Patient self-efficacy and health locus of control: relationships with health status and arthritis-related expenditure
Patient self-efficacy and health locus of control: relationships with health status and arthritis-related expenditure
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DOI：
10.1093/rheumatology/kei114
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发表时间：
2006-01-01
期刊：
影响因子：
5.5
通讯作者：
Brooks, PM
中科院分区：
文献类型：
--
作者：
Cross, MJ;March, LM;Brooks, PM
Objective.探讨社区类风湿关节炎（RA）和骨关节炎（OA）患者自我效能、健康心理控制源、健康状况与直接医疗费用的关系。这项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更大研究的一部分。社区居民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和健康控制点的问卷。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健康状况较好，总体成本较低。健康心理控制源与健康状况不一致。具有较高自我效能感的OA受访者报告了更好的健康状况和更低的成本。健康心理控制源的影响更大。具有较高外部控制点的OA受访者报告疼痛和功能更差。对机会作为健康决定因素的更高信念与更多的全科医生就诊以及受访者和卫生系统的更高成本相关。更高的自我效能感，这是经得起改变，通过教育计划，与更好的健康状况和更低的成本，以回答和卫生系统在这个横断面研究。控制点的影响较小，然而，倾向是那些具有较高的外部控制点，有较高的成本和更差的健康状况。由于这些结构的测量是简单的，结果可能会影响健康状况，这些结果对未来的干预研究，以提高生活质量和减少关节炎对医疗保健系统和患者的经济影响的影响。
Objective. 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).Methods. 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.Results. 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.Conclusion. 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.