The Paradoxical Role of Perceived Control in Late Life Health Behavior

Long-term risk factor management and adverse events in patients with early-onset myocardial infarction-a "real-world" study

BACKGROUND

International guidelines emphasize the importance of preventive efforts after early-onset myocardial infarction (EOMI); however, data on "real-world" long-term risk factor management and adverse event rates in this special patient group is scarce.

METHODS

In this German registry study, 301 patients with MI aged ≤ 45 years were investigated. Risk factor control was assessed at the time of index MI and after 1 year. Major adverse cardiac and cerebrovascular events (MACCE) and its predictors were analyzed during long-term follow-up (median duration 49 months).

RESULTS

A majority of patients with EOMI presented with insufficient risk factor control, even during 1-year follow-up. After 1-year 42% of patients were persistent smokers; 74% were physically inactive. The rate of obesity increased significantly from index MI (41%) to 1-year follow-up (46%, p = 0.03) as well as the rate of dysglycemia (index MI: 40%; 1-year follow-up: 51%, p < 0.01) and diabetes mellitus (index MI: 20%; 1-year follow-up: 24%, p < 0.01). 66% of the patients with diabetes mellitus had unsatisfactory HbA1c after 1 year; 69% of the patients did not attain guideline-recommended lipid targets. The rate of MACCE during long-term follow-up was 20% (incidence rate 0.05 per person-year). In a multivariable analysis smoking (HR 2.2, HR 1.3-3.7, p < 0.01) and physical inactivity (HR 2.8, HR 1.2-6.7, p = 0.02) were significant predictors for the occurrence of MACCE.

CONCLUSION

Insufficient long-term risk factor control was common in patients with EOMI and was associated with an elevated rate of MACCE. The study reveals that better strategies for prevention in young patients are crucially needed.

Perceived control across the adult lifespan: Longitudinal changes in global control and daily stressor control

Perceived control is an important psychosocial resource for health and well-being across the lifespan. Global control (i.e., overall perceived control) decreases over time in studies following people every few years to upwards of 10 years. Changes across wider intervals of the lifespan, however, have yet to be examined. Further, how perceived control changes for specific aspects of daily life, such as stressors, remains comparatively less clear. Using data from the Midlife in the United States National Study of Daily Experiences (NSDE, N = 1,940, M = 56.25 years, SD = 12.20, 57% female), we examined longitudinal changes in global control across 20 years and daily stressor control across 10 years. Global control was assessed in the first wave of the NSDE (∼1996). In follow-up waves, conducted in ∼2008 and ∼2017, participants again not only reported their global control but also reported their perceived control over stressors they experience across 8 consecutive days. Longitudinal analyses revealed differential change trajectories for global control across 20 years and stressor control across 10 years (ps < .001). Global control declined for younger and older adults but stayed relatively stable for individuals in midlife. The rate of decline in daily stressor control was steeper than the decline in global control and did not vary by age at baseline. In addition, declines were amplified among individuals with higher global control at baseline. Results suggest that daily stressor control is a specific aspect of control beliefs that follows a different rate of change than global control. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The relation between autonomy support and music enjoyment in online learning for music undergraduates in the post-COVID-19 era

Music enjoyment is considered to predict music-related academic performance and career choice. Although relevant research in non-music fields has demonstrated the association between teachers' autonomy support and students' academic enjoyment, it remains unknown whether this association is valid in the music discipline. In addition, in the post-COVID-19 era, online education has become a common way of teaching and learning for music undergraduates. In the form of online learning, the mechanisms mediating teachers' music autonomy support and students' music academic enjoyment are also unknown. This study draws on Pekrun's theory of achievement emotions and control values to explore the mediating role of attributions and values in the association between autonomous support and academic achievement. In this study, 270 undergraduates majoring in music eventually completed the online surveys. Results from structural equation modeling indicated that autonomy support positively predicted music enjoyment and that attributions (i.e., internal attribution and external attribution) and values (i.e., intrinsic value, attainment value, utility value) mediated the association between autonomy support and music enjoyment. The findings also provide insights into possible avenue for promoting music enjoyment emotion during online teaching in the post-COVID-19 era. Implications and limitations are discussed in the study.

