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Amato C, Iovino P, Longobucco Y, Salvadori E, Diaz RG, Castiglione S, Guadagno MG, Vellone E, Rasero L. Reciprocal associations between beliefs about medicines, health locus of control and adherence to immunosuppressive medication in allogeneic hematopoietic cell transplant patients: Findings from the ADE-TRAM study. Eur J Oncol Nurs 2023; 67:102410. [PMID: 37804755 DOI: 10.1016/j.ejon.2023.102410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/22/2023] [Accepted: 09/07/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE Patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT) are required to strictly adhere to immunosuppressive medications to avoid rejection and infective complications. Since medication adherence is among the most important modifiable behaviors to achieve better outcomes, the aims of this study were to measure the baseline and longitudinal trends of medication adherence and investigate the psychological factors associated with medication adherence in allo-HSCT patients. METHODS This was a single-center, longitudinal study of patients who underwent allo-HSCT to treat hematological malignancies at the University hospital of Florence (Italy). Adherence was measured with the Immunosuppressive Medication Self-Management Scale; psychological factors (i.e., beliefs about medicines and health locus of control) were measured with the Beliefs About Medicines Questionnaire and Multidimensional Health locus of Control Scale. Data were collected 1, 3, 6 and 12 months after discharge. A mixed effects model was performed after adjusting for demographic characteristics. RESULTS 50 adult patients were included in this study. Adherence to immunosuppressant was optimal and increased significantly 3 months after bone marrow transplantation (B = 0.23, p = 0.041). Patients with lower concerns about immunosuppressive medications were more likely to be adherent (B = 0.02, p = 0.040), while those having beliefs that their disease was due to external factors were less likely to be adherent (B = -0.02, p = 0.026) than their counterparts. CONCLUSIONS These results underline the importance of psychological factors in affecting adherence to immunosuppressants of allo-HSCT patients. Healthcare providers and researchers should target medication beliefs and reorient locus of control with appropriate interventions, in order to improve adherence.
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Affiliation(s)
- Carla Amato
- Health Sciences Department, University of Florence, Florence, Italy.
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy.
| | - Yari Longobucco
- Health Sciences Department, University of Florence, Florence, Italy.
| | | | | | - Sabrina Castiglione
- Bone Marrow Transplantation Unit, Careggi University Hospital, Florence, Italy.
| | | | - Ercole Vellone
- Department of Biomedicine and Prevention University of Rome Tor Vergata, Rome, Italy; Department of Nursing and Obstetrics, Wroclaw Medical University, Poland.
| | - Laura Rasero
- Health Sciences Department, University of Florence, Florence, Italy.
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Xing Z, Ji M, Shan Y, Dong Z, Xu X. Using the Multidimensional Health Locus of Control Scale Form C to Investigate Health Beliefs About Bladder Cancer Prevention and Treatment Among Male Patients: Cross-Sectional Study. JMIR Form Res 2023; 7:e43345. [PMID: 37585255 PMCID: PMC10468698 DOI: 10.2196/43345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Bladder cancer is a leading cause of death among Chinese male populations in recent years. The health locus of control construct can mediate health status and outcomes, and it has proven helpful in predicting and explaining specific health-related behaviors. However, it has never been used to investigate health beliefs about bladder cancer prevention and treatment. OBJECTIVE This study aimed to classify male patients into different latent groups according to their beliefs about bladder cancer prevention and treatment and to identify associated factors to provide implications for the delivery of tailored education and interventions and the administration of targeted prevention and treatment. METHODS First, we designed a four-section questionnaire to solicit data: section 1-age, gender, and education; section 2-the communicative subscale of the All Aspects of Health Literacy Scale; section 3-the eHealth Literacy Scale; and section 4-health beliefs about bladder cancer prevention and treatment measured by the Multidimensional Health Locus of Control Scale Form C. We hypothesized that the participants' health beliefs about bladder cancer prevention