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. Author manuscript; available in PMC: 2024 Apr 24.
Published in final edited form as: Nurs Res. 2023 Apr 24;72(4):272–280. doi: 10.1097/NNR.0000000000000660

Table 4.

Hierarchical Structural Regression Models that Estimate Unique Contribution of Co-occurring Symptoms on the Cancer-Related Cognitive Impairment Latent Variable for Either Social Determinants of Health, Patient Specific Factors, or Treatment Factors

Exogenous Latent Variables Models Path coefficient Z-statistic p-value Model R2 Change in R2* 95% Confidence interval
Pairwise comparison model testing for social determinants of health
SDOHa Model 1 0.863 8.27 < .001 0.427 n/a 0.66, 1.07
SDOH
CoOccSymb 		Model 2 0.443
−0.951		 3.37
−9.11		 .001
< .001		 0.630 0.203 0.19, 0.70
−1.16, −0.75
Pairwise comparison model testing for patient-specific factors
PtSpecFxc Model 1 −0.873 −19.50 < .001 0.433 n/a −0.96, −0.79
PtSpecFx
CoOccSym		 Model 2 0.611
−1.729		 1.92
−4.92		 .055
< .001		 0.577 0.144 −0.01, 1.23
−2.42, −1.04
Pairwise comparison model testing for treatment factors
TxFxd Model 1 0.092 2.20 .028 0.008 n/a 0.01, 0.17
TxFx
CoOccSym		 Model 2 −0.059
−1.189		 −1.18
−18.23		 .237
< .001		 0.582 .574 −0.16, 0.04
−1.32, −1.06

Note. CFI = Comparative fit index; CoOccSym = co-occurring symptoms; PtSpecFx = patient specific factors; RMSEA = root mean squared of approximation; SDOH = social determinants of health; SRM = structural regression model; TxFx = treatment factors.

*

Change in R2 between SRM of latent variable and outcome variable versus SRM of latent variable, outcome variable, and co-occurring symptoms

a

Indicator variables for social determinants of health included: years of education, annual income, cumulative lifetime stress, resilience levels

b

Indicator variables for co-occurring symptoms included: morning and evening fatigue, state anxiety, depressive symptoms, sleep disturbance, occurrence of pain

c

Indicator variables for patient-specific factors included: age, functional status, comorbidity burden, the personality domain of neuroticism, perceived stress, cancer-specific stress

d

Indicator variables for treatment factors included: white blood cell count, hemoglobin level, a rating of the toxicity of the chemotherapy regimen, number and type(s) of medications in the antiemetic regimen, chemotherapy cycle length