Who Is Willing to Get Vaccinated? A Study into the Psychological, Socio-Demographic, and Cultural Determinants of COVID-19 Vaccination Intentions

Crucial to the success of the COVID-19 vaccination campaign is the rate of people who adhere to it. This study aimed to investigate the reasons underlying people’s willingness to get vaccinated in a sample of Italian adults, considering the effects of different individual characteristics and psychological variables upon positive vs. negative/hesitant vaccination intentions, as well as subjects’ self-reported motivations for such intentions. An anonymous cross-sectional survey was distributed online in February 2021. The results showed that trust in science, number of vaccinations received in 2019, and belief that COVID-19 is more severe than the common flu, were associated with positive vaccination intentions. “Chance externality” health locus of control showed both direct and indirect effects upon positive vaccination intentions. Anxiety symptoms and participants’ perceived psychological status also showed indirect positive effects. Subjects’ self-reported motivations varied interestingly across positive vs. negative/hesitant intentions. Implications of these findings for identifying effective pro-vaccination messages are discussed in the final section of the paper.

Factors Associated with Medication Non-Adherence among Patients with Lifestyle-Related Non-Communicable Diseases

This cross-sectional study explored the association between medication non-adherence and its factors in patients with non-communicable diseases (NCDs) using an online structured questionnaire emailed to 30,000 people (aged over 20 years who lived in Japan at the time of the survey). The questions concerned respondents’ characteristics, medication non-adherence, health beliefs, lifestyles, and trouble taking medication. Factors related to non-adherence were analyzed among patients with lifestyle-related NCDs categorized into two age groups: 20–59, and >60 years. Unintentional (p < 0.001) and intentional (p < 0.001) non-adherence were more common among patients aged 20–59 than in older adults. NCD patients aged 20–59 experienced significantly more trouble taking medication than older adults. Multiple regression analysis showed that for patients aged 20–59 with NCDs, unintentional non-adherence was significantly and positively associated with current smoking habits (β = 0.280, p < 0.001), while intentional non-adherence was significantly and positively associated with alcohol consumption (β = 0.147, p = 0.020) and current smoking habits (β = 0.172, p = 0.007). In patients aged 20–59, unhealthy eating habits (β = −0.136, p = 0.034) and lack of exercise (β = −0.151, p = 0.020) were negatively associated with intentional non-adherence. In conclusion, factors affecting medication non-adherence in patients with lifestyle-related diseases are related to health awareness, lifestyle, and medication barriers.

The Impact of the COVID-19 Pandemic on Self-Reported Management of Chronic Conditions

Chronic conditions (CCs) management during the COVID-19 pandemic and the impact of the pandemic on patient activation (PA) and health locus of control (HLOC) remain unknown. This cross-sectional online survey study examined the role of COVID-19 pandemic-related worry or fear in PA and HLOC among patients with CCs. Individuals with CCs (n = 300) were recruited through MTurk Amazon. The questionnaire included sociodemographic questions, the Patient Activation Measure, and the Multidimensional Health Locus of Control-Form B. Out of the 300 participants, 9.7% were diagnosed with COVID-19, and 7.3% were hospitalized. Patients with cancer, chronic kidney disease, chronic obstructive pulmonary disease, drug abuse/substance abuse, and stroke reported significant difficulties in managing their CCs due to worry or fear because of COVID-19. More than half of the sample (45.7%) reported COVID-19-related worry or fear about managing their CCs, and these patients had lower PA and lower external HLOC compared to patients not affected by COVID-19-related worry or fear. Health professionals should provide more support for patients facing difficulties in managing their CCs during the COVID-19 pandemic.

Selected psychological predictors of medication adherence in the older adults with chronic diseases

Aim

The main goal of the study was to assess the significance of selected psychological factors related to the adherence to medication recommendations among the older adults with chronic diseases.

Design

It was designed as a cross-sectional study, aimed at assessing the importance of selected psychological factors in complying with medication recommendations among older adults.