and treatment measured in section 4 could be closely associated with information collected through sections 1 to 3. We recruited 718 Chinese male patients from Qilu Hospital of Shandong University, China, and invited them to participate in a web-based questionnaire survey. Finally, we used latent class analysis to identify subgroups of men based on their categorical responses to the items on the Multidimensional Health Locus of Control Scale Form C and ascertained factors contributing to the low self-efficacy group identified. RESULTS We identified 2 subgroups defined as low and moderate self-efficacy groups representing 75.8% (544/718) and 24.2% (174/718) of the total sample, respectively. Men in the low self-efficacy cluster (cluster 1: 544/718, 75.8%) were less likely to believe in their own capability or doctors' advice to achieve optimal outcomes in bladder cancer prevention and treatment. Men in the moderate self-efficacy cluster (cluster 2: 174/718, 24.2%) had distinct psychological traits. They had stronger beliefs in their own capability to manage their health with regard to bladder cancer prevention and treatment and moderate to high levels of trust in health and medical professionals and their advice to achieve better prevention and treatment outcomes. Four factors contributing to low self-efficacy were identified, including limited education (Year 6 to Year 12), aged ≥44 years, limited communicative health literacy, and limited digital health literacy. CONCLUSIONS This was the first study investigating beliefs about bladder cancer prevention and treatment among Chinese male patients. Given that bladder cancer represents a leading cause of death among Chinese male populations in recent years, the low self-efficacy cluster and associated contributing factors identified in this study can provide implications for clinical practice, health education, medical research, and health policy-making.
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Affiliation(s)
- Zhaoquan Xing
- Department of Urology, Qilu Hospital of Shandong University, Ji'nan, China
| | - Meng Ji
- The University of Sydney, Sydney, Australia
| | - Yi Shan
- School of Foreign Studies, Nantong University, Nantong, China
| | - Zhaogang Dong
- Department of Clinical Laboratory, Qilu Hospital of Shandong Universit, Ji'nan, China
| | - Xiaofei Xu
- Center for Reproductive Medicine,Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Ji'nan, China
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Martos T, Sallay V, Rafael B, Konkolÿ Thege B. Preferred ways of giving birth in non-pregnant and pregnant nulliparous women: the role of control beliefs. J Psychosom Obstet Gynaecol 2021; 42:201-211. [PMID: 31928281 DOI: 10.1080/0167482x.2019.1710486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To explore the association between delivery-specific, health-related control beliefs and preferred ways of delivery in nulliparous Hungarian women. Moreover, since data about the delivery-specific control beliefs and delivery-related preferences of non-pregnant nulliparous women are lacking, the present study also seeks to provide descriptive information in this regard. METHODS A total of 984 Hungarian nulliparous women (26.45 ± 5.42 years; 660/77.2% non-pregnant and 224/22.8% pregnant) were included in the present study. The online assessment included measures of delivery-specific (internal-, healthcare professional-, and chance-related) health control beliefs, fears of childbirth, self-esteem, as well as preferences regarding delivery setting (i.e. spontaneous vaginal birth in hospital, planned cesarean birth and home birth). RESULTS Healthcare professional-related control beliefs were associated with a stronger preference for spontaneous vaginal birth in hospital (OR = 1.87, 95% CI: 1.56-2.23) and planned cesarean birth (OR = 1.96, 95% CI: 1.60-2.40), alongside a weaker preference for home birth (OR = 0.31, 95% CI: 0.25-0.39). In contrast, internal delivery-specific control beliefs predicted a weaker preference for planned cesarean (OR = 0.66, 95% CI: 0.55-0.78) and a stronger preference for home birth (OR = 1.63, 95% CI: 1.33-2.00). A general preference index for medicalized ways of delivery was negatively associated with internal - and positively with healthcare professional - and chance-related control beliefs (βs = -.173, .074 and .445, respectively). CONCLUSIONS Delivery-related control beliefs are important psychological characteristics in the prediction of preferences for ways of delivery. Understanding delivery-specific control beliefs may be an important component of supporting women to give birth in a mentally and physically healthy way.
