The relationship of health locus of control and cardiac rehabilitation to mastery of illness-related stress

The study examined the relationships among participation in outpatient rehabilitation, health locus of control, and mastery of stress with coronary artery disease A sample of 111 persons who had been hospitalized for coronary artery disease completed the Master of Stress Instrument (MSI) and the Multidimensional Health Locus of Control Scale One fourth of the sample had participated in the hospital's cardiac rehabilitation programme Results showed no difference between cardiac-rehabilitation participants and nonparticipants on mastery, internal locus of control or stress Demographic characteristics of age, education, race and gender revealed no significant correlation with either the total MSI score or its component measures However, internal locus of control was significantly and positively correlated to both growth and total mastery A stronger relationship was found between internal locus of control and change This finding supports the hypothesis that health-internals achieve higher levels of mastery     

Validation of the multidimensional health locus of control scales for labor and delivery

No current instrument assesses women's health locus of control beliefs in relation to childbirth. Form C of the Multidimensional Health Locus of Control Scales was used to develop items for a new instrument specific to labor and delivery (MHLC-LD). Psychometric analyses conducted with two independent samples of pregnant women supported a three-factor model of the new instrument, consisting of Internal, Powerful Others, and Chance subscales. Results revealed modest coefficient alphas (>.70) for the subscales and demonstrated construct validity in known group analyses. Future validation research will focus on improving the internal consistency reliability of the MHLC-LD, testing factorial invariance across demographic groups, and examining the relationships between obstetric risk, previous birth experiences, and beliefs about control over childbirth outcomes.     

The relationship of weight loss, locus of control, and social support

This study investigated the relationship between weight loss, locus of control, and social support. It was hypothesized that internals would be more successful in weight reduction than externals/powerful others or externals/chance; that participants with higher social-support scores would be more successful in weight reduction than participants with lower social support scores; and that social support would contribute more to success in weight reduction in externals/powerful others than in internals or externals/chance. Subjects were 46 female employees of a large life insurance company who had participated in a nutrition and weight control program. They were studied six months later to assess weight change, locus of control (specifically, using a multidimensional health locus of control scale and a modified weight locus of control scale) and social support (using an investigator-developed scale). Study findings did not support the hypotheses. Rather, a significant negative relationship was found between social support and weight reduction in the case of internals. Possible explanations for the findings were discussed, along with recommendations for practice and further research. For example, it was suggested that it may be most desirable for those attempting weight loss to be sufficiently internal that they believe they are capable of bringing their weight under control, yet sufficiently external that they are amenable to the advice of health professionals.     

Translation of the multidimensional health locus of control scales for users of American sign language

ABSTRACT This paper describes the translation of the Multidimensional Health Locus of Control (MHLC) scales into American Sign Language (ASL). Translation is an essential first step toward validating the instrument for use in the Deaf community, a commonly overlooked minority community. This translated MHLC/ASL can be utilized by public health nurses researching the Deaf community to create and evaluate targeted health interventions. It can be used in clinical settings to guide the context of the provider-patient dialogue. The MHLC was translated using focus groups, following recommended procedures. 5 bilingual participants translated the MHLC into ASL; 5 others back-translated the ASL version into English. Both focus groups identified and addressed language and cultural problems before the final ASL version of the MHLC was permanently captured by motion picture photography for consistent administration. Nine of the 24 items were directly translatable into ASL. The remaining items required further discussion to achieve cultural equivalence with ASL expressions. The MHLC/ASL is now ready for validation within the Deaf community.     

The relationship between locus of control, instrumental and expressive traits among nurses

The purpose of this study was to explore the relationship between locus of control and sex role orientation among nurses. Ninety-eight participants, working female registered nurses between the ages of 30 and 59, were placed into one of four sex type groups using scores on the Personal Attributes Questionnaire. The groups were then compared to each other using Rotter's Locus of Control Scale. Previous research findings had indicated that women in a traditional female occupation would be sex typed in role orientation and externally locused. The subjects in this study exhibited variability in locus of control and sex role orientation. Locus of control orientation was not related to sex role orientation. The implications of the results were discussed and directions for future research were considered.     