Methods

The study involved 345 older adults with chronic diseases, assessed the importance of selected psychological factors, such as: health locus of control, stress coping and mindfulness in adhering to medication recommendations older persons. To answer the research questions, we performed frequency analyses, basic descriptive statistics analyses together with the Kolmogorov-Smirnov test, Student's t tests for independent samples, monofactorial analysis of variance in the intergroup diagram, analysis correlation with the Pearson correlation coefficient, Spearman's rank correlation ρ analysis and stepwise linear regression analysis.

Results

The study identified psychological predictors of medication adherence, which explained 12% of the variability. An emotion-oriented coping proved to be the most important factor. Additionally, powerful other health locus of control and mindful attention were shown to have a positive effect.

Association between parents and peer attachment with health locus of control: a cross-sectional study among Iranian adolescents

INTRODUCTION

Evidence suggests that the quality of family relationships is associated with health locus of control in family members. The present study aimed to determine the correlation between the health locus of control and adolescent-parent attachment.

MATERIALS AND METHODS

In this descriptive, analytical cross-sectional study, at each of these 10 schools, 40 students aged 14 and 15, will be randomly selected among Behbahan middle schools. 400 students were selected. Rotters Locus of Control Scale and the Inventory of Parent and Peer Attachment (IPPA) were used for data collection. Data were analyzed using SPSS software and Pearson correlation coefficient, t-test and ANOVA statistical techniques.

RESULTS

Findings showed that the mean and standard deviation of attachment level to father (95.97±19.66), mother (99.62±15.60) friends (93.78±17.59) were all high. Between source of health control (intrinsic, affective, and luck), parental attachment and peers have predictive power (beta=0.263, p≤0.001).

CONCLUSION

According to the findings, to increase attachment to parents, it is better that Intervention should also be carried out on the father and the mother and health Locus control will be increased.

Exploring public attitude toward biofeedback technologies: Knowledge, preferences and personality tendencies

Background: Biofeedback is increasingly used in the clinical area and in daily health monitoring through wearable devices (e.g. smart watches). Nevertheless, it remains rather unknown. This study aimed to assess, in a sample of Italian citizens, the level of knowledge, attitudes, perceived efficacy and personality tendencies which could affect the uptake of biofeedback technologies.

Design and Methods: Participants were recruited by advertising the survey on the social networks, from March to May 2019. 160 subjects filled in an ad hoc online questionnaire assessing socio-demographic variables, clinical status, physical activity, knowledge and attitude towards biofeedback, psychological tendencies toward health.

Results: Data showed a good level of interest in biofeedback training in spite of poor knowledge about such technologies. Sport and chronic diseases were not correlated to a greater use of biofeedback. People informed about biofeedback technologies were more interested in undergoing biofeedback training and had higher scores in the Health Locus of Control. Finally, people who showed a positive perception of their own health (Health Esteem) did not rely on these technologies.

Discussion: Despite the huge spread of biofeedback technologies, our results disconfirmed the expectation that people having an active lifestyle or a disease were more familiar with biofeedback systems. The attitude toward such technologies seems to depend on individual tendencies.

Conclusions: This study suggests the importance to improve general public literacy on biofeedback technologies, tailor tools on their needs and characteristics, empower people’s sense of internal health control for promoting a valid use and a proper knowledge of biofeedback.

Determinants of Maintaining a Daily Yoga Practice: Health Locus of Control and Self-determination Theory Perspective

Background

Despite the growing evidence of the health benefits of a yoga practice, little is known about the factors that contribute to its sustained practice.

Aims

The objectives of the present study were twofold: (1) to describe the personal characteristics (age, education level, and marital status) and yoga asana-related behavior of participants who practice Ashtanga and (2) to examine the health locus of control (HLOC) (an individual's beliefs about the extent of control that they have over things that happen to them) and self-determination theories. (People are able to become self-determined when their needs for competence, connection, and autonomy are fulfilled in relation to the motivated behavior.).

