Rothman I, Tennant A, Mills R J, Young C A
Liverpool University Hospitals Foundation Trust, Prescot Street, Liverpool, L7 8XP, UK.
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
J Clin Psychol Med Settings. 2023 Dec;30(4):821-835. doi: 10.1007/s10880-023-09938-4. Epub 2023 Feb 6.
Health Locus of control (LOC) refers to one's beliefs regarding control over one's health. This study aimed to determine the relationship between LOC on clinical and psychosocial aspects associated with multiple sclerosis (MS). 5059 participants with MS completed a questionnaire pack including the Multidimensional Health Locus of Control Scale. Associations between LOC and sociodemographic (age, gender, educational level) and clinical variables (duration, disability, depression, anxiety, self-efficacy, QoL) were explored. LOC was found to be significantly associated with all of the clinical variables and age, but not gender or educational level. When controlling for level of disability, Chance (CLOC) was associated with higher self-efficacy, lower anxiety and higher QoL than Powerful Others (PLOC), while Internal (ILOC) had no association. The proportion with ILOC preference was lower in increased disability. In MS, believing that health is controlled mainly by chance confers the most benefit with regard to quality of life. There is prima-facie evidence that LOC preference changes with MS progression, in a pattern that is protective against psychological distress.
健康控制点(LOC)指的是个人对自身健康控制的信念。本研究旨在确定健康控制点与多发性硬化症(MS)相关的临床和心理社会方面之间的关系。5059名MS患者完成了一套问卷,其中包括多维健康控制点量表。探讨了健康控制点与社会人口统计学因素(年龄、性别、教育水平)以及临床变量(病程、残疾、抑郁、焦虑、自我效能感、生活质量)之间的关联。结果发现,健康控制点与所有临床变量及年龄均显著相关,但与性别或教育水平无关。在控制残疾程度后,与“他人强大控制”(PLOC)相比,“机遇控制”(CLOC)与更高的自我效能感、更低的焦虑水平及更高的生活质量相关,而“内控”(ILOC)则无此关联。残疾程度增加时,偏好“内控”的比例较低。在MS患者中,认为健康主要由机遇控制在生活质量方面益处最大。有初步证据表明,健康控制点偏好随MS病情进展而变化,其模式可预防心理困扰。