Internal Health Locus Research Articles

The Impact of Age on the Health Locus of Control in Different Cultural Contexts during the Covid-19 Pandemic

The current study analyzes the impact of age life cycles on the Health Locus of Control construct in different cultural contexts during the Covid-19 pandemic. The purpose is to examine whether different age categories impact the health behavior of individuals and change the Internal Health Locus of Control (IHLC), Powerful Others Health Locus of Control (PHLC), and Chance Health Locus of Control (CHLC) during the outbreak in Asia and Europe of the Covid-19 pandemic. A total of 2617 respondents aged 18–80 from Asia and Europe completed an online version of the Multidimensional Health Locus of Control Scale – Form A. To examine the impact of age on the Health locus of control construct, the study participants were divided into three age groups: up to 35, from 36 to 50, and over 50. Data analysis reveals that along with the influence of cultural context on the Health locus of control construct, age periods also impact and change IHLC, PHLC, and CHLC levels. Respondents from Asia, under the age of 35 and in mature adulthood, have a strong tendency to rely on themselves (IHLC) in the regulation of their health behavior. Europeans, compared to Asians, have consistently lower IHLC levels throughout the life cycle. Results also yield differences in relation to PHLC: Europeans, compared to Asians, are less likely to trust powerful others at an early age, while in adulthood, the health control by powerful others increases dramatically. Data analysis also shows that young Asians tend to rely on chance, fate, or luck (CHLC), however, this tendency is not observed among young Europeans. The opposite trend is observed with age: while in Asian culture levels of CHLC decrease with age, in European contexts, these levels increase.

Determinant Health Locus of Internal and External Health Locus of Control as a Predicator of Quality of Life in Type II Dm Patients In Tetunyung Village Takengon East 2021

Diabetes Mellitus (DM) is a metabolic disorder disease characterized by loss of carbohydrate tolerance. Problems with the quality of life of DM patients are quite complex problems. This will affect several aspects of life, DM conditions that are not managed properly in the long term will contribute to the occurrence of chronic complications. This will have an impact on the patient's quality of life. Decreased quality of life can affect the life expectancy of DM patients and can significantly affect the increase in mortality. This study aims to determine the determinants of internal health locus of control and external health locus of control as predictors of quality of life in type 2 diabetes patients in Tetunyung village, East Takengon in 2021. This study used a cross-sectional study design, the population in this study were Type-2 diabetes mellitus sufferers in Tetunyung Takengon Timur Village as many as 103 Type-2 DM sufferers. The sample in this study was selected by purposive sampling with the criteria of Type 2 DM sufferers with a total of 40 patients. Research instrument in the form of a questionnaire. Bivariate analysis using multiple linear regression. The results of the study found that what affects the quality of life in patients with type-2 diabetes mellitus is the internal locus of control as much as 66%. The results of calculations using the SPSS program with a p value of 0.000 (p <0.05). The conclusion in this study is that there is a relationship between locus of control and quality of life where when individuals with good locus of control will produce a good quality of life.

"All Hands on Deck": Psychological Characteristics of Women with Experience of Oncological Disease Participating in Sailing Cruise-A Pilot Study.

Background: In addition to searching for effective methods of treatment, interventions are sought to support well-being, quality of life, mental health, and recovery. Sailing has its specific features, including task orientation, challenges, contact with people, and nature. This specificity may be treated as a potential therapeutic factor, but it is also likely that people with certain psychological characteristics are involved in it. Therefore, the study aimed to assess some psychological features of women with cancer experience who decided to take part in the Onco-Cruise (Polish: Onko-Rejs). Methods: Participants were 56 women (M = 46.73; SD = 9.21). We used NEO-FFI, the Zimbardo Time Perspective Inventory, and The Multidimensional Health Locus of Control Scale. Results: Onco-Cruises participants were characterized by a high level of extraversion (M = 32.48; SD = 7.02; sten score M = 7.21; Mo = 7), openness (M = 31.50; SD = 6.31; sten score M = 7.41; Mo = 8), low neuroticism (M = 21.62; SD = 9.33; sten score M = 4.96), predominance of present hedonistic (M = 12.55, SD = 1.46) and future time perspective (M = 11.39; SD = 2.67), and the internal health locus of control (M = 23.25, SD = 5.43). Conclusion: Group sailing can be favorable for broadly understood health and cancer recovery, but people who choose this activity have certain psychological predispositions, especially indicating high needs for stimulation. Permanent features should be taken into account when proposing various interventions for oncology patients to best suit them to their natural possibilities and preferences and, thus, make them most effective.

Intention to use smartwatch health applications: A regulatory fit and locus of control perspective

Smartwatch applications are growing in popularity, but little is known about why people are motivated to use different smartwatch health apps. Drawing on regulatory focus theory, we propose that the fit between individuals’ regulatory focus (i.e., primarily prevention or primarily promotion) and the regulatory properties of smartwatch health apps (i.e., primarily promotion apps or primarily prevention apps) helps to explain individuals’ motivations related to intentions to use smartwatch health apps. Further, we show that individuals’ internal health locus of control strengthens the effect of regulatory fit. This study contributes by demonstrating how regulatory focus and locus of control influence intentions to use smartwatch health apps.

Health locus of control in a pandemic situation: cross-cultural differences between European and Asian respondents.

The present cross-cultural study examined the health locus of control construct during the COVID-19 pandemic. The scientific purpose of the study was to determine whether, during the pandemic situation, cultural and sex differences influence the health locus of control construct and change the internal health locus of control (IHLC), powerful others health locus of control (PHLC), and chance health locus of control (CHLC). A total of 2617 recipients aged 18-70 years from Asia (China, India, and Indonesia), and Europe (Bulgaria, Germany, and Hungary) completed a questionnaire about their health. The participants completed an online version of the Multidimensional Health Locus of Control Scale - Form A. The survey shows that in a pandemic life-threatening situation, most individuals strive to rely on IHLC and/or PHLC, and fewer of them tend to rely on CHLC. However, there are differences (p < .001) between the two cultural samples: the representatives of Asian collectivistic culture are more dominated by PHLC, compared to the representatives of the European individualistic culture. When the comparison is between individuals from different cultures, sex differentiation affects the health locus of control, and as a result, significant differences in relation to IHLC, PHLC, and CHLC levels (p < .05) appear. In conclusion, the study indicates that cultural differences influence both the IHLC and PHLC levels, and that Asian participants are dominated by PHLC more than European respondents. Asian females are more likely to seek support from powerful others (PHLC) compared to European women, who perceive themselves as more independent. Asian male participants are prepared to rely on powerful others (doctors or medical institutions), while European male respondents are prone to rely on themselves mainly (IHLC). The results show that sex differences do not significantly affect the health locus of control within the same cultural group.

Health locus of control in a pandemic situation: cross-cultural differences between European and Asian respondents

BackgroundThe present cross-cultural study examined the health locus of control construct during the COVID-19 pandemic. The scien-tific purpose of the study was to determine whether, during the pandemic situation, cultural and sex differences influence the health locus of control construct and change the internal health locus of control (IHLC), powerful others health locus of control (PHLC), and chance health locus of control (CHLC).Participants and procedureA total of 2617 recipients aged 18-70 years from Asia (China, India, and Indonesia), and Europe (Bulgaria, Germany, and Hungary) completed a questionnaire about their health. The participants completed an online version of the Multidimen-sional Health Locus of Control Scale – Form A.ResultsThe survey shows that in a pandemic life-threatening situation, most individuals strive to rely on IHLC and/or PHLC, and fewer of them tend to rely on CHLC. However, there are differences (p &lt; .001) between the two cultural samples: the rep-resentatives of Asian collectivistic culture are more dominated by PHLC, compared to the representatives of the European individualistic culture. When the comparison is between individuals from different cultures, sex differentiation affects the health locus of control, and as a result, significant differences in relation to IHLC, PHLC, and CHLC levels (р &lt; .05) appear.ConclusionsIn conclusion, the study indicates that cultural differences influence both the IHLC and PHLC levels, and that Asian partici-pants are dominated by PHLC more than European respondents. Asian females are more likely to seek support from pow-erful others (PHLC) compared to European women, who perceive themselves as more independent. Asian male partici-pants are prepared to rely on powerful others (doctors or medical institutions), while European male respondents are prone to rely on themselves mainly (IHLC). The results show that sex differences do not significantly affect the health locus of control within the same cultural group.

The Mediating Role of Dispositional Optimism in the Relationship between Health Locus of Control and Self-Efficacy in Pregnant Women at Risk of Preterm Delivery.

Difficult situations during pregnancy, such as threatened preterm labor, trigger negative experiences in women. The levels of stress experienced and the way individuals cope with it depend on their personal resources, such as optimism, internal health locus of control, and self-efficacy, among other factors. The purpose of this paper was to determine the role of dispositional optimism in the relationship between health locus of control and self-efficacy in pregnant women with threatened preterm labor. Dispositional optimism plays the role of mediator in relationships between: (1) internal health control and self-efficacy; and (2) impact of random events on one’s health and self-efficacy. Dispositional optimism does not mediate the relationship between the perceived impact of others on one’s health and self-efficacy. For women with a high-risk pregnancy, dispositional optimism is a significant resource for coping with the problems they encounter. It changes the direction (from negative to positive) of the association between experiencing the impact of external factors (random events) on one’s health and perceived self-efficacy. It prevents the cycle of loss caused by the interpretation of random events as having an impact on one’s health, and acts as a mediator to initiate a cycle of gains that leads to greater perceived self-efficacy. Optimistic pregnant women maintain a positive outlook, even when confronted with difficult, negative experiences such as threatened preterm labor.

Peculiarities of mental health of staff of educational and research organizations in the conditions of war

Introduction. In times of war, the problem of studying, maintaining and promoting the mental health of staff of organizations, in particular, educational and research organizations, gains importance as it affects staff well-being and work performance as well as the effectiveness of organizations in general. Aim: to empirically determine the levels of and factors behind the mental health of staff of educational and research organizations. Methods. The study used a set of tools called Mental Health in Wartime, which included diagnostic instruments and a special questionnaire to study various components of mental health of staff of educational and research organizations and the factors that affect it. The survey was conducted using Google Form. Results. The staff of educational and research organizations had a number of war-specific mental health problems (serious (high level) negative mental conditions, reduced positive mental health, and internal health locus of control). There were both negative and positive trends in staff mental health compared with pre-war times. Educational and research organization staff's age, position, and security-related characteristics of residence had relationship with staff mental health during the war. Conclusions. The findings suggest that the problem of mental health of staff of educational and research organizations in wartime is a significant social and personal problem, which needs effective psychological programs to solve it.

Health Locus of Control and Health Behaviors in Organ Transplant Recipients: A Multicenter Study

Adherence to health behaviors and to immunosuppressant medications are variables among heart transplant recipients with potential life-threatening outcomes. It is understood that patients with psychosocial barriers are at increased risk of poor outcomes due to various factors. Health locus of control includes any activity that can be done to prevent health problems. Health locus of control is defined as individual beliefs based on past experiences in health issues and having internal and or external control. The literature suggests that patients with a strong internal locus of control have a sense of responsibility for their health behaviors. To investigate the effect of the health locus of control on the level of self-reported health behaviors among organ transplant recipients. A cross-sectional design was used for this study. The study group comprises 222 individuals after heart, kidney, lung, and liver transplantation. The following standardized tools were used: The Multidimensional Health Locus of Control, The Health Behavior Inventory, Morisky Medication-Taking Adherence Scale 4-item. Data were analyzed using IBM SPSS. The level of significance for the statistical test was set at 0.05. Powerful Others scored the highest among the 3 Health Locus of Control scales in heart, kidney, and liver recipients. Participants paid little attention to Healthy eating habits; however, the total score of the Health Behavior Inventory was high (91.68-94.40). There was a difference between the kind of transplant and center for 4 aspects of health behavior. Higher scores of The Multidimensional Health Locus of Control were associated with higher scores of Health Behaviors and level of adherence. Greater Powerful Others and Internal Health Locus of control predict higher health behaviors explaining 42 % of the variance. The intensification of declared health behaviors is high. However, in educating posttransplant patients, attention should be paid to strengthening proper healthy eating habits. Associations between health locus of control dimensions and health behavior have been shown among transplant recipients. The health locus of control significantly predicts the intensity of health behaviors. these findings support the need to consider health control beliefs while designing preventive strategies in this group of patients.

Multiple sclerosis: relationship between locus of control and quality of life in persons with low versus high disability

ABSTRACT Background: Health Locus of Control (HLOC) is the degree to which individuals believe that their health outcomes are controlled by ‘external’ factors – environmental forces, chance, fate, other people, or some higher power – or by ‘internal’ factors – their own behavior or action. Most of the literature on HLOC associates an Internal Health Locus of Control (IHLOC) to pro-health behaviors and better health outcomes. However, a few studies also suggest that in chronic illnesses, an External Health Locus of Control (EHLOC) could be beneficial with respect to pro-health behaviors and perceptions of Quality of Life (QoL), challenging assumptions about what leads to the most effective psychological coping in the face of difficult circumstances. Multiple sclerosis (MS) is a chronic immune condition of the central nervous system and the most frequent cause of non-traumatic disability in young adults, often despite treatment. Method: The primary goal of this non-experimental, cross-sectional, quantitative study of 89 individuals with MS was to explore the HLOC of individuals with MS, and to identify whether holding an EHLOC positively impacts the MS patients’ perceived QoL while taking into consideration their level of disability. Results: This research found that individuals with higher disability scores tended to hold more EHLOC beliefs, and that there was a significant correlation between QoL and holding EHLOC beliefs. Conclusion: This study was able to capture the importance of control beliefs in the QoL of individuals with MS with higher disability. The clinical implications of the findingare explored and areas for further research are suggested.

Psychological Impact of Predictive Genetic Testing for Inherited Alzheimer Disease and Frontotemporal Dementia: The IT-DIAfN Protocol.

Aim:Our aim was to evaluate the psychological impact of predictive genetic testing in individuals at-risk for inherited dementia who underwent a structured counseling and testing protocol.Methods:Participants were healthy at-risk relatives from families with at least one affected patient, in whom a disease-associated genetic variant had been ascertained. A comprehensive psychological assessment (personality, anxiety and depression, quality of life, coping strategies, resilience and health-related beliefs) was administered at baseline, at 6 months and 12 months follow-up.Results:Twenty-four participants from 13 families were included. Sixteen participants underwent blood sampling and genetic analysis; 6 resulted to be carriers of pathogenic variants (1 in PSEN1, 1 in PSEN2, 4 in GRN). Carriers showed higher score on the Resilience Scale for Adults (RSA) – social competence, and on Multidimensional Health Locus of Control – internal, than noncarriers (P=0.03 for both). Ten at-risk relatives who completed the follow-up showed improvement in RSA – planned future (P=0.01) with respect to baseline.Discussion:Our case series showed that at-risk individuals undergoing predictive testing showed benefit on personal life and no detrimental impact on a broad range of psychological outcomes. Higher social skills and lower internal health locus of control in carriