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

Abstract

Purpose To evaluate if Locus of Control (LOC) predicts various quality of life (QOL) and mental well-being measures among terminally ill cancer patients at the time of palliative care consult. Methods Multi-site analysis of patients with advanced cancer being seen as new patients in a Palliative and Supportive Care outpatient clinic. Patients completed the following surveys: Locus of Control Scale (LOC), Functional Assessment of Chronic Illness Therapy-General (FACT-G), Functional Assessment of Chronic Illness Therapy–Spiritual (FACIT-Sp), Hospital Anxiety Depression Scale (HADS), and Herth Hope Index (HHI). Regression models were created to examine the effect of LOC upon QOL, symptoms, and other measures of mental well-being. These models adjusted for the effect of age, gender, race, partnership status, education, and months since diagnosis as potential confounders. Results This study enrolled 100 patients. After adjusting for site, race and partnership status, higher levels of LOC Chance predicted decreased QOL (FACT-G) (p< 0.01). Higher levels of LOC Chance also correlated with increased depression and anxiety (p≤0.01) and decreased meaning/peace and faith (p≤0.01). Additionally, higher levels of LOC Chance predicted decreased hope (HHI) (p≤0.001). Conclusions Terminally ill cancer patients with a high LOC chance may be at risk for decreased physical and mental well-being at the end of life. Efforts should be made to identify these patients and design interventions to increase their feeling of control over the situation in order to improve physical and mental well-being at the end of life.

Locus of control moderates the association of COVID-19 stress and general mental distress: Results of a cross-sectional survey in two large samples from Norway, Germany, and Austria

“…In terms of the current state of research, it can be said that, to our knowledge, until now the moderating role of LoC has not been investigated with respect to COVID-19 related outcomes. Our findings confirm results of previous studies that established LoC as a resource to maintain and improve mental health [30,[34][35][36][37][38].…”

“…Cross-sectional and longitudinal studies from various international regions found that higher internal LoC and lower external LoC were moderately associated with greater mental health, lower situational stress, and lower mental distress, like depression and anxiety [30,[34][35][36][37][38].…”

Locus of control moderates the association of COVID-19 stress and general mental distress: results of a Norwegian and a German-speaking cross-sectional survey

“…[ 31 – 33 ]). Cross-sectional and longitudinal studies from various international regions found that higher internal LoC and lower external LoC were moderately associated with greater mental health, lower situational stress, and lower mental distress, like depression and anxiety [ 30 , 34 – 38 ]. Studies on psychosocial factors during the COVID-19 pandemic also investigated the role of LoC.…”

Cross-cultural adaptation of Rotter's General Locus of Control instrument

“…[3][4][5][6] Among patients suffering from such conditions, both recent and historical literature have established frequent associations between higher scores (indicating externalized LoC) on the General Locus of Control (GLoC) questionnaire and decreased physical and mental well-being, increased anxiety, and negative correlations with prognosis. [1][2][3][5][6][7][8][9][10] The questionnaire was developed by Rotter et al at the University of Connecticut as an instrument to measure and quantify a person's general sense of LoC. 1 The GLoC questionnaire has been validated and widely used in many different countries and languages, but still lacks a Brazilian Portuguese version.…”