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Affiliation(s)
- Tamás Martos
- Institute of Psychology, University of Szeged, Szeged, Hungary
| | - Viola Sallay
- Institute of Psychology, University of Szeged, Szeged, Hungary
| | - Beatrix Rafael
- Institute of Psychology, University of Szeged, Szeged, Hungary.,Department of Medical Rehabilitation and Physical Medicine, University of Szeged, Szeged, Hungary
| | - Barna Konkolÿ Thege
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Marton G, Pizzoli SFM, Vergani L, Mazzocco K, Monzani D, Bailo L, Pancani L, Pravettoni G. Patients' health locus of control and preferences about the role that they want to play in the medical decision-making process. PSYCHOL HEALTH MED 2020; 26:260-266. [PMID: 32323553 DOI: 10.1080/13548506.2020.1748211] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Health locus of control (HLOC) may influence people's behavior regarding their health as well as their desires to be involved in the medical decision-making. Our study aimed to examine HLOC's relations with people's control preferences about the medical decision-making. A total of 153 people filled out the self-administered version of the Control Preference Scale and the Multidimensional Health Locus of Control Scale - form C. The most preferred role is the collaborative one. However, HLOC explained heterogeneity in people's control preferences: lower scores in external HLOC were related to a greater preference for the active and the collaborative role. From the personalized medicine perspective, an accurate evaluation of the patient's HLOC could help tailoring the decision-making process within the clinical context.
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Affiliation(s)
- Giulia Marton
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS , Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan , Milan, Italy
| | - Silvia Francesca Maria Pizzoli
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS , Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan , Milan, Italy
| | - Laura Vergani
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS , Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan , Milan, Italy
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS , Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan , Milan, Italy
| | - Dario Monzani
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS , Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan , Milan, Italy
| | - Luca Bailo
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS , Milan, Italy
| | - Luca Pancani
- Department of Psychology, University of Milan - Bicocca , Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS , Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan , Milan, Italy
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Mirzania M, Khajavi A, Moshki M. Validity and Reliability of Form C of the Multidimensional Health Locus of Control Scale in Pregnant Women. IRANIAN JOURNAL OF MEDICAL SCIENCES 2019; 44:307-314. [PMID: 31439974 PMCID: PMC6661515 DOI: 10.30476/ijms.2019.44957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background The health locus of control (HLC) can indirectly determine the health status. The current study aimed to assess the validity and reliability of Form C of the Multidimensional Health Locus of Control (MHLC-C) scale in pregnant women. Methods 554 pregnant women participated in this cross-sectional study conducted in 2017; they referred to community health centers affiliated with Mashhad and Gonabad Medical Sciences Universities. Multi-stage random sampling was done. In this study, first, the questionnaire was translated into Farsi; then, face validity and construct validity were done through exploratory factor analysis, and concurrent criterion validity was also examined. Moreover, the reliability was assessed through internal consistency and stability methods. Results The results of the exploratory factor analysis showed that the MHLC-C scale consisted of four subscales, i.e. Chance, Internal, Other People, and Doctors, which accounted for 51.18% of variance. The results of the reliability analysis showed an acceptable internal consistency for the scale (Cronbach's alpha coefficient for subscales from 0.62 to 0.90). Also, the test-retest results showed good stability for all subscales other than Doctors (P<0.05). The concurrent validity of Forms B and C of MHLC scale showed a positive and significant correlation between subscales. Conclusion The results of this study showed that the MHLC-C scale had acceptable validity and reliability in pregnant women and is suggested as an applicable criterion for assessing individuals control beliefs with any medical or health-related condition in Iran.
