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Quality of life after sudden cardiac arrest: Structural equation modeling
R Burr... - 2011 - Quality of life after sudden cardiac arrest: Structural equation modeling Quality of life has been conceptualized and measured in diverse ways. The purpose of this study was to test a causal model developed from a theoretical framework of quality of life for chronic illness, ...
Quality of life has been conceptualized and measured in diverse ways. The purpose of this study was to test a causal model developed from a theoretical framework of quality of life for chronic illness, adapted and applied to sudden cardiac arrest (SCA).
The model identified the concepts and described the relationships of several indicators to perceived quality of life. The sample consisted of 117 persons (95 M, 22 F) who had experienced out-of-hospital SCA. Three indicators of quality satisfaction and importance of: peace of mind, happiness in general, and life in general. Two indicators of socioeconomic status were: monthly income and educational attainment. Two latent variables of heart rate variability (HRV) described autonomic nervous system imbalance: the SDANN reflected a general measurement of HRV, including a circadian component; the other included three indicators of parasympathetic neural components of HRV: two time-domain (RMSSD) and RR50) and one frequency-domain (the integral of the power spectrum in the high frequency bandwidth) measurements. Three indicators of manifest symptom distress were: anxiety (felt tense or keyed up, 0-4), depression (felt sad, depressed, lost interest in things or felt hopeless, 0-4), and anger (recently felt angry, irritable, difficulty controlling temper, 0-4). Three indicators of activities of daily living were: walking (difficulty walking 1 block or climbing 1 flight of stairs, 1-5), housework (difficulty doing work around the house such as cleaning, light yard work, home maintenance, 1-5), and errands (difficulty doing errands such as grocery shopping, 1-5). Three indicators of perceived health status were: satisfaction with own health, sum of sick days (number of days in bed and number of days activities were cut down due to illness, with the sum log transformed), and satisfaction with and importance of level of energy/fatigue.
Confirmatory factor analysis on a larger set of indicators yielded those represented in the model, which was tested using AMOS 3.1 Maximum-likelihood estimates of all model parameters and chi-square goodness-of-fit statistics indicated that the specified model provided an adequate representation of the data: chi-square=124.06, d.f.=115, p=.266, goodness-of-fit index=.895, delta-1 (Bentler-Bonett)=.884, rho-1 (Bollen)=.846, delta-1 (Bollen)=.991, and rho-2 (Tucker-Lewis)=.987. Results suggest that low HRV and high levels of manifest symptom distress contributed to reporting limitations in daily living, and all the latent variables contributed to a less positive perception of health status, resulting in a lower perceived quality of life among SCA survivors.
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Quality of life after sudden cardiac arrest: Structural equation modeling |
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