Methods

Ashtanga yoga practitioners (n = 100, age range: 20-62 years) reported practicing yoga at least once a week completed self-report questionnaires: demographics, asana practice, the Perceived Choice and Awareness of Self Scale, HLOC, the General Health Questionnaire-12, the Perceived Stress Scale, and the State-Trait Anxiety Inventory.

Results

It was observed that participants practiced yoga for an average 6.43 years, 5 days a week for 93 min representing a sustained, motivated health-related behavior. Years of practice and percentage of time spent in home practice explain 9% of the variance in the awareness of self, and 7% is explained by the number of practice days a week and state anxiety. Ashtanga yoga practitioners have a high internal HLOC; this is related to reduced trait anxiety and increased perceived choice.

Conclusions

The Mysore system of yoga appears to facilitate sustained health-related behavior; it is suggested that health promotion should acknowledge the three aspects of self-determination theory: competence, autonomy, and relatedness, while focusing on the increasing intrinsic motivation and internalizing HLOC.

Short report: sleep quality and associations with health locus of control and coping styles in young people with ankylosing spondylitis

The poor sleep of young people with ankylosing spondylitis (AS) has not attracted enough attention of clinicians and experts. This study aimed to evaluate the sleep quality and associations with health locus of control (HLC) and coping styles in young people with AS. A total of 133 patients completed the measures of demographics, disease characteristics, HLC, coping styles, and Pittsburgh sleep quality index (PSQI). The patients were worse than general population in PSQI global score and multiple domains. Among patients, the poor sleep was positively related to chance HLC (CHLC) and resignation. Resignation completely mediated the association between CHLC and sleep. There were severe sleep problems in young people with AS, and strategies to change the resignation coping style should be implemented.

Psychological factors associated with self-management in multiple sclerosis

OBJECTIVE

Patient's engagement in their own treatment has been shown to improve clinical outcomes. A better understanding of the association between self-management in multiple sclerosis (MS) and potentially modifiable psychological factors may provide clinicians with strategies to design and stimulate better patient activation for self-managing health. Therefore, in this study, we examined whether cognitive factors, namely self-efficacy, acceptance of illness, optimism, and health locus of control (HLC), are associated with self-management in MS.

METHODS

This is a cross-sectional study. A total of 382 patients with MS who completed the MS Self-Management Scale-Revised and the questionnaires that measure self-efficacy, optimism, illness acceptance, and HLC were included in the study.

RESULTS

A hierarchical multiple regression revealed that power of others' HLC (b = 0.42, P ≤ .001), optimism (b = 0.27, P ≤ .01), internal HLC (b = -0.11, P = .017), and self-efficacy (b = 0.11, P = .031), together with control variables (longer disease duration and higher disability), explained 30% of the variance in the dependent variable.

CONCLUSIONS

In the case of MS, self-management is associated with patient's perception that healthcare professionals control their health, higher self-efficacy, optimism, and, surprisingly, lower internal HLC. The results of this study indicate the vital role of the healthcare staff in encouraging the patients with MS toward activities related to self-management and provide new insights on the psychological intervention aimed at improving self-management by patients.

Psychometric evaluation of the Multidimensional Health Locus of Control scales in English- and Spanish-speaking Hispanic Americans

The English and Spanish versions of the Multidimensional Health Locus of Control scales have not been psychometrically evaluated for use with Hispanic Americans. Hispanic American adults (N = 436) completed the English (n = 210) or Spanish (n = 226) Multidimensional Health Locus of Control scales. A multiple-group confirmatory factor analysis did not support equivalent four-factor structures for Spanish- and English-speaking Hispanic Americans. Follow-up exploratory factor analyses of the 24 items supported an 18-item, four-factor structure for English-speaking Hispanic Americans and a 22-item, three-factor structure for Spanish-speaking Hispanic Americans. These results suggest caution when using the Multidimensional Health Locus of Control scales with Hispanic Americans.