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Affiliation(s)
- Marjan Mirzania
- Department of Health Education and Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abdoljavad Khajavi
- Department of Social Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Moshki
- Department of Health Education and Promotion, School of Health; Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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Bonafé FSS, Campos LAD, Marôco J, Campos JADB. Locus of control among individuals with different pain conditions. Braz Oral Res 2018; 32:e127. [DOI: 10.1590/1807-3107bor-2018.vol32.0127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 11/05/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - João Marôco
- University Institute of Psychological, Social, and Life Sciences – ISPA, Portugal
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Cossart AR, Staatz CE, Campbell SB, Isbel NM, Cottrell WN. Investigating barriers to immunosuppressant medication adherence in renal transplant patients. Nephrology (Carlton) 2018; 24:102-110. [DOI: 10.1111/nep.13214] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 12/11/2022]
Affiliation(s)
| | | | - Scott Bryan Campbell
- Department of NephrologyUniversity of Queensland at the Princess Alexandra Hospital Brisbane Australia
| | - Nicole Maree Isbel
- Department of NephrologyUniversity of Queensland at the Princess Alexandra Hospital Brisbane Australia
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Health locus of control: Its relationship with medication adherence and medication wastage. Res Social Adm Pharm 2017; 14:1015-1019. [PMID: 29306720 DOI: 10.1016/j.sapharm.2017.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 12/08/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Non-adherence is a significant factor contributing to medication wastage. Whilst there is some evidence on the influence of patients' health locus of control in relation to adherence, there has been little inquiry into its relationship with mediation wastage. OBJECTIVES To determine the relationship between medication adherence and health locus of control as well as medication wastage and health locus of control in patients with chronic conditions. METHODS Outpatients having a diagnosis of asthma, cardiovascular conditions, or diabetes participated in a cross-sectional study employing a self-administered questionnaire. The questionnaire determined presence of unused medication (wastage), adherence using 'Tool for Adherence Behaviour Screening' (TABS), and health locus of control using 'Multidimensional Health Locus of Control' (MHLC) scale Form C. Logistic regression was performed to ascertain the effects of MHLC and demographics in relation to adherence and wastage. MHLC beliefs were divided into 8 types of health locus of control. One-Way ANOVA was used to assess differences between conditions and belief types. P-values ≤ .05 were considered significant. RESULTS There were 330 patients recruited (58% male; age, mean±(SD): 61 ± 15 years; 110 asthma, 110 cardiovascular, 110 diabetes). In terms of health locus of control, females had higher 'doctors' beliefs (p = .054) and significantly lower 'other people' beliefs (p = < .0005). Lower 'chance' beliefs (p = .016) were associated with adherence. Lower 'doctors' beliefs and higher 'other people' beliefs were significantly associated with wastage (p = < .0005). There was a significant difference in adherence (p = < .0005) and in wastage (p = .002) between the eight types of health control. 'Yea-sayers' had the least presence of unused medication, followed by 'pure internal' believers. 'Pure powerful others external' had the highest presence of unused medication. CONCLUSIONS Healthcare professionals should take into account patients' health locus of control beliefs whilst conducting an intervention with patients; this can impact positively medication adherence and minimisation of medication wastage.
