Graduation Year


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Degree Granting Department


Major Professor

Susan C. Mcmillan



The Mediating Effect of Distress Caused by Constipation on Predictors of Quality of Life of Hospice Patients with Cancer.

Key positive outcomes for hospice patients include the prevention and alleviation of physical and psychological distress, maintenance of physical and mental functioning and all aspects of quality of life. This research used secondary analysis of previously gathered data to answer new research questions with alternative strategies to examine relationships not previously analyzed. The researchers collected data from 717 cancer patients who had been admitted to one of two private hospices. The aim of their experimental intervention was to define the effectiveness of using standardized assessment tools to provide systematic feedback to hospice staff about hospice patients and their caregivers. The aim of this secondary analysis was to assess the mediating effect of constipation distress on the relationship between constipation intensity and the hospice patients' QOL. Variables included in the analysis were: Quality of Life, Constipation Distress, Sociodemographic Characteristics (Age, gender, marital status, race/ culture, education, and socioeconomic status), Clinical Characteristics (Type of cancer, Co-morbidities, Functional/mental Health status), and Constipation Intensity.

The data analyzed using descriptive statistics, including the frequency, percentage, means and standard deviation for quality of life. A relationship between quality of life and sociodemographic variables and between quality of life and clinical characteristics were evaluated with Pearson correlation coefficients. An exploratory mediation analysis was used to assess the mediation effect of the constipation distress.

Results showed that age, ethnicity, constipation severity and functional status were predictors of QOL (P<0.0), and the bootstrapping showed that constipation distress has a mediation effect on the relationship between constipation severity and quality of life. The symptom intensity and distress as well as the relationship between constipation and quality of life need to be seen in a holistic approach to achieve the best symptom management for cancer patients.

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Nursing Commons