Cross M J, March L M, Lapsley H M, Byrne E, Brooks P M
Institute of Bone and Joint Research, University of Sydney, NSW, Australia.
Rheumatology (Oxford). 2006 Jan;45(1):92-6. doi: 10.1093/rheumatology/kei114. Epub 2005 Nov 15.
To explore the relationship between measures of self-efficacy, health locus of control, health status and direct medical expenditure among community-dwelling subjects with rheumatoid arthritis (RA) and osteoarthritis (OA).
This analysis is part of a larger ongoing study of the costs and outcomes of arthritis and its treatments. Community-dwelling RA and OA respondents completed questionnaires concerning arthritis-related expenditure, health status, arthritis related self-efficacy and health locus of control.
Data were obtained from 70 RA respondents and 223 OA respondents. The majority of respondents were female with a mean age of 63 yr for RA respondents and 68 yr for OA respondents. Among the RA respondents, those with higher self-efficacy reported better health status and lower overall costs. Health locus of control was not consistently correlated with health status. OA respondents with higher self-efficacy reported better health status and lower costs. Health locus of control had more influence. OA respondents with higher external locus of control reported worse pain and function. A higher belief in chance as a determinant of health was correlated with more visits to general practitioners and a higher cost to both the respondent and the health system.
Higher self-efficacy, which is amenable to change through education programmes, was associated with better health status and lower costs to the respondent and the health system in this cross-sectional study. Locus of control had less of an influence; however, the tendency was for those with higher external locus of control to have higher costs and worse health status. As the measurement of these constructs is simple and the outcome potentially affects health status, these results have implications for future intervention studies to improve quality of life and reduce the financial impact of arthritis on both the health-care system and patients.
探讨类风湿关节炎（RA）和骨关节炎（OA）社区居民的自我效能感、健康控制点、健康状况与直接医疗支出之间的关系。
本分析是一项正在进行的关于关节炎及其治疗的成本和结果的大型研究的一部分。社区居住的RA和OA受访者完成了关于关节炎相关支出、健康状况、关节炎相关自我效能感和健康控制点的问卷调查。
数据来自70名RA受访者和223名OA受访者。大多数受访者为女性，RA受访者的平均年龄为63岁，OA受访者的平均年龄为68岁。在RA受访者中，自我效能感较高的人报告的健康状况较好，总体成本较低。健康控制点与健康状况并非始终相关。自我效能感较高的OA受访者报告的健康状况较好，成本较低。健康控制点的影响更大。外部控制点较高的OA受访者报告的疼痛和功能较差。将机遇视为健康决定因素的信念越强，与看全科医生的次数越多以及受访者和卫生系统的成本越高相关。
在这项横断面研究中，较高的自我效能感（可通过教育计划改变）与较好的健康状况以及受访者和卫生系统较低的成本相关。控制点的影响较小；然而，趋势是外部控制点较高的人成本较高，健康状况较差。由于这些构念的测量简单，且结果可能影响健康状况，这些结果对未来旨在改善生活质量并减少关节炎对医疗保健系统和患者的经济影响的干预研究具有启示意义。
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