Relationship of self-concept, health locus of control, and perceived cancer treatment options to the practice of breast self-examination

Breast cancer remains one of the most prevalent forms of cancer for women in the United States. Recognition of the fact that no more than 40% of women practice breast self-exam (BSE) is of major concern in that BSE has been identified as one method of early detection. The factors that encourage or discourage women to perform BSE need to be identified. The current study investigated the relationships between women's practice of BSE, self-concept, locus of control, and knowledge of treatment options for breast cancer. One mammogram screening center provided the 235 subjects who completed the questionnaires. Subjects who practiced BSE more frequently had a slightly higher self-concept score and were more aware of breast cancer treatment options (r = 0.16, p less than 0.05). Weak correlations were found between chance locus of control and BSE frequency of practice (r = 0.22, p less than 0.05). The majority of subjects reported irregular BSE practice, both as to whether they practiced BSE on a monthly basis and as to the time of the month for BSE.     

African Americans with cancer: the relationships among self-esteem,locus of control,and health perception

The purpose of this study was to describe and examine the relationships among self-esteem, locus of control, and perceived health status in African Americans with cancer and to identify predictors of perceived health status. A convenience sample of 95 oncology outpatients at two large medical facilities completed the Tennessee Self-Concept Scale, the Multidimensional Health Locus of Control Scale, and the Cantril Ladder, a measurement of perceived health. In an audiotaped interview two open-ended questions were used to clarify participants' Cantril Ladder scores. A significant positive relationship was discovered between self-esteem and powerful others health locus of control (p <.05). Participants tended to view God as the Powerful Other capable of influencing their health and well-being. Self-esteem and an internal health locus of control were found to account for 23% of the perceived variance in health status. In addition, interview data indicated that participants with normal to high levels of self-esteem and an internal health locus of control perceived their state of health and well-being positively.     

The relationship of HMOs, health insurance, and delivery systems to breast cancer outcomes

BACKGROUND: The current climate of anger and frustration with managed care has heightened interest in the quality of health care provided by managed-care plans, particularly health maintenance organizations (HMOs). This breast cancer outcomes study, investigating relationships of health insurance and delivery systems to stage at diagnosis, treatment selected, and survival, is based in a heavily penetrated, highly competitive HMO market. METHODS: Data for 1,788 residents of northern California younger than 65 years of age at diagnosis (1987-1993) were provided by a population-based cancer registry. Patient insurance included fee-for-service (FFS), group-model HMO, nongroup HMO, publicly insured, and uninsured. Diagnosis and treatment occurred in 73 hospitals (large, medium/moderately small, or very small community, rural, teaching, or HMO-owned hospitals). Regression models examined relationships of insurance and hospital type to 3 outcomes (stage, treatment, and survival), controlling for age, ethnicity, education, neighborhood occupational class, and time period. RESULTS: Early diagnosis was as likely for group-model and nongroup-model HMO-insured patients as for the private FFS-insured patients. In 1987-1990, HMO-owned hospitals were leaders in treating 46% of early-stage breast cancers with breast-conserving surgery plus radiation (BCS+); by 1991-1993, the most significant increases in BCS+ use occurred at teaching and large community hospitals. Survival of group-model HMO, nongroup-model HMO, and FFS patients was not significantly different. Publicly insured/uninsured patients had more stage III/IV disease (OR=2.01, P = 0.006) and greater all-cause mortality (risk ratio 1.46, P = 0.015). CONCLUSIONS: Group-model and nongroup-model HMO patients are similar to FFS-insured patients in stage at diagnosis and survival outcomes. Treatment selection is related to hospital type rather than insurance coverage.     