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Leone D, Borghi L, Lamiani G, Barlascini L, Bini T, d’Arminio Monforte A, Vegni E. Illness Representations of HIV Positive Patients Are Associated with Virologic Success. Front Psychol 2016; 7:1991. [PMID: 28066307 PMCID: PMC5179507 DOI: 10.3389/fpsyg.2016.01991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 12/06/2016] [Indexed: 11/13/2022] Open
Abstract
Introduction: It is important for HIV positive patients to be engaged in their care and be adherent to treatment in order to reduce disease progression and mortality. Studies found that illness representations influence adherence through the mediating role of coping behaviors. However, no study has ever tested if patient engagement to the visits mediate the relationship between illness perceptions and adherence. This study aimed to explore illness representations of HIV positive patients and test the hypothesis that illness representations predict adherence through the mediating role of a component of behavioral engagement. Methods: HIV-positive patients treated with highly active antiretroviral therapy (HAART) for at least one year and presenting to a check-up visit were eligible to participate in the study. Patients completed the Illness Perception Questionnaire-Revised. Behavioral engagement was measured based on the patients' clinical attendance to the check-up visits; adherence to HAART was measured by viral load. Undetectable viral load or HIV-RNA < 40 copies/ml were considered indexes of virologic success. Results: A total of 161 patients participated in the study. Most of them coherently attributed the experienced symptoms to HIV/HAART; perceived their condition as chronic, stable, coherent, judged the therapy as effective, and attributed their disease to the HIV virus and to their behavior or bad luck. The majority of patients (80.1%) regularly attended check-up visits and 88.5% of them reached virologic success. The mediation model did not show good fit indexes. However, a significant direct effect of two independent variables on virologic success was found. Specifically, the perception that the disease does not have serious consequences on patient's life and the prevalence of negative emotions toward HIV were associated with virologic success. On the contrary, the patient's perception that the disease has serious consequences on his/her life and the prevalence of positive emotions were associated with virologic failure. This model showed good fit indexes (CFI = 1; TLI = 1; RMSEA = 0.00; and WRMSR = 0.309). Discussion: Results do not support the mediating role of behavioral engagement in the relationship between illness representations and adherence. As perception of serious consequences coupled with positive emotions are directly associated with virologic failure, clinicians should take them into account to promote treatment adherence.
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Affiliation(s)
- Daniela Leone
- Unit of Clinical Psychology, Department of Health Sciences, University of MilanMilan, Italy
| | - Lidia Borghi
- Unit of Clinical Psychology, Department of Health Sciences, University of MilanMilan, Italy
| | - Giulia Lamiani
- Department of Biomedical Sciences, Humanitas UniversityMilan, Italy
| | - Luca Barlascini
- Unit of Clinical Psychology, ASST Santi Paolo e Carlo, Presidio San Paolo University HospitalMilan, Italy
| | - Teresa Bini
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo, Presidio San Paolo University Hospital, University of MilanMilan, Italy
| | - Antonella d’Arminio Monforte
- Clinic of Infectious Diseases, Department of Health Sciences, ASST Santi Paolo e Carlo, Presidio San Paolo University Hospital, University of MilanMilan, Italy
| | - Elena Vegni
- Unit of Clinical Psychology, Department of Health Sciences, University of MilanMilan, Italy
- Unit of Clinical Psychology, ASST Santi Paolo e Carlo, Presidio San Paolo University HospitalMilan, Italy
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Castarlenas E, Solé E, Racine M, Sánchez-Rodríguez E, Jensen MP, Miró J. Locus of control and pain: Validity of the Form C of the Multidimensional Health Locus of Control scales when used with adolescents. J Health Psychol 2016; 23:1853-1862. [PMID: 27682338 DOI: 10.1177/1359105316669860] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to examine the factor structure, reliability, and validity of the Form C of the Multidimensional Health Locus of Control scales in adolescents. A confirmatory factor analysis indicated that adequate fit of a four-factor model and the internal consistency of the scales were adequate. Criterion validity of the four scales of the Form C of the Multidimensional Health Locus of Control was also supported by significant correlations with measures of pain-related self-efficacy, anxiety, and coping strategies. The results indicate that the four Form C of the Multidimensional Health Locus of Control scale scores are reliable and valid and therefore support their use to assess pain-related locus of control beliefs in adolescents.
