The relationship between health locus of control and self-efficacy in patients with heart failure

Authors

Patient Safety Research Center, Clinical Research Institute, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran

Abstract

Background: Self-efficacy and the health locus of control (HLC) are the most important determinants of compliance with self-care behaviors in patients with heart failure (HF). However, there is still a lack of studies in this area. Objective: This study aimed at investigating the relationship between HLC and self-efficacy in patients with HF. Methods: This cross-sectional study was conducted on 170 patients with HF in 2019 in Urmia, Iran. The participants were enrolled by using a consecutive sampling method. Data collection was conducted by using a demographic questionnaire, the questionnaire for assessing the Strategies Used by People to Promote Health (SUPPH), and the Multidimensional Health Locus of Control (MHLC) Scale. Descriptive statistics, the Pearson correlation coefficient, and stepwise linear regression analysis were used to analyze the data. Results: The mean age of the participaants was 67.47 ± 11.27 years. The majority of participants were male (59.8%) and married (76.8%). Among the components of the MHLC, the internal and powerful others obtained the highest mean scores (28.52 ± 5.97 vs. 26.6 ± 4.01). On average, the patients possessed about half of the self-efficacy scores. The internal HLC (IHLC) only had a direct correlation with the overall score of self-efficacy (r=0.24, P = 0.03), and the powerful others HLC (PHLC) was directly correlated with a positive attitude (r=0.39, P = 0.001) and the overall score of self-efficacy (r=0.32, P = 0.004). In regression analysis, only the scores of IHLC and PHLC were associated with the self-efficacy scores. Conclusion: Patients' self-efficacy improves as the mean scores of the IHLC and PHLC increase.

Keywords


1.     Lippi G, Sanchis-Gomar F. Global epidemiology and future trends
of heart failure. AME Med J 2020;5:15.
2.     Zeighami Mohammadi SH, Farmani P, Shakoor M, Fahidy F,
Fallah Taherpazir E, Mohseni B. Correlation between type D
personality and quality of life in heart failure patients. Int J BioMed
Public Health 2018;1:76-81.
3.     Sarrafzadegan N, Mohammmadifard N. Cardiovascular disease
in Iran in the last 40 years: Prevalence, mortality, morbidity,
challenges and strategies for cardiovascular prevention. Arch Iran
Med 2019;22:204-10.
4.     van der Velden J, van der Wall EE, Paulus WJ. Heart failure with
preserved ejection fraction: Current status and challenges for the
future. Neth Heart J 2016;24:225-6.
5.     Boczor S, Eisele M, RakebrandtA, Menzel A, Blozik E, Träder JM,
et al. RECODE-HF study group. Prognostic factors associated with
quality of life in heart failure patients considering the use of the
generic EQ-5D-5L™ in primary care: New follow-up results of the
observational RECODE-HF study. BMC Fam Pract 2021;22:202.
6.     Surikova J, Payne A, Miller KL, Ravaei A, Nolan RP. A cultural
and gender-based approach to understanding patient adjustment to
chronic heart failure. Health Qual Life Outcomes 2020;18:238.
7.     Bidwell JT, Hostinar CE, Higgins MK, Abshire MA, Cothran F,
Butts B, et al. Caregiver subjective and physiological markers
of stress and patient heart failure severity in family care dyads.
Psychoneuroendocrinology 2021;133:105399.
8.     Urbich M, Globe G, Pantiri K, Heisen M, Bennison C, Wirtz HS,
et al. A systematic review of medical costs associated with
heart failure in the USA (2014-2020). Pharmacoeconomics
2020;38:1219-36.
9.     Davoodvand S, Elahi N, Haghighizadeh M, Effectiveness of shortterm cardiac rehabilitation on clinical manifestations in post-MI
Patients. Hayat 2009;15:66-73.
10.     Eller LS, Lev EL, Yuan C, Watkins AV. Describing self-care selfefficacy: Definition, measurement, outcomes, and implications. Int
J Nurs Knowl 2018;29:38-48.
11.     Akbari O, Vaghar SSA, Saadatjoo SA, Kazemi T. Effect of
continuous care model on the self-efficacy of patients with
myocardial infarction in controlling disease complications. Med
Surg Nurs J 2015;3:185-94.
12.     GuntzvillerLM, KingAJ,Jensen JD, DavisLA. Self-efficacy, health
literacy, and nutrition and exercise behaviors in a low-income,
Hispanic population. J Immigr Minor Health 2017;19:489-93.
13.     Pourmovahed Z, Mazloomy Mahmoodabad SS,
Zareei Mahmoodabadi H, Tavangar H, Yassini Ardekani SM,
Vaezi AA. Deficiency of self-efficacy in problem-solving as a
contributory factor in family instability: A qualitative study. Iran J
Psychiatry 2018;13:32-9.
14.     Alias M, Akasah ZA, Kesot MJ. Relationships between locus
of control, self-efficacy, efforts and academic achievement
among engineering students. In MATEC Web of Conferences
2016;68:18004.
15.     Rydlewska A, Krzysztofik J, Libergal J, Rybak A, Banasiak W,
Ponikowski P, et al. Health locus of control and the sense of selfefficacy in patients with systolic heart failure: A pilot study. Patient
Prefer Adherence 2013;7:337-43.
16.     Pahlevan Sharif S. Locus of control, quality of life, anxiety, and
depression among Malaysian breast cancer patients: The mediating
role of uncertainty. Eur J Oncol Nurs 2017;27:28-35.
17.     Houts SS, Warland RH. Rotter’s social learning theory of personality
and dietary behavior. J Nutr Educ Behav 1989;21:172-9.
18.     Náfrádi L, Nakamoto K, Schulz PJ. Is patient empowerment the
key to promote adherence? A systematic review of the relationship
between self-efficacy, health locus of control and medication
adherence. PLoS One 2017;12:e0186458.
19.     Schilling S, Ritter VS, Skinner A, Yin HS, Sanders LM,
Rothman RL, et al. Relationship between parental locus of control
and childhood injury. J Prim Prev 2020;41:547-6520.     Schreitmüller J, Loerbroks A. The role of self-efficacy and locus
of control in asthma-related needs and outcomes: A cross-sectional
study. J Asthma 2020;57:196-204.
21.     Abredari H, Bolourchifard F, Rassouli M, Nasiri N, Taher M,
Abedi A. Health locus of control and self-care behaviors in diabetic
foot patients. Med J Islam Repub Iran 2015;29:283.
22.     Heidari M, Ghodusi M. Relationship of assess self-esteem and
locus of control with quality of life during treatment stages in
patients referring to drug addiction rehabilitation centers. Mater
Sociomed 2016;28:263-7.
23.     Büyükkaya Besen D, Günüşen N, Arda Sürücü H, Koşar C.
Predictor effect of locus of control (LOC) on self-care activities
and metabolic control in individuals with type 2 diabetes. PeerJ
2016;4:e2722.
24.     Rogowska AM, Zmaczyńska-Witek B, Mazurkiewicz M, Kardasz Z.
Themediating effect ofself-efficacy on the relationship between health
locus of control and life satisfaction: A moderator role of movement
disability. Disabil Health J 2020;13:100923.
25.     Siennicka AE, Gościńska-Bis K, Wilczek J, Wójcik M,
Błaszczyk R, Szymański FM, et al. Perception of health control
and self-efficacy in heart failure. Kardiol Pol 2016;74:168-78.
26.     Tovar EG, Dekker RL, Chung ML, Gokun Y, Moser DK,
Lennie TA, et al. Self-efficacy mediates the relationship of
depressive symptoms and social support with adherence in patients
with heart failure. J Health Psychol 2016;21:2673-83.
27.     Rideout A, Tolmie E, Lindsay G. Health locus of control in patients
undergoing coronary artery surgery - changes and associated
outcomes: A seven-year cohort study. Eur J Cardiovasc Nurs
2017;16:46-56.
28.     Lev EL, Owen SV. A measure of self-care self-efficacy. Res Nurs
Health 1996;19:421-9.
29.     Tsay SL, Hung LO. Empowerment of patients with end-stage
renal disease–a randomized controlled trial. Int J Nurs Stud
2004;41:59-65.
30.     Azizi Fini I, Adib-Hajbaghery M, Salahshoorian Fard A.
Khachian A. The effect of health-promotion strategies education on
self-care self-efficacy in patients with bone marrow transplantation.
Iran J Crit Care Nurs 2011;4:109-16.
31.     Wallston KA, Wallston BS, DeVellis R. Development of the
multidimensional health locus of control (MHLC) scales. Health
Educ Monogr 1978;6:160-70.
32.     Moshki M, Ghofranipour F, Hajizadeh E, Azadfallah P. Validity
and reliability of the multidimensional health locus of control scale
for college students. BMC Public Health 2007;7:295.
33.     Hekmatpou D, Mohammadi E, Ahmadi F, Arefi S, Rafie M. The
effectiveness of applying ‘‘making sensitivity to re-admission
caring model’’on controlling congestive heart failure complications
among hospitalized patients in Tehran cardiovascular centers,
2009. RJMS 2010;17:33-50.
34.     Indelicato L, Mariano V, Galasso S, Boscari F, Cipponeri E,
Negri C, et al. Influence of health locus of control and fear of
hypoglycaemia on glycaemic control and treatment satisfaction in
people with type 1 diabetes on insulin pump therapy. Diabet Med
2017;34:691-7.
35.     Suresh R, Wang W, Koh KWL, Shorey S, Lopez V. Self-efficacy
and health-related quality of life among heart failure patients in
Singapore: A descriptive correlational study. J Transcult Nurs
2018;29:326-34.
36.     Boroumand S, Shahriari M, Abbasi Jebeli M, Baghersad Z,
Baradaranfard F, Ahmadpoori F. Determine the level of selfefficacy and its related factors in patients with ischemic heart
disease: A descriptive correlational study. IJNR 2015;9:61-9.
37.     Do V, Young L, Barnason S, Tran H. Relationships between
activation level, knowledge, self-efficacy, and self-management
behavior in heart failure patients discharged from rural hospitals.
F1000Res 2015;4:150.
38.     Ashagi MM, Beheshtifar M. The relationship between locus
of control (internal-external) and self-efficacy beliefs of Yazd
University of Medical Sciences. IJEAS 2015;2:257845.