A STRUCTURAL MODEL OF INNER STRENGTH OF SPOUSAL CAREGIVERS AMONG PATIENTS WITH ADVANCED CANCER

Abstract

Advanced cancer affects distress among female-caregiver spouses because of changes in daily care­giving responsibilities. However, inner strength increases problem solving skills and decreases caregiving stress. The purpose of this study was to develop a causal model of inner strength among female-caregiver spouses of patients with advanced cancer and examine the causal relationship among coping ability, social support, caregiver burden, spirituality, and inner strength. The participants consisted of 195 female- caregiver spouses of patients with advanced cancer at Saraburi Hospital, National Cancer Insti­tute, and Lopburi Cancer Hospital. A set of questionnaires (demographic records, Inner strength Scale, Zarit Burden Interview, Social Support Questionnaire, Jalowiec Coping Scale, and Spiritual Well-Being Scale) was used to collect data. Data were analyzed using descriptive statistics, and Structural Equation Modeling.

Findings revealed that the final model fitted with the empirical data and explained 60% of the variance in female-caregiver spouses’ inner strength. The results indicated that coping ability, social support, caregiver burden, and spirituality had a significant positive and direct effect on female-care-giver spouses’ inner strength. Coping ability had a direct positive effect on inner strength and an indirect effect on inner strength through caregiver burden. Social support had a direct positive effect on inner strength and an indirect effect on inner strength through spirituality. As expected, spirituality had a direct positive effect on inner strength and indirect effect on inner strength through caregiver burden. Nurses should assess the female-caregiver spouses’ inner strength. Nursing interventions should be developed based on the findings to enhance inner strength among the female-caregiver spouses.