Perceived health competence,health locus of control,and patient adherence in renal dialysis

An emerging view in the literature regarding health locus of control (HLC) and health behavior suggests that HLC beliefs might affect behavior only through the interaction of HLC with other health-related expectancies. We examined internal and powerful others HLC beliefs as moderators of the relationship between a recently developed measure of perceived health competence and medical regimen adherence in 81 renal dialysis patients. The hypothesized interaction was significant, suggesting a moderating role for HLC. The pattern of the interaction differed from prediction. Greater perceived health competence was associated with more favorable adherence only for those patients scoring low on internal and high on powerful others HLC. This pattern suggests that a high degree of perceived competence is advantageous for those patients with predominant confidence in the actions of their health-care providers.This work was supported in part by National Institute of Diabetes and Digestive and Kidney Diseases grant 1R29 DK49129-01 awarded to Alan Christensen.We would like to thank the staff and patients of the University of Iowa Hospitals and Clinics and Covenant Medical Center Renal Dialysis Programs. We especially acknowledge the assistance of Carl Richards, George Sadewasser, Lisa Nelson, and Dana Wedeking.     

Health beliefs, health locus of control, and women's mammography behavior

Research has shown that routine mammography screening can significantly reduce mortality from breast cancer. The use of mammography screening, however, remains well below national goals. In an effort to understand the factors that influence women's mammography behaviors, this study explored the relation between health beliefs, locus of control, and women's mammography practice. Survey instruments used were Champion's health belief scales and the Multidimensional Health Locus of Control (MHLC) scales. The study used a convenience sample of 25 African Americans and 72 white women ages 35 to 84. Findings showed that women who participated in mammography screening were significantly more likely to perceive greater benefits, greater health motivation, and fewer barriers to screening than those who did not participate. These same three variables were similarly associated with greater frequency of receiving mammograms. It also was found that perceived benefits and health motivation were significantly correlated with shorter duration of time since the last mammogram. No support was found for perceived susceptibility, perceived seriousness, and health locus of control as predictors of women's mammography behavior. Implications for nursing research in further examining the MHLC and the Health Belief Model construct of susceptibility as they relate to mammography behavior are identified. Practice implications for nurses are suggested.     

Agoraphobia,depression, mental health locus of control,and attributional styles

The specificity of an external locus of control and the specificity of attributional biases to agoraphobic and to depressed patients were examined by comparing Multidimensional Health Locus of Control scales (MHLC) and Attributional Style Questionnaire (ASQ) scores for samples of (a) nondepressed agoraphobic patients, (b) nonanxious depressed patients, and (c) comorbid patients. Agoraphobic and comorbid patients externalized mental health locus of control to chance more than did depressed patients. Agoraphobic and comorbid patients attributed good events to more stable causes than did depressed patients. Agoraphobic and comorbid patients also scored significantly higher than depressed patients on a composite measure of internality, stability, and globality ratings regarding causes of good events. Comorbid patients attributed bad events to more global causes than did agoraphobic patients. When globality ratings for good and bad events were summed, comorbid patients scored significantly higher than the other groups.This research was supported by grants from the Haldis and Josef Andresen Legacy and from the Research Institute, Modum Bads Nervesanatorium. We are indebted to project adviser Svenn Torgersen, and to Thorleif Lund, Svein Magnussen, and Helge M. Roennestad for assistance in the preparation of this paper.     

Relationship of health locus of control to lifestyle change programs

The relationship of health locus of control (HLC) scores to changes in physical parameters of 339 participants in a lifestyle change program was examined. Physical parameters included weight, blood pressure, low density lipoproteins, triglycerides, and the ratio between cholesterol and high density lipoproteins. Data were collected on admission and on completion of the 24-day residential program, and at a 6-month followup. There were significant changes in HLC scores (p less than .001) from admission to discharge. Weight changes at 6 months were positively correlated with admission HLC composite scores (p less than .01) and chance dimension (p less than .05) scores. There were negative correlations at 6 months between admission powerful other scores and changes in triglycerides (p less than .01) and changes in the ratio of cholesterol and high density lipids (p less than .01).