Interaction between self-perceived disease control and self-management behaviours among Chinese middle-aged and older hypertensive patients: the role of subjective life expectancy

Background

One of the effective ways to control hypertension is long-term self-management, which is difficult to maintain. Therefore, understanding how people engage in the process of self-management behaviour change is necessary. In this study, we aimed to examine the dynamic relationship between self-perceived disease control and self-management behaviours in Chinese middle-aged and older hypertensive patients, namely, medication use, self-monitoring, physical activity, tobacco and alcohol avoidance, and to explore the mediating role of subjective life expectancy (SLE) on this relationship.

Methods

Data were obtained from a nationally representative sample of 508 middle-aged and older hypertensive patients (aged 45+) from the 2013, 2015, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. A cross-lagged panel model combined with mediation analysis was used to determine the dynamic relationship between self-perceived disease control and self-management behaviours and to clarify the mediating effect of SLE on this ascertained relationship.

Results

Good self-perceived disease control subsequently predicted good medication use, self-monitoring and physical activity, and vice versa. Subjective life expectancy (SLE) partially mediated the prospective reciprocal relationships between self-perceived disease control and these self-management behaviours, which accounted for 37.11, 25.88, and 19.39% of the total effect of self-perceived disease control on medication use, self-monitoring and physical activity, respectively. These self-management behaviours had a significant and positive feedback effect on self-perceived disease control. However, neither the direct and indirect effects (via SLE) of self-perceived disease control on tobacco and alcohol avoidance were revealed.

Conclusions

Positive feedback loops of present self-perceived disease control, future SLE and self-management behaviours (medication use, self-monitoring, and physical activity) help middle-aged and older hypertensive patients adhere to these behaviours but are useless for the avoidance of addictive behaviours. Interventions aimed at enhancing the effect perception of general self-management behaviours (e.g., medication use, self-monitoring and physical activity) on the present disease control perspective, and future lifespan perspective would be beneficial for the consistent self-management behaviours of middle-aged and older hypertensive patients. The utility of present disease control perception to these self-management behaviours was much higher than the utility of future expectations. Alternative stress relief strategies may be conducive to long-term changes in addictive behaviours.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12990-8.

Patient expectations shape convalescence after major liver surgery - A prospective, randomized study

BACKGROUND

Several studies suggest an important influence of patient expectations on outcomes. We hypothesized that patient expectations with regard to length of postoperative stay influence convalescence after liver resections.

METHOD

This prospective, randomized study compared patients who were preoperatively either informed to be expected to stay 7-10 days (short arm) or 12-16 days (long arm) after major liver resections (≥4 segments). Additionally, psychological traits were assessed using questionnaires and the time to fulfillment of objective discharge criteria [oral analgesics only, first bowel movement, ability to tolerate solid food, full mobilization, no complications which need general anesthesia (>CD IIIa)] was defined as the primary endpoint.

RESULTS

Patients in the short arm reached the objective discharge criteria after 8.39 days (SD 3.60), while patients in the long arm needed 12.73 days (SD 3.43) (p = 0.001). The actual length of stay in the short arm was 12.00 (IQR 8-16) and 19.3 days in the long arm (IQR 14-26) (p = 0.008). A more pronounced self-efficacy correlated with earlier fulfillment of the objective discharge criteria (p = 0.048), whereas patients placing a high value on their health needed more time (p = 0.049).

CONCLUSION

The expectation of a shorter length of stay results in a quicker objective, physical patient convalescence after major liver resections.

Perceived Onset Time of Medical Conditions: The Interplay Between Subjective Fear and Risk in Four Lifestyle Domains

Engaging in unhealthy behaviors (e.g., smoking, drinking) and not engaging in healthy ones (e.g., exercising, consuming fruit and vegetables) are both relatively prevalent among individuals despite the available information about their risks for health. People's perception of an event's time course can be used to gauge their risk perception for that event thus casting light on any possible misperception and suggesting directions for health-promoting interventions. This study investigates people's perception of the time of onset of 5 noncommunicable diseases (e.g., "having high blood pressure") associated with 4 health-related behaviors: Smoking, drinking, exercising, and eating fruit and vegetable. Participants from Italy (N = 214) and the UK (N = 151) gave onset time estimates of how long they thought it would take for 5 noncommunicable diseases to occur in the life of an 18-year-old person who starts or stops adopting those health-related behaviors. Results showed that participants who rated the noncommunicable diseases as more likely to themselves perceived the onset time of these diseases as more temporally proximal. Participants who were more afraid of developing the noncommunicable diseases estimated their onset time as delayed.

