Health locus of control and cardiovascular risk factors in veterans with type 2 diabetes

Abstract

PURPOSE Perceptions of control impact outcomes in veterans with chronic disease. The purpose of this study was to examine the association between control orientation and clinical and quality of life (QOL) outcomes in male veterans with type 2 diabetes (T2DM). METHODS Cross-sectional study of 283 male veterans from a primary care clinic in the southeastern US. Health locus of control (LOC) was the main predictor and assessed using the Multidimensional Health Locus of Control Scale. Clinical outcomes were glycosylated hemoglobin A1c (HbA1c), systolic (SBP) and diastolic (DBP) blood pressure, and low-density lipoprotein cholesterol (LDL-C). Physical (PCS) and mental (MCS) health component scores for QOL were assessed using the Veterans RAND 12-Item Health Survey. Unadjusted and adjusted multivariate analyses were performed to assess associations between LOC and outcomes. RESULTS Unadjusted analyses showed internal LOC associated with HbA1c (β=0.036; 95% CI 0.001,0.071), external LOC:powerful others inversely associated with LDL-C (β=−0.794; 95% CI −1.483,−0.104), and external LOC:chance inversely associated with MCS QOL (β=−0.418; 95% CI −0.859,−0.173). These associated remained significant when adjusting for relevant covariates. Adjusted analyses also demonstrated a significant relationship between external LOC:chance and PCS QOL (β=0.308; 95% CI 0.002,0.614). CONCLUSIONS In this sample of male veterans with T2DM, internal LOC was significantly associated with glycemic control, and external was significantly associated with QOL and LDL-C, when adjusting for relevant covariates. Assessments of control orientation should be performed to understand the perceptions of patients, thus better equipping physicians with information to maximize care opportunities for veterans with T2DM.

Watchful Waiting Strategy May Reduce Low-Value Diagnostic Testing

“…Locus of control theory suggests that patient perception of control may be associated with positive health outcomes. 24,25 When patients request tests, a negative response from physicians may threaten patients' sense of autonomy or control, whereas a watchful waiting approach may validate patients' concerns and bolster their sense of control over their health and symptoms. 26 In contrast to watchful waiting, reassurance by itself may be perceived by patients as invalidating their concerns.…”

Tip 2 Diyabetli Bireylerin Sağlık Kontrol Odaklarının Değerlendirilmesi

“…7 Ayrıca, iç kontrol odağının daha iyi fiziksel ve mental sağlık durumu ve ileriye dönük olumlu sağlık davranışlarıyla ilişkili olduğu belirtilmektedir. 10 Diyabette sağlık kontrol odakları ile ilgili çalışmalarda, iç kontrol odağına sahip bireylerde düzenli diyet ve egzersiz oranlarının yüksek olduğu, 12,13 iç kontrol odağının HbA1c düzeyi ile ilişkili 11 öz-etkililik ve öz bakım davranışlarıyla pozitif bir etkileşim içerisinde olduğu görülmüştür. 14 Ülkemizde, sağlık kontrol odağı algısı üzerinde yapılan araştırmalar incelendiğinde, genellikle eğitim bilimleri ve psikoloji gibi alanlarda yapıldığı, sağlıkla ilgili olarak diyabet alanında ise sınırlı sayıda 3 , araştırmanın olduğu görülmüştür.…”

Nothing left to chance? The impact of locus of control on physical and mental quality of life in terminal cancer patients

“…Others relinquish control of their fate and leave matters to a “powerful other” or chance. The individual’s perception of control regarding life circumstances can impact his or her physical quality of life (QOL) and overall mental well-being (1–4). …”