PURPOSE Understanding the activities of daily living (ADL) of cancer patients at the end-of-life stage may help healthcare providers develop interventions for preserving physical function and enhance patient's dignity in an everyday care context. This study aims to develop and test a causal effect model of physical function in terminal cancer patients. METHODS A total of 238 participants were recruited from two hospitals in South Korea. The data were collected using a structured questionnaire including demographics, visual analogue scale for pain, Functional Assessment of Chronic Illness Therapy-Fatigue, and Katz index of independence in ADL. The collected data were analyzed using SPSS WIN 25.0 and AMOS 23.0 programs for structural equation modeling procedures. RESULTS Most participants were aged 65 years or older (65.5%), male (53.8%), and inpatients (74.4%). The most common primary cancer site was gastrointestinal tract (44.1%). Physical function of the participants was positively influenced by regular exercise and negatively influenced by hospitalization, fatigue, and pain, explaining 35.1% of the variance. In this study, regular exercise improved participants' ADL level directly and indirectly either by reducing fatigue or decreasing fatigue through controlling pain. Pain did not affect ADL directly but decreased ADL level indirectly through fatigue as a mediator. CONCLUSION ADL was positively influenced by regular exercise and was negatively influenced by hospitalization, fatigue, and pain. Based on these results, in order to minimizing the problems of physical function in terminal cancer patients, interventions that reduce pain and fatigue and provide regular exercise are required.

中文翻译：

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了解晚期癌症患者身体功能的结构方程建模方法。

目的 了解癌症患者临终阶段的日常生活 (ADL) 活动可能有助于医疗保健提供者制定干预措施，以保持身体机能并提高患者在日常护理环境中的尊严。本研究旨在开发和测试晚期癌症患者身体功能的因果关系模型。方法 从韩国的两家医院共招募了 238 名参与者。使用结构化问卷收集数据，包括人口统计学、疼痛视觉模拟量表、慢性病治疗疲劳功能评估和 ADL 中的 Katz 独立指数。收集的数据使用 SPSS WIN 25.0 和 AMOS 23.0 程序进行结构方程建模程序分析。结果 大多数参与者年龄在 65 岁或以上（65.5%），男性（53.8%），和住院患者（74.4%）。最常见的原发癌部位是胃肠道（44.1%）。参与者的身体机能受到定期锻炼的积极影响，而受到住院、疲劳和疼痛的消极影响，解释了 35.1% 的方差。在这项研究中，定期锻炼通过减少疲劳或通过控制疼痛减轻疲劳直接或间接地提高了参与者的 ADL 水平。疼痛不直接影响 ADL，但通过疲劳作为中介间接降低了 ADL 水平。结论 ADL 受到规律运动的积极影响，而受到住院、疲劳和疼痛的消极影响。基于这些结果，为了尽量减少晚期癌症患者的身体机能问题，