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Hutcheson C, Fleming MP, Martin CR. An examination and appreciation of the dimensions of locus of control in psychosis: issues and relationships between constructs and measurement. J Psychiatr Ment Health Nurs 2014; 21:906-16. [PMID: 24842279 DOI: 10.1111/jpm.12160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2014] [Indexed: 11/30/2022]
Abstract
Internal locus of control is associated with better psychological outcomes in comparison with external locus of control. Individuals experiencing a psychotic episode have a more external orientation, an externalizing bias for negative events and associations between paranoid delusions and external locus of control. The concept of multidimensional locus of control as measured by the Multidimensional Health Locus of Control (MHLC) scale may provide important information about the nature and course of psychotic symptoms. This narrative review explored the relationship between the orientation of locus of control and psychosis. Few studies have used the scale in samples with people experiencing psychotic symptoms and so there is limited evidence about the psychometric properties of the MHLC scale within this client group, although the findings from studies that have explored the properties of this tool in other groups suggest it could be a valuable instrument for use in psychosis. Further research is required to determine both the relationship between locus of control and psychosis in terms of therapeutic factors and outcome, and also the veracity of the MHLC scale as an instrument of choice in this group.
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Affiliation(s)
- C Hutcheson
- Occupational Therapy, Ayrshire and Arran National Health Service Board, University of the West of Scotland, Ayr, UK
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Konkolÿ Thege B, Rafael B, Rohánszky M. Psychometric properties of the multidimensional health locus of control scale form C in a non-Western culture. PLoS One 2014; 9:e107108. [PMID: 25202967 PMCID: PMC4159290 DOI: 10.1371/journal.pone.0107108] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 08/11/2014] [Indexed: 11/23/2022] Open
Abstract
Form C of the Multidimensional Health Locus of Control Scales (MHLC-C) was designed to investigate health-related control beliefs of persons with an existing medical condition. The aim of the present study was to examine the psychometric properties of this instrument in a culture characterized by external control beliefs and learned helplessness—contrary to the societal context of original test development. Altogether, 374 Hungarian patients with cancer, irritable bowel syndrome, diabetes, and cardiovascular and musculoskeletal disorders were enrolled in the study. Besides the MHLC-C, instruments measuring general control beliefs, anxiety, depression, self-efficacy, and health behaviors were also administered to evaluate the validity of the scale. Both exploratory and confirmatory factor analytic techniques were used to investigate the factor structure of the scale. Our results showed that the Hungarian adaptation of the instrument had a slightly different structure than the one originally hypothesized: in the present sample, a three-factor structure emerged where the items of the Doctors and the Others subscales loaded onto a single common component. Internal reliability of all three subscales was adequate (alphas between .71 and .79). Data concerning the instrument's validity were comparable with previous results from Western countries. These findings may suggest that health locus of control can be construed very similarly to Western countries even in a post-communist society—regardless of the potential differences in general control beliefs.
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Affiliation(s)
- Barna Konkolÿ Thege
- Department of Psychology, University of Calgary, Calgary, Canada
- Firebird Foundation, Budapest, Hungary
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
- * E-mail:
| | - Beatrix Rafael
- Psychiatric Clinic, University of Szeged, Szeged, Hungary
- Special Hospital of Chest Illnesses, Deszk, Hungary
| | - Magda Rohánszky
- Firebird Foundation, Budapest, Hungary
- Department of Oncology, Szent László Hospital, Budapest, Hungary
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Abstract
This cross-sectional study examined physical, psychological, and social factors associated with quality of life (QOL) among a sample of 399 rural women with HIV disease living in the Southeastern United States. Of the socio-demographic variables, age (p = .003), race (p < .0001), and time of HIV diagnosis (p = .03) were significantly associated with QOL. In bi-variate analysis, HIV symptoms (frequency and extent symptoms were bothersome), perceived stigma, internalized stigma, and depression were significantly and negatively associated with QOL whereas social support, problem-focused coping, perceived situational control, and healthy lifestyles were significantly and positively associated with QOL (all p < .0001). In adjusted analysis, HIV symptom frequency, depression, problem-focused coping, perceived situational control, perceived stigma, healthy lifestyles, and race remained significant predictors of QOL and explained 55% of the variance in QOL among the study participants (model F (7, 390) = 66.7; p < .0001). The study findings identify potential points of interventions to improve QOL among rural women with HIV disease.