Associations Between Control Beliefs and Response Time Inconsistency in Older Adults Vary as a Function of Attentional Task Demands

OBJECTIVE

Control beliefs are established correlates of cognitive aging. Despite recent demonstrations that response time inconsistency (RTI) represents a proxy for cognitive processing efficiency, few investigations have explored links between RTI and psychosocial correlates. We examined associations among RTI and control beliefs (perceived competence and locus of control) for two choice-response time (RT) tasks varying in their attentional demands.

METHOD

Control beliefs and RTI were measured weekly for 5 weeks in a sample of 304 community-dwelling older adults (Mage = 74.11 years, SD = 6.05, range = 64-92, 68.58% female).

RESULTS

Multilevel models revealed that for the attentionally demanding task, reporting higher perceived competence than usual was associated with lower RTI for relatively younger participants and greater RTI for relatively older participants. For the less attentionally demanding task, reporting higher perceived competence than usual was associated with lower RTI for relatively older participants. Links between locus of control and RTI were comparatively scant.

DISCUSSION

Our findings suggest that control beliefs may have adaptive and maladaptive influences on RTI, depending on dimension of control beliefs, individual differences in level of control beliefs and age, as well as attentional task demands. Both for whom and when control beliefs can be leveraged to optimize cognitive aging are discussed.

Perceived Asthma Control Care and Health Care Participation in Patients with Asthma

BACKGROUND

Asthma is one of the most severe and life-threatening health problems, the better control of which is one of the main goals in asthma management to be achieved by patients' balanced participation in the treatment process. This study aimed to investigate asthma control, perceived care, and health care participation in patients with asthma.

MATERIALS AND METHODS

This descriptive-analytical study included 221 asthmatic patients, who were selected using the convenience sampling method from those referring to pulmonary clinics in Kerman, Iran. The required data were collected using three questionnaires including Asthma Control Test (ACT), Perceived Care of Asthma Questionnaire (PCAQ), and Partners in Health Scale (PIH). The linear regression test was used to analyze the collected data with SPSS software version 21.

RESULTS

In this study, 14.31, 42.22, and 87.33% of the patients had a favorable condition in asthma control, perceived asthma care, health participation, respectively. The disease duration was significantly associated with the level of perceived asthma care. Moreover, perceived asthma care had a significant relationship only with occupation. From another perspective, the relationship between marital status, level of education, city of residence, disease duration, and occupation with health care participation was significant.

CONCLUSION

Patients would have more control over asthma if there were training programs underpinned by disease-based strategies and educational content regarding the risk factors of the disease, and the patients' experience and knowledge of the disease were promoted. Furthermore, reinforcing self-control and perceived asthma care skills and involving patients in healthcare process would also enhance the disease control.

The Detrimental Consequences of Overestimating Future Health in Late Life

OBJECTIVES

Although forecasting a positive future can be adaptive, it may not be when expectations are unmet. Our study examined whether such inaccurate expectations about future health status (overestimation) were maladaptive for older adults who commonly experience late life declines in physical functioning.

METHOD

We analyzed data from the nationally representative German Aging Survey (DEAS; 1996-2011; n = 2,539; age range 60-85 years) using multilevel growth models that assessed the influence of inaccurate health expectations on older adults' physical functioning over a 9-year period.

RESULTS

Overestimating future health status predicted reduced day-to-day physical functioning when age, gender, and self-rated health were controlled. A Time × Overestimation interaction indicated that the negative effects of overestimation on physical functioning became more pronounced over the 9-year period.

DISCUSSION

Results suggest that repeatedly unmet health expectations may undermine motivational resources and accelerate late life declines in physical functioning.

Health Behavior and Health and Psychosocial Planning for Retirement among Spanish Health Professionals

The aging of the workforce among health professionals demands attention to the study of their health behavior before retirement. The aim of the present study is to analyze the relationships between health planning and psychosocial planning—on the one hand—and health professionals’ health behavior, on the other. In addition, we will study the mediator role of public protection, self-insurance, and self-protection in the relationship between planning and health behavior. The sample includes 169 healthcare professionals from a public hospital in Spain. A serial mediation model estimating all of the parameters simultaneously was tested. The findings have confirmed the relationship between health planning and health behavior, as well as the serial mediation of the behaviors in this relationship. As the main causes of death in the Western world are not transmittable diseases, but cardiovascular diseases, diabetes, and other diseases that are closely linked to lifestyle factors, our findings strongly support that we are responsible for our long-term health status and well-being.