Health Locus of Control in Parents of Children with Leukemia and Associations with Their Life Perceptions and Depression Symptomatology

In childhood cancer, parents have an important role in the promotion of their children's wellbeing and in their adoption of a locus of control style towards their children's health. The current study aimed at identifying types of locus of control in parents of children with leukemia and the possible association with depressive symptomatology and current life perception. One hundred and four parents were recruited at the Hematology-Oncology Clinic of the Department of Woman's and Child's Health, University of Padua, one month after a leukemia diagnosis. Participants were Caucasian with a mean age of 37.28 years (SD = 5.89), mostly mothers (87.5%) and with a mean of 12.16 years of education (SD = 3.82). After signing the informed consent, they filled in the Ladder of Life, the Brief Symptom Inventory-18 and the Parental Health Locus of Control (PHLOC) questionnaires. Paired-samples t-test (t = -14.42; df = 103; p = 0.0001) showed that parents of children with leukemia were more inclined to have an external locus of control than an internal one. The hierarchical regression analysis model (R² = 0.34; F = 4.32; p = 0.0001) identified health professional influence (ß = -0.28; p = 0.004), current life perception (ß = -0.3; p = 0.013) and future life perception (ß = -0.26; p = 0.012) as significant predictors of parental depression. Current life perception was best predicted (R² = 0.25; F = 3.96; p = 0.01) by the parental influence locus of control style (ß = 0.25; p = 0.03). Improving trust in the medical staff care and strengthening the internal locus of control in parents could be a preventive program to cope with parental depression symptomatology.

Selected psychological aspects and medication adherence in oncological patients

Objective

The aim of this study was to analyze the relationships between selected psychological features and adherence to therapy in oncological patients.

Methods

The study included 102 patients of oncological clinics, 66.67% of whom were female. The average (SD) age of the study subjects was 49.15 ± 18.16 years old. The following tools were used: Morisky Medication Adherence Questionnaire (MAQ‐4), Multidimensional Health Locus of Control, Coping Inventory for Stressful Situations, Personal Values Inventory (LWO), and a study‐specific survey questionnaire.

Results

High MAQ‐4 scores were declared by 39.2% of the subjects, medium scores by 32.3% and low scores by 28.5%. The values were higher in female patients (P = .23), younger subjects (P < .001), and in individuals with higher education (P = .03). The greatest adherence was observed in subjects who placed their locus of control in chance (P = .022). Significant relationships were identified between the level of medication adherence and the use of avoidance strategies of coping with stress (P = .037), including the willingness to engage in social relationships (P = .04). It was demonstrated that the risk of noncompliance in the analyzed group was associated with a lower assessment of appearance (OR = 0.75) and health (OR = 0.78) on the scale of values.

Conclusion

Medication adherence in oncological patients is related to the health locus of control, strategies of coping with stress, and the value assigned to appearance and health.

Comparison of health locus of control in oncological and non-oncological patients

Aim of the study

The aim of the study was to investigate whether there are differences in the various dimensions of the health locus of control between oncological and non-oncological patients and to determine whether there is a relationship between the level of health locus of control and the type, duration of disease and gender.

Material and methods

The study was conducted at the Department of Hematology and the 1^st Department of Cardiology of the University Hospital in Krakow. 204 patients were enrolled. Our own questionnaire developed for this purpose and the Multidimensional Health Locus of Control scale were used. The US normalization group and the Polish standardization groups of the chronically ill patients were used for comparative analysis.

Results

Analysis showed significant differences between women and men in the Internal control scale (p < 0.02). The respondents from both groups showed lower scores in the Internal locus of control and much higher scores in the dimension Powerful Others. In the group of oncological patients, a negative correlation was found between the Internal scale of health locus of control and the duration of the disease (p = 0.007). There was a significant difference between oncological and non-oncological patients in the Powerful Others scale (p < 0.004).

Conclusions

The results suggest that oncologically ill patients could be more convinced that others are responsible for their health when compared to non-oncological patients. The longer the disease persists in oncological patients, the weaker is their internal motivation to achieve good treatment results.

The effect of preconception counselling on health locus of control and stress in Iranian women: a randomized control trial

Preconception counseling can improve women's health and pregnancy outcomes. Internal health locus of control and belief in the benefits of health-promoting behaviors improve people's engagement in health-promoting behaviors. This study examined whether preconception counseling was related to stress and health locus of control. This randomized controlled trial was conducted from March to November 2016 on 152 healthy 18-35-year-old women intending to become pregnant within the next year in Iran. The intervention group received six sessions of group counseling, and the control group received only usual care. The Perceived Stress Scale, Multidimensional Health Locus of Control Scales and checklist for preconception control were completed before and after the intervention. Repeated measures ANOVA showed a significant post-intervention increase in the mean internal health locus of control (P < .001) and preconception control scores (P = .034) in the intervention group and the mean perceived stress score (P = .001), and chance health locus of control (P = .013) decreased significantly. Preconception counseling was associated with increased internal locus of control and reduced perceived stress. Preconception counselors should consider reinforcing women's internal beliefs with an emphasis on the effect of the couple's own behaviors and exposures on pregnancy and fetal outcomes.

Health locus of control and mental health in patients with multiple sclerosis: Mediating effect of coping strategies

In patients with multiple sclerosis (MS), mental health is significantly affected and conditioned by many factors, including psychological ones. This study team aimed to determine whether different coping strategies mediate the relationship between health locus of control (HLC) and mental health in MS patients. In this cross-sectional study, a total of 382 patients with MS were included. The patients completed General Health Questionnaire-12, Coping Inventory for Stressful Situations, and Multidimensional Health Locus of Control Scale. The demographic and clinical characteristics of the patients were collected using a self-report survey and neurological assessment. A mediation analysis was used to test the study hypothesis. Problem-oriented coping was found to be a significant mediator in the relationship between internal HLC and mental health (indirect effect: -0.129 [95% confidence interval [CI]: -0.193, -0.079]; standardized indirect effect: -0.113 [95% CI: -0.165, -0.070]). Emotion-focused coping was found to be a significant mediator in the relationship between power of others HLC and mental health (indirect effect: 0.114 [95% CI: 0.058, 0.178]; standardized indirect effect: 0.125 [95% CI: 0.062, 0.195]). Emotion-focused coping was also found to be a significant mediator in the relationship between chance HLC and mental health (indirect effect: 0.215 [95% CI: 0.154, 0.281]; standardized indirect effect: 0.209 [95% CI: 0.149, 0.272]). Patients with internal HLC were found to have positive mental health due to their problem-focused coping strategies, while patients with external HLC had worse mental health as they used more emotion-focused strategies. Hence, problem-focused and emotion-focused coping strategies can be considered mediators of the relationship between HLC and mental health in patients with MS.

Relationship of Health Locus of Control with Breast Cancer Screening Belief of Iranian Women

Promoting breast cancer screening (BCS) behavior of women can lead to a reduction in mortality. The health locus of control affects cancer screening behavior of women; however, there is not sufficient evidence regaring this issue in Iran. The overall goal of our study is to determine the relationship of the health locus of control with the breast cancer screening belief of Iranian Women. This is a cross-sectional study carried out on 325 women in Tehran. The Multidimensional Health Locus of Control (MHLC), Breast Cancer Screening Belief Questionnaire (BCSBQ), and Demographic questionnaire were used for collecting data. Statistical analyze was performed by the SPSS version 17 software. The Pearson correlation and regression model were used for data analyze. In this study, 325 women, age 18 to 75 years, participated in this study. The mean±SD of BCSBQ and MHLC score was 40.72±10.41 and 67.78±17.67 respectively. The regression analysis showed that for the one-unit increase in the Internal Health Locus of Control (IHLC), Powerful others Health Locus of Control (PHLC), and Chance Health Locus of Control (CHLC) score (dimensions of Health Locus of Control), the total BCSBQ scores increased 0.54, 0.31, and 0.57 respectively. For each unit increase in age and education, the knowledge and perceptions of the BC score increased 0.05 and 0.23 units respectively. For the one-unit increase in the IHLC, PHLC, age, and education dimensions, the attitudes towards the general health check-up score increased 0.17, 0.1, 0.05, and 0.188 respectively. The current study provided new insights about the BCSB of Iranian women with MHLC. In the study, all the dimensions of the health locus of control were useful in predicting the breast cancer screening belief of the participants.

Associations of different adherences in patients with type 2 diabetes mellitus

PURPOSE

The objective of our cross-sectional study is to explore the adherence behavior of patients with type 2 diabetes mellitus (T2DM) by examining the association between the various types of adherence. The success of diabetic therapy partly relies on patient motivation, psych-odemographic variables (self-efficacy, health literacy, and health locus of control [HLOC]), and adherence. The aim of our research was to explore the attitudes of T2DM patients toward medication and lifestyle therapy, thus gaining a deeper insight into the role of adherence-determining parameters in disease management.

PATIENTS AND METHODS

The sample for the present study consisted of 113 T2DM inpatients (75 women and 38 men) with a mean age of 60.56 years (SD=12.94, range: 20-85 years) diagnosed with T2DM for an average of 13 years (SD=8.23). Participants completed the Diabetes Adherence Questionnaire conceptualized by the research team in accordance with the mapping of psychological and psychosocial parameters. We examined the associations between variables using Spearman's rank correlation. Multivariate regression analysis was used to examine predictive variables for adherent behavior. In addition, we attempted to examine factors with a negative effect on adherence using factor analysis.

RESULTS

Based on our results, a high level of medication adherence negatively correlated with lifestyle adherence. Multivariate regression analysis showed that blood glucose monitoring adherence is mostly predicted by social-external HLOC, diabetes self-efficacy, and internal HLOC, while dietary adherence is predicted by the patient's self-efficacy and duration of the illness. Additionally, understanding and following the diabetes treatment were significantly associated with dietary adherence and high levels of patient self-efficacy, while health literacy was mostly predicted by internal HLOC.

CONCLUSION

Adherence to medication, diet, glucose monitoring, and physical exercise showed different levels in T2DM patients and were in association with psychodemographic factors.

How to effectively design public health interventions: Implications from the interaction effects between socioeconomic status and health locus of control beliefs on healthy dietary behaviours among US adults

This study investigated whether individuals with different socioeconomic status (SES) should be provided differently tailored health messages to promote healthy dietary behaviour (HDB). Prior research has suggested that people with different SESs tend to exhibit different types of beliefs about health, but it remains unclear how SES interacts with these beliefs to influence health outcomes. To better understand the differences in HDB between high- and low-SES populations and propose effective intervention strategies, we examined (i) how SES is associated with HDB, (ii) how internal health locus of control (HLC) and powerful others HLC are associated with HDB, and (iii) how SES interacts with internal and powerful others HLC to influence HDB. Using data from the Annenberg National Health Communication Survey, collected from 2005 to 2012 (N = 6,262) in the United States, hierarchical multiple regression analyses were conducted. Education level was found to be positively associated with HDB, while income level was not. Both internal and powerful others HLC beliefs were positively associated with HDB. The positive relationship between internal HLC and HDB strengthened as the level of education and income increased, whereas the positive relationship between powerful others HLC and HDB weakened as respondents' education level increased. These results suggest that the design and delivery of communication messages should be tailored to populations' specific SES and HLC beliefs for effective public health interventions. For example, messages enhancing internal HLC (e.g. providing specific skills and knowledge about health behaviours) might be more helpful for the richer and more-educated, while messages appealing to one's powerful others HLC beliefs (e.g. advice on health lifestyles given by well-known health professionals) might be more effective for less-educated people.

Psychometric Properties of the God Locus of Health Control Scale in Churchgoing Latinas

This study evaluated the psychometric properties of the Spanish version of the God Locus of Health Control scale, a measure of the extent to which an individual believes God has control over one's health, among a sample of churchgoing Latinas (N = 398). Confirmatory factor analysis showed support for a one-factor structure and internal consistency reliability, as measured by Cronbach's coefficient alpha, was good. Evidence for convergent validity was demonstrated by significant correlations in the expected magnitudes and directions with two measures of perceived religious involvement in health. These results suggest that the God Locus of Health Control scale can be used to examine the extent to which God is perceived to control an individual's health among Latinas.

