A survey study of adults with chronic conditions: Examining the correlation between patient activation and health locus of control

Objectives This study aimed to examine (1) the association between patient activation (PA), health locus of control (HLOC), sociodemographic and clinical factors, and (2) the effect of HLOC dimensions, sociodemographic and clinical factors on PA. Methods Three hundred U.S. adults, with at least one chronic condition (CC) were recruited through Amazon Mechanical Turk and completed an online survey which included sociodemographic questions, the Patient Activation Measure® - 10, and the Multidimensional Locus of Control (MHLC) - Form B. Statistical analyses, including descriptive, correlation, and multiple linear regression, were conducted using IBM SPSS v25. Results Of the 300 participants, more than half were male (66.3%), White (70.7%), with at least a college degree (76.0%), and employed full-time (79.0%). The average PA score was 68.8 ± 14.5. Multiple linear regression indicated that participants who reported they were Black, retired, with a greater number of CCs, and with higher scores in Chance MHLC had higher PA, while participants with higher scores in Internal MHLC, were unemployed and reported to have been affected by COVID-19-related worry or fear to manage their CC, had lower PA. Discussion HLOC dimensions should be addressed concurrently with PA for patients with CCs, thus adding to a more patient-centered clinical approach.

Involvement in Health Behavior After Heart Transplantation: The Role of Personal Resources and Health Status. Single-Center Observational Study

Introduction: Heart transplantation affects all spheres of the patients’ functioning - their physical well-being and coping with everyday situations, as well as their identity and social functioning. Its long-term effects depend on the effective cooperation with the transplant team. Post-transplant patients are expected to be committed to adherence to recommendations. Patients’ subjective characteristics could increase the risk of difficulties during treatment or might have a protective effect. The major aim of the study was to evaluate the level of engagement in health behavior in heart transplant recipients in relation to their personal resources, such as personality traits, and their health status.Material and Method: The observational ex post facto model was proposed. Participants completed a set of psychological questionnaires. In the study, there were used questionnaires regarding health behavior (HBI), personality traits (NEO-FFI), health locus of control (MHLC), self-efficacy (GSES) and health status (GHQ-28). The group included in the analyses consisted of 107 heart transplant patients. They ranged in age from 19 to 75 years; 10.3% of them were women.Results: According to norms, 71% patients reported high level of engagement in health behavior. There were significant differences in the level of dietary habits and other types of health behaviors. The best predictors of overall health behavior were conscientiousness (β = 0.20, p < 0.05) and health locus of control (Powerful Others) (β = 0.25, p < 0.05). The prophylaxis behavior was related significantly to the level of conscientiousness (p < 0.05) and health locus of control (Internal and Powerful Others) (p < 0.05; p < 0.01). The level of positive mental attitude was related significantly to agreeableness (p < 0.05), health locus of control (Powerful Others) (p < 0.01), and self-efficacy (p < 0.01). Everyday healthy practices were related significantly to openness to experience (p < 0.01) and health locus of control (all categories: Internal, Powerful Others and Chance) (p < 0.05; p < 0.01; p < 0.05, respectively).Conclusion: Majority of heart transplant patients is engaged in high level of health behavior. Among the various forms of health-relevant habits, heart transplant patients adhere significantly less frequently to a healthy diet. Among examined resources, the best predictors of caring about health are generalized self-efficacy and age at the time of HTx.

The Role of Aging Anxiety, Ageism, and Health Locus of Control on Middle-Aged Adults Health Outcomes and Behaviors

Older adults with more ageist attitudes and aging anxiety and who endorse an external health locus of control (HLOC) have poorer mental and physical health and less engagement in healthy behaviors than those who report less ageist attitudes, aging anxiety, and endorse an internal HLOC. However, middle-aged adults have not been examined in this literature. Using Terror Management Theory as a framework, this study examined the relationship of middle-aged adults’ aging anxiety, ageist attitudes, and HLOC with health behaviors and mental and physical health outcomes. 391 middle-aged participants (40-55 years) completed measures of ageist attitudes, aging anxiety, HLOC (Internal, External, and Powerful Other), engagement in health behaviors, mental health, and physical health. The path analysis model demonstrated acceptable fit, χ2(2)=7.794, p=.02, CFI=.99, TLI=.92, RMSEA=.09). For health behaviors, eight of the 10 paths were significant; higher aging anxiety, higher ageist attitudes, and less endorsement of internal HLOC were related to less engagement in healthy behaviors. For mental health and physical health, five of the 10 paths were significant; in general, higher aging anxiety, higher ageist attitudes, and less endorsement of internal HLOC were related to poorer mental and physical health. This study demonstrated that middle-aged adults’ aging anxiety, ageist attitudes, and health locus of control are related to their health behaviors and mental and physical health. Furthermore, higher endorsement of specific forms of ageist attitudes and aging anxiety were related to worse reported mental and physical health and to less engagement in health behaviors. Implications of these findings will be discussed.