Family Member Death and Subjective Life Expectancy Among Black and White Older Adults

Objective: To examine whether exposure to family member deaths throughout the life course is associated with subjective life expectancy-a person's assessment of their own mortality risk-at age 65, with attention to differences by race. Method: We analyzed 11 waves of data from a study of men and women above age 50 (Health and Retirement Study; n = 13,973). Results: Experiencing the deaths of multiple family members before the respondent is 50 years old is negatively associated with subjective life expectancy at age 65. Discussion: Understanding the life-course predictors of older adults' subjective life expectancy is particularly important because survival expectations influence long-term planning, health, and longevity. Moreover, Black Americans are exposed to more family member deaths earlier in their life compared with White Americans, with implications for long-term health and well-being.

Paradoxical Effects of Perceived Control on Survival

Objectives

Appraising health as controllable is typically thought to be adaptive, but recent evidence suggests the paradoxical possibility that perceived control (PC) can be detrimental. We considered the premise that high PC should have a survival benefit when it is part of an adaptive mindset involving high value (importance) for health, but it might be detrimental when it is part of a mindset comprised of low health value (HV). In addition, we examined whether the survival consequences of PC and HV vary with advancing age.

Method

Interviews were conducted with a heterogeneous sample of community-dwelling adults (n = 341; 72-99 years) to assess appraisals of control and value in the domain of health. Mortality data were obtained over 12 years from a provincial health registry.

Results

Both age and HV moderated the PC effect on mortality. The predicted beneficial and detrimental PC effects emerged at younger ages: higher PC predicted longer survival times when health was highly valued but shorter survival times when health was less highly valued.

Discussion

These findings deepen the knowledge regarding the conditions under which PC is or is not adaptive, suggesting the consequences depend on age and the extent to which health is valued.

Data relating to change in locus of control orientation of parents overtime (from pre-birth to 20 years later), participating in the Avon Longitudinal Study of Parents and Children (ALSPAC)

Locus of control (LOC) measures an individual׳s expectancy regarding their ability to affect what happens to them based on their behavior. Those with an internal LOC (ILOC) believe their own behavior influences what happens to them. Those with an external LOC (ELOC) perceive that what happens to them is beyond their control (i.e. determined by luck, fate, chance or powerful others) [1]. A vast amount of research (mainly cross-sectional) suggests that an ELOC is associated with many adverse personal, social, academic and health outcomes. LOC data were uniquely collected prenatally from over 12,000 pregnant women and their partners enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). The LOC measure used was a shortened version of the adult version of the Nowicki-Strickland Internal-External locus of control scale. This was administered to the mothers within self-completion questionnaires at three-time points: during pregnancy, at 6 and at 18 years post-partum. In parallel, self-completion questionnaires containing the same LOC questions were completed by their partners during pregnancy, at 6 and 20 years later. ALSPAC LOC data are unique in that they measured orientation over time and on a much larger sample of respondents than is usual. We describe the scale used, why it was chosen and how individual scores changed over time.

Personality and demographic correlates of New Zealanders' confidence in the safety of childhood vaccinations

Despite extensive scientific evidence on the safety of standard vaccinations, some parents express skeptical attitudes towards the safety of childhood immunisations. This paper uses data from the 2013/14 New Zealand Attitudes and Values Study (NZAVS) survey (N=16,642) to explore the distribution, and demographic and personality correlates of New Zealanders' attitudes towards the safety of childhood vaccinations. Around two thirds (68.5%) of New Zealanders strongly agreed/were confident that "it is safe to vaccinate children following the standard New Zealand immunisation schedule," 26% were skeptical and 5.5% were strongly opposed. Multiple regression analysis indicated that people lower on Conscientiousness and Agreeableness but higher on Openness to Experience expressed lower confidence about vaccine safety. Having higher subjective health satisfaction, living rurally, being Māori, single, employed and not a parent were all associated with lower confidence, while a higher income and educational attainment were associated with greater confidence. Our findings suggest that the majority of New Zealand adults trust in the safety of scheduled childhood vaccinations, but about one third do express some degree of concern. This finding highlights the importance of improving public education about the safety and necessity of vaccinations.