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Ruffin R, Ironson G, Fletcher MA, Balbin E, Schneiderman N. Health Locus of Control Beliefs and Healthy Survival with AIDS. Int J Behav Med 2011; 19:512-7. [DOI: 10.1007/s12529-011-9185-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Otto C, Bischof G, Rumpf HJ, Meyer C, Hapke U, John U. Multiple dimensions of health locus of control in a representative population sample: ordinal factor analysis and cross-validation of an existing three and a new four factor model. BMC Med Res Methodol 2011; 11:114. [PMID: 21838862 PMCID: PMC3175204 DOI: 10.1186/1471-2288-11-114] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 08/12/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Based on the general approach of locus of control, health locus of control (HLOC) concerns control-beliefs due to illness, sickness and health. HLOC research results provide an improved understanding of health related behaviour and patients' compliance in medical care. HLOC research distinguishes between beliefs due to Internality, Externality powerful Others (POs) and Externality Chance. However, evidences for differentiating the POs dimension were found. Previous factor analyses used selected and predominantly clinical samples, while non-clinical studies are rare. The present study is the first analysis of the HLOC structure based on a large representative general population sample providing important information for non-clinical research and public health care. METHODS The standardised German questionnaire which assesses HLOC was used in a representative adult general population sample for a region in Northern Germany (N = 4,075). Data analyses used ordinal factor analyses in LISREL and Mplus. Alternative theory-driven models with one to four latent variables were compared using confirmatory factor analysis. Fit indices, chi-square difference tests, residuals and factor loadings were considered for model comparison. Exploratory factor analysis was used for further model development. Results were cross-validated splitting the total sample randomly and using the cross-validation index. RESULTS A model with four latent variables (Internality, Formal Help, Informal Help and Chance) best represented the HLOC construct (three-dimensional model: normed chi-square = 9.55; RMSEA = 0.066; CFI = 0.931; SRMR = 0.075; four-dimensional model: normed chi-square = 8.65; RMSEA = 0.062; CFI = 0.940; SRMR = 0.071; chi-square difference test: p < 0.001). After excluding one item, the superiority of the four- over the three-dimensional HLOC construct became very obvious (three-dimensional model: normed chi-square = 7.74; RMSEA = 0.059; CFI = 0.950; SRMR = 0.079; four-dimensional model: normed chi-square = 5.75; RMSEA = 0.049; CFI = 0.965; SRMR = 0.065; chi-square difference test: p < 0.001). Results were confirmed by cross-validation. Results based on our large community sample indicated that western general populations separate health-related control-beliefs concerning formal and informal assistance. CONCLUSIONS Future non-clinical HLOC studies in western cultures should consider four dimensions of HLOC: Internality, Formal Help, Informal Help and Chance. However, the standardised German instrument needs modification. Therefore, confirmation of our results may be useful. Future research should compare HLOC structure between clinical and non-clinical samples as well as cross-culturally.
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Affiliation(s)
- Christiane Otto
- University of Göttingen; Department of Medical Psychology & Sociology, Waldweg 37, 37073 Göttingen, Germany
| | - Gallus Bischof
- University of Lübeck, Research group S:TEP, Department of Psychiatry and Psychotherapy, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Hans-Jürgen Rumpf
- University of Lübeck, Research group S:TEP, Department of Psychiatry and Psychotherapy, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Christian Meyer
- University of Greifswald, Institute of Epidemiology and Social Medicine, Walther-Rathenau-Str. 48, 17475 Greifswald, Germany
| | - Ulfert Hapke
- Robert Koch-Institute, FG 22, Seestr. 10, 13353 Berlin, Germany
| | - Ulrich John
- University of Greifswald, Institute of Epidemiology and Social Medicine, Walther-Rathenau-Str. 48, 17475 Greifswald, Germany
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