Nutritional Behaviors, Health Literacy, and Health Locus of Control of Secondary Schoolers in Southern Poland: A Cross-Sectional Study

Nutritional behaviors remain an essential part of a healthy lifestyle. It seems obvious that unfavorable health behaviors adopted in adolescence are maintained late in adulthood and may have a profound effect on health status. The main aim of this study was to assess the association between nutritional behaviors and health literacy (HL), health locus of control (HLC), and socioeconomic variables in secondary school pupils from a voivodship (the main unit of territorial division) in southern Poland. The analysis was based on dataTable from a paper-and-pencil survey taken by 2223 pupils from schools selected as the result of cluster sampling. The survey questionnaire encompassed a set of five items asking about dietary patterns and the consumption of fruit and vegetables as well as fast food, a European Health Literacy Project Questionnaire consisting of 47 items, the Multidimensional Health Locus of Control (MHLC) scale, and items asking about sociodemographic and economic variables. Uni- and multivariate logistic regression models have been developed to assess the predictors of indicator nutrition behaviors. The adjusted models revealed that internal HLC was not significantly associated with any of analyzed nutritional behaviors. “Powerful other HLC” and “Chance HLC” (dimension of external HLC) were significant predictors of the selected dietary patterns. Furthermore, higher HL was associated with higher consumption of fruit and vegetables [odds ratio, 95% confidence interval (OR, 95% CI)]: 1.02 (1.01–1.04) and with lower consumption of fast food (OR, 95% CI, 0.98, 0.95–0.999). There was a significant relationship between gender, the size of the household, self-assessed economic situation, expenditures on mobile phones, and weekly duration of Internet use and selected nutrition behaviors. In conclusion, developed regression models confirmed a significant relationship between HL and the types of consumed food, but not with dieting patterns. Contrary to earlier studies, internal HLC was not associated with nutrition behaviors. In our study, boys showed more favorable nutritional behaviors than girls. More intense use of the Internet was associated with less beneficial nutritional behaviors. This study brings important results that should have an impact on health promotion interventions addressed to adolescents in southern Poland.

Relationships Among the Internal Health Locus of Control, Mental Health Problems, and Subjective Well-Being of Adults in South Korea

The purpose of this study was to confirm the relationship between internal health locus of control, mental health problems, and subjective well-being in adults during the prolonged COVID-19 pandemic. In particular, the mediating effect of mental health problems on the relationship between internal health locus of control and subjective well-being was examined. A cross-sectional descriptive design was conducted via online survey. The participants were 600 adults over 20 years of age living in South Korea. The collected data were analyzed using hierarchical regression analysis and SPSS Process Macro (Model 4). As a result of the study, the internal health locus of control had a significant negative effect on mental health problems. In addition, in the process of the internal health locus of control affecting subjective well-being, the mediating effect of mental health problems was significantly shown. In the period of an infectious disease pandemic such as COVID-19, it is necessary to establish a strong internal health locus of control of individuals and to promote monitoring and treatment introduction for those with a low internal health locus of control. In addition, it was discussed that controlling mental health problems can improve subjective well-being, which is life satisfaction and happiness.

The COVID-19 Pandemic: Role of Coping Humor and Internal Health Locus of Control on Social Dysfunction and Anxiety & Depression

The concerns about the impact of social distancing on mental health have been widely discussed. This study aimed to know the predictive effect of coping humor and Internal Health Locus of Control (Internal HLoC) on social dysfunction and anxiety & depression during the implementation of the COVID-19 social distancing agenda. This study was also intended to assess the effect of humor content on coping humor. A quantitative approach was used as the method ofthe study with 243 online-recruited participants, and PLS-SEM analysis was applied to find out the predictive effect in this study. The results and conclusions showed that anxiety & depression predict social dysfunction (β = 0.584, t-value = 11.93, f2 = 0.563). It was found that coping humor was able to directly increase the Internal HLoC (β = 0.187, t-value = 2.60, f2 = 0.036) and indirectly decrease social dysfunction (β = -0.144, t-value = 2.85) and anxiety & depression (β = -0.070, t-value = 2.42). Humor content unrelated to the issue of COVID-19 directly increase the coping-humor level (β = 0.266, t-value = 4.13,f2= 0.076), and indirectly increase Internal HLoC (β = 0.050, t-value = 2.07), and decrease anxiety & depression level (β = -0.046, t-value = 2.20). On the other hand, Internal HLoC directly decrease levels of social dysfunction (β = -0.233, t-value = 4.126, f2 = 0.089) and anxiety & depression (β = -0.373, t-value= 7.84, f2 = 0.161).

The dark side of the quarantine: night eating, sleep quality and the health locus of control in women

Purpose Staying at home for a prolonged period, the stress during COVID-19 quarantine may affect sleep quality, night eating behaviours of individuals. This paper aims to identify the relationship between night eating behaviour, sleep quality, perceptions of health locus of control in women during the pandemic. Design/methodology/approach An anonymous, Web based, cross-sectional study was conducted for the duration of a month (April-May, 2020). The study evaluated the nutritional habits of the participants. Anthropometric measurements were noted. Night Eating Syndrome Questionnaire (NESQ), Pittsburgh Sleep Quality Index (PSQI), Multi-dimensional Health Locus of Control-A were used for data collection. Findings With a mean age of 33 ± 8 years, 529 women participated in the study. The mean NESQ score was 14.4 ± 4.7, PSQI score was 6.4 ± 2.9. Higher night eating scores were observed in participants with chance locus of control (CLC) perception when compared to participants with internal health locus of control (IHLC) perception (p < 0.05). Lower sleep quality was observed in obese participants compared to normal/overweight participants (p < 0.05). It was also found that night eating behaviours significantly predicted sleep quality (R = 0.36, R2 = 0.13; p < 0.01), explaining about 13.3% of total variance of sleep quality. Research limitations/implications Only internet users and women participated in the study, and the questionnaire form was applied online; the information was obtained in the form of the participants' own statements. Practical implications It was found that night eating behaviour significantly predicted sleep quality during the pandemic. It was also determined that the individuals with high chance locus of control perception had higher NES scores than the individuals with high internal locus of control perception. Originality/value The night eating behaviours significantly predict sleep quality, individuals with a high perception of CLC had a higher night eating score than individuals with high perception of IHLC during the pandemic.

Association between health locus of control and perceived stress in college student during the COVID-19 outbreak: a cross-sectional study in Iran

Background The COVID-19 pandemic as a global mental health crisis has affected everyone, including students. The present study aimed to determine and investigate the relationship between health locus of control and perceived stress in students of Bushehr University of Medical Sciences (southern Iran) during the outbreak of COVID-19. Methods The present cross-sectional study examined 250 students of Bushehr University of Medical Sciences. We performed simple random sampling and utilized the demographic information form, Multidimensional Health Locus of Control scale (MHLCS) by Wallston, and Perceived Stress Scale (PSS) by Cohen to collect data. We analyzed data using the SPSS, Pearson correlation coefficient, and the hierarchical regression model with an error level of 5%. Results The mean perceived stress was 30.74 ± 8.09, and 92.4% of the students had moderate and high stress levels. Among the components of the health locus of control, the internal health locus of control (IHLC) had the highest mean in students (27.55 ± 3.81). Furthermore, the internal health locus of control (R = − 0.30, P < 0.001) had a significant inverse relationship, with perceived stress and the chance health locus of control (CHLC) (R = 0.30, P < 0.001) had a significant direct relationship. In the final regression model, the health locus of control and all the variables predicted 22.7% of the perceived stress variation in students during the COVID-19 period. Conclusion The results indicated that the internal health locus of control was associated with a reduction of perceived stress, and the powerful others health locus of control (PHLC) was related to its increase in students during the COVID-19 pandemic. Given the uncertain future, in the present work, universities are suggested to design web-based educational interventions alongside the curriculum to further strengthen the internal health locus of control and thus help reduce their perceived stress.