The Impact of Prenatal Parental Locus of Control on Children's Psychological Outcomes in Infancy and Early Childhood: A Prospective 5 Year Study

Locus of control is one of the most widely studied concepts in the history of personality psychology. In spite of its popularity and its associations with numerous relevant outcomes, the ability of locus of control to predict future behaviors involving parenting effectiveness has been under researched. The few parent locus of control children's outcome studies are characterized by cross-sectional methodologies that focus on mothers. The present study uses a prospective methodology to compare data on mothers' and fathers' locus of control with their child's behavior outcomes from a large scale research project, the Avon Longitudinal Study of Parents and Children (ALSPAC). Based on Rotter's Social Learning Theory published in 1954 and past empirical research, it was predicted and found that parent internality was associated with more positive child outcomes than parent externality. More specifically, when both parents were internal, their children had more positive outcomes in sleeping, eating, and tantrum behavior as compared to any other parent locus of control combination. However external parents had a less restrictive attitude which appeared to have a more beneficial effect on picky eating. Results confirmed how important parent locus of control is in the lives of children. Based on the findings, researchers are urged to develop interventions to change advice to parents and promote more internal locus of control among parents.

Perceived Control and Aging: A Mini-Review and Directions for Future Research

This brief review on perceived control and aging is organized according to 3 perspectives of research involving description, explanation, and modification. An extensive body of literature has utilized cross-sectional and correlational methods to describe the sociodemographic variations and outcomes associated with perceived control. This work has focused on differences in perceived control as a function of age, sex, education, socioeconomic status, and culture and has identified positive associations with many aging-related outcomes involving health and well-being. With growing evidence regarding the health benefits of perceived control in the context of a declining sense of control with aging, there has been an increased effort to uncover the mechanisms involved, with the hopes of developing methods to maintain and/or promote adaptive control beliefs throughout adulthood. Through longitudinal and experimental work, researchers are beginning to clarify the directionality and elucidate the mechanisms to explain the associations. Recent evidence from longitudinal studies shows that control beliefs have an impact on subsequent changes in health. Yet, the findings suggest that it is not a unidirectional relationship. A conceptual model suggesting an ongoing reciprocal relationship between perceived control and health and well-being is discussed. Research examining the mechanisms that link perceived control to aging-related outcomes can help to inform and to develop effective interventions that are tailored to the individual's specific barriers and goals. We consider new directions for research, including more attention to intraindividual variability and reactivity to daily challenges, such as stress, with the goal of advancing our understanding of how perceived control contributes to aging-related outcomes. More work is needed to develop strategies to enhance control beliefs in later life. Although it will not always be possible to modify control beliefs, researchers can take these beliefs into account when developing interventions. A personalized approach is recommended as a way to tailor interventions that are compatible with individuals' beliefs about control to facilitate adaptive behavior change. Conclusions focus on selected issues and considerations for future research.

The antecedents of women's external locus of control: Associations with characteristics of their parents and their early childhood

Locus of control (LOC) measures individuals' expectancies regarding their ability to affect what happens to them based on how they behave. The more they believe their behaviour has something to do with what happens to them the more internal they are. In contrast the more they perceive that what happens to them is beyond their control and determined by luck, fate, chance or powerful others the more external they are. Copious research findings suggest that external LOC (ELOC) is associated with many adverse personal, social, academic and health outcomes. In spite of its importance in so many areas of human behaviour relatively little is known about the features of the early background of individuals that contributes to these expectancies. This is the first in a number of studies that will suggest possible antecedents and consequences of having a high ELOC. The study takes advantage of the data collected in the Avon Longitudinal Study of Parents and Children (ALSPAC), which started by studying pregnancies in 1991-1992 of residents in an area of south-west England. Over 12000 of the women who enrolled during pregnancy completed a set of questions in mid-pregnancy from which an LOC score was computed. ELOC was defined as a score greater than the median. The relationships with characteristics of the women's parents and her early childhood (<6 years) are considered first as unadjusted odds ratios and then as adjusted after analysis using hierarchical sets of stepwise logistic regressions. The relative contributions to the women's ELOC was measured using a goodness-of-fit (GOF) measure. The analyses demonstrated the independent importance of maternal and paternal backgrounds as well as features of her early childhood (<6 years). The final model identified nine independent features (each with P < 0.0001): year of birth of her mother, maternal and paternal education levels, father smoked, mother smoked when pregnant, year of birth of study woman, the number of older siblings she had, whether her father was absent during this period, and whether she spent her childhood in the study area. In conclusion, the woman's LOC appears to be independently influenced by a number of characteristics which may give clues as to possible mechanisms-and how internality may be supported in the future. Subsequent papers will assess both whether features of later childhood influence the woman's LOC and whether the LOC of men in the study have similar antecedents.