Health-related quality of life in pediatric patients with cancer: A structural equation approach with the roy adaptation model

The purpose of this study was to test the Roy Adaptation Model-based theory of health-related quality of life in Taiwanese children with cancer. The environmental stimuli included severity of illness, age, gender, communication with others, and understanding of the illness. The severity of the illness was considered as a latent variable construct, including the stage of illness, laboratory values, and number of hospitalizations. Biopsychosocial responses, that is health-related quality of life, was hypothesized as a latent variable that consisted of (1) physical function, (2) psychologic function, (3) peer/school function, (4) treatment/disease symptoms, and (5) cognition functions. In total, 102 children with cancer participated in the study. Structural equation modeling was used to examine 2 Roy Adaptation Model-based theory propositions. The findings showed that the construct of severity of illness demonstrated excellent fit with the stage of illness, laboratory values, and total number of hospitalizations. Second, the health-related quality of life also demonstrated good construct validity with 5 domains. Third, this study supported the Roy Adaptation Model-based theory proposition that environmental stimuli influenced biopsychosocial responses.