The pain, depression, disability pathway in those with low back pain: a moderation analysis of health locus of control

Low back pain (LBP) is common, impacts on the individual and society, and is a major health concern. Psychological consequences of LBP, such as depression, are significant barriers to recovery, but mechanisms for the development of depression are less well understood. One potential mechanism is the individual’s health locus of control (HLoC), that is, perception of the level of control an individual has over their health. The objective of this study is to investigate the moderation effect of HLoC on the pain–depression–disability pathway in those with LBP. The design is a nested cross-sectional analysis of two existing cohorts of patients (n=637) who had previously consulted their primary care physician about LBP. Measures were taken of HLoC, pain intensity and interference, depression, disability, and bothersomeness. Structural Equation Modeling analysis was applied to two path models that examined the pain to depression to disability pathway moderated by the HLoC constructs of Internality and Externality, respectively. Critical ratio (CR) difference tests were applied to the coefficients using pairwise comparisons. The results show that both models had an acceptable model fit and pathways were significant. CR tests indicated a significant moderation effect, with stronger pathway coefficients for depression for those who report low Internality (β 0.48), compared to those with high Internality (β 0.28). No moderation effects were found within the Externality model. HLoC Internality significantly moderates the pain–depression pathway in those with LBP, meaning that those who have a low perception of control report greater levels of depression. HLoC may signify depression among people with LBP, and could potentially be a target for intervention.

The Impact of Health Locus of Control and Anxiety on Self-Monitored Blood Glucose Concentration in Women with Gestational Diabetes Mellitus

BACKGROUND

The purpose of this study was to evaluate the associations between health locus of control (HLC), anxiety, and glycemic control from the time of diagnosis of gestational diabetes (GDM) to the end of pregnancy.

METHODS

The study group comprised 165 women with GDM. Baseline HLC (∼27 weeks of gestation) was assessed by the Multidimensional HLC Scale. The level of anxiety was measured at baseline and follow-up (37 weeks of gestation) by the State-Trait Anxiety Inventory. Using questionnaires, we collected information about the level of fear related to measuring blood glucose several times per day, dietary regimen, and insulin therapy, as well as fear for the baby and its health, patient's own health, and having diabetes in the next pregnancy. Glycemic control was evaluated by self-monitored fasting and postprandial blood glucose levels.

RESULTS

Baseline state anxiety was significantly higher than trait anxiety. From baseline to follow-up, the state anxiety and percentage of women with increased fear for their infant's health, diabetic diet, self-monitoring of blood glucose, and insulin injection significantly decreased. In comparison to women with blood glucose in the low tertile, those with blood glucose in the high tertile had significantly higher scores in the chance HLC subscale and a similar level of state anxiety. Blood glucose was positively correlated with the chance HLC score.

CONCLUSIONS

Chance HLC beliefs seem to be associated with poorer glycemic outcomes in women with GDM. Our results suggest the need for further efforts to reduce the GDM-associated state anxiety.

"In God we trust" and other factors influencing trial of labor versus Repeat cesarean section

PURPOSE

To investigate factors influencing women's decisions to undergo trial of labor after cesarean (TOLAC) or elective repeat cesarean delivery (ERCD) based on the Multidimensional Health Locus of Control (MHLC), religious observance and family planning.

MATERIALS AND METHODS

Cross-sectional study of candidates for TOLAC or ERCD at two hospitals in Israel. Eligible women completed a demographic questionnaire and Form C of the MHLC scale.

RESULTS

The study included 197 women. Those who chose TOLAC (N = 101) were more religiously observant, wanted more children and had higher Internal and Chance health locus of control. Women who chose ERCD (N = 96) were more likely to be secular and had a higher health locus of control influenced by Powerful Others, notably physicians. Women not influenced by others were more likely to choose TOLAC.

