대한종양간호학회 17 (17): 124-132, 2017

7 전미경, "간이식 수혜자의 자기관리 구조모형" 한국간호과학회 47 (47): 663-675, 2017

8 La Guardia JG, "Within-person variation in security of attachment : A self-determination theory perspective on attachment, need fulfillment, and well-being" 79 (79): 367-384, 2000

9 Deci EL, "The"what"and"why"of goal pursuits : Human needs and the self-determination of behavior" 11 (11): 227-268, 2000

10 Lee SG, "The relationship between treatment intention and compliance in newly detected hypertensive patients" 34 (34): 417-426, 2001

11 Ciechanowski PS, "The patient-provider relationship : attachment theory and adherence to treatment in diabetes" 158 (158): 29-35, 2001

12 Baron RM, "The moderator-mediator variable distinction in social psychological research : conceptual, strategic, and statistical considerations" 51 (51): 1173-1182, 1986

13 Petkov J, "The internal consistency and construct validity of the partners in health scale : Validation of a patient rated chronic condition self-management measure" 19 (19): 1079-1085, 2010

14 Polit DF, "Statistical power in nursing research" 39 (39): 365-369, 1990

15 Lorig KR, "Self-management education : History, definition, outcomes, and mechanisms" 26 (26): 1-7, 2003

16 Barlow J, "Self-management approaches for people with chronic conditions : A review" 48 (48): 177-187, 2002

17 Ng JY, "Self-determination theory applied to health contexts : A meta-analysis" 7 (7): 325-340, 2012

18 Deci EL, "Self-determination theory : a macrotheory of human motivation, development, and health" 49 (49): 182-185, 2008

19 Bodenheimer T, "Patient self-management of chronic disease in primary care" 288 (288): 2469-2475, 2002

20 Williams GC, "Motivational predictors of weight loss and weight-loss maintenance" 70 (70): 115-126, 1996

21 Halvari AEM, "Motivational predictors of change in oral health : An experimental test of self-determination theory" 30 (30): 295-306, 2006

22 Bodenheimer T, "Improving primary care for patients with chronic illness" 288 (288): 1775-1779, 2002

23 Ryan RM, "Facilitating health behaviour change and its maintenance : Interventions based on self-determination theory" 10 (10): 2-5, 2008

24 Lorig KR, "Effect of a self-management program on patients with chronic disease" 4 (4): 256-262, 2001

25 Williams GC, "Computer-assisted intervention improves patient-centered diabetes care by increasing autonomy support" 26 (26): 728-734, 2007

26 National Cancer Center, "Cancer statistics"

27 Schmidt K, "Autonomy support in primary care : validation of the German version of the Health Care Climate Questionnaire" 65 (65): 206-211, 2012

28 Barlow JH, "A 12-month follow-up study of self-management training for people with chronic disease: Are changes maintained over time?" 10 (10): 589-599, 2005