Health locus of control and cardiovascular risk factors in veterans with type 2 diabetes.
Health locus of control and cardiovascular risk factors in veterans with type 2 diabetes.
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DOI：
10.1007/s12020-015-0677-8
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发表时间：
2016-01
期刊：
影响因子：
3.7
通讯作者：
Egede LE
中科院分区：
文献类型：
--
作者：
Williams JS;Lynch CP;Voronca D;Egede LE
患有慢性病的退伍军人对控制的看法会影响结果。本研究的目的是检验男性退伍军人2型糖尿病(T2 DM)患者的控制取向与临床和生活质量(QOL)结果之间的关系。对美国东南部一家初级保健诊所的283名男性退伍军人进行的横断面研究。健康心理控制源(LOC)是主要的预测因子，并使用多维健康心理控制源量表进行评估。临床结果是糖化血红蛋白A1c(HbA1c)、收缩压(SBP)和舒张压(DBP)以及低密度脂蛋白胆固醇(LDL-C)。生活质量的生理(PCS)和心理(MCS)健康部分得分使用退伍军人兰德12项健康调查进行评估。未经调整和经调整的多变量分析被用于评估LOC和结果之间的关联。未校正分析显示，内部LOC与HbA1c相关(β=0.036；95%CI为0.001，0.071)，外部LOC与低密度脂蛋白呈负相关(β=−0.794；95%CI−1.483，−0.104)，外部LOC：机会与MCS生活质量负相关(β=−0.418；95%CI−0.859，−0.173)。在对相关协变量进行调整时，这些相关因素仍然显著。调整后的分析还显示，外部生活质量：机会和PCS生活质量之间存在显著关系(β=0.308；95%CI为0.002，0.614)。在这个患有T2 DM的男性退伍军人样本中，调整相关协变量后，内部LOC与血糖控制显著相关，外部LOC与生活质量和低密度脂蛋白显著相关。应进行对照导向评估，以了解患者的看法，从而更好地为医生提供信息，使患有T2 DM的退伍军人获得最大限度的护理机会。
Perceptions of control impact outcomes in veterans with chronic disease. The purpose of this study was to examine the association between control orientation and clinical and quality of life (QOL) outcomes in male veterans with type 2 diabetes (T2DM). Cross-sectional study of 283 male veterans from a primary care clinic in the southeastern US. Health locus of control (LOC) was the main predictor and assessed using the Multidimensional Health Locus of Control Scale. Clinical outcomes were glycosylated hemoglobin A1c (HbA1c), systolic (SBP) and diastolic (DBP) blood pressure, and low-density lipoprotein cholesterol (LDL-C). Physical (PCS) and mental (MCS) health component scores for QOL were assessed using the Veterans RAND 12-Item Health Survey. Unadjusted and adjusted multivariate analyses were performed to assess associations between LOC and outcomes. Unadjusted analyses showed internal LOC associated with HbA1c (β=0.036; 95% CI 0.001,0.071), external LOC:powerful others inversely associated with LDL-C (β=−0.794; 95% CI −1.483,−0.104), and external LOC:chance inversely associated with MCS QOL (β=−0.418; 95% CI −0.859,−0.173). These associated remained significant when adjusting for relevant covariates. Adjusted analyses also demonstrated a significant relationship between external LOC:chance and PCS QOL (β=0.308; 95% CI 0.002,0.614). In this sample of male veterans with T2DM, internal LOC was significantly associated with glycemic control, and external was significantly associated with QOL and LDL-C, when adjusting for relevant covariates. Assessments of control orientation should be performed to understand the perceptions of patients, thus better equipping physicians with information to maximize care opportunities for veterans with T2DM.