CONCLUSIONS

A woman's choice of TOLAC or ERCD is influenced by her sense of control over her health, degree of religious observance and number of children desired. Healthcare providers can use this information to better understand, counsel and educate women regarding appropriate delivery decisions. Women who feel in control of their health, educated about delivery options and are less influenced by provider preference, might choose TOLAC; thus, reducing the rate of unnecessary ERCD.

Examining maternal age, breastfeeding self-efficacy and health locus of control in psychological wellbeing of mothers

We investigated the direct and interaction influence of maternal age, breastfeeding self-efficacy (BSE), health locus of control (HLOC) on six dimensions of psychological wellbeing of breastfeeding mothers in Lagos, Nigeria. Data were collected from a convenience sample of 291 mothers attending health facilities in two suburb local government areas. The survey included socio-demographics (maternal age, marital status, ethnicity, education level and position of the baby currently breastfeeding), breastfeeding self-efficacy, health locus of control and psychological wellbeing scales. Independent variables were tested against sense of autonomy, positive relations with others, purpose in life, self-acceptance, environmental mastery and personal growth using factorial Multivariate Analysis of Variance. Results showed direct influence of BSE, HLOC and maternal age on various dimensions of psychological wellbeing. Interaction influences indicate BSE and HLOC on environmental mastery; BSE and maternal age on self-acceptance and HLOC and maternal age on sense of autonomy, positive relationship with others and self-acceptance respectively. In conclusion, maternal age, breastfeeding self-efficacy and health locus of control are vital for mothers to enjoy plenty dimensions of psychological wellbeing. Breastfeeding mothers need to be confident in their abilities to breastfeed and have control over their health-related behaviour in order to enjoy sufficient dimensions of psychological wellbeing.

Gender and health behaviours of hypertensive patients: mediating role of control beliefs

Previous studies have reported gender differences in patients' health behaviours but few studied hypertensive patients. The potential underlying factors that may mediate gender influences on health behaviours is also a more critical area worthy of investigation. This study examined health locus of control (HLC) as a pathway of gender effects on health behaviours of hypertensive patients. The Multidimensional HLC Scale (Form C) and Wellness behaviour subscale of Health Behaviour Checklist were completed by 400 hypertensive outpatients in two Nigerian hospitals: Enugu State University Teaching Hospital, Park Lane, Enugu, and Bishop Shanahan Specialist Hospital, Nsukka. Hierarchical multiple regression results showed that gender significantly predicted health behaviours. Gender also significantly predicted internal HLC, chance HLC, and other people HLC, but did not predict doctor HLC. The association between gender and health behaviours was fully mediated by internal HLC, chance HLC and other people HLC. Understanding the explanatory mechanisms linking socio-demographic factors and health behaviours is considered of great importance for future research and healthcare intervention.

Forming a Stress Management and Health Promotion Program for Women Undergoing Chemotherapy for Breast Cancer: A Pilot Randomized Controlled Trial

OBJECTIVE

To assess the effects of an 8-week stress management and health promotion program on women undergoing breast cancer chemotherapy treatment. Patients and methods A total of 61 patients were recruited in 2 cancer centers and were randomly assigned to the intervention program (n = 30) or control group (n = 31). The intervention program consisted of different stress management techniques, which were combined with instructions for lifestyle modification. Assessments were carried out through questionnaires and measurement of body mass index (BMI) at baseline and at the end of the 8-week program.

RESULTS

In all, 25 participants completed the intervention program, whereas 28 participants completed the observational control program. The intervention program resulted in a small effect size on internal dimension of Health Locus of Control (HLC) and a medium effect size on stress, depression, anxiety, night sleep duration, and chance dimension of HLC. A strong effect size was recorded for BMI and sleep onset latency. Self-rated health, spiritual well-being, and powerful others dimension of HLC were not significantly affected. Additionally, some of the participants reported a reduction in the side effects caused by chemotherapy.

CONCLUSIONS

The intervention resulted in several benefits for the general health status of patients. Therefore, it should be considered as feasible and potentially beneficial for women undergoing breast cancer chemotherapy. However, it is necessary for this intervention to be tested through a randomized controlled trial in a larger sample of patients before adopting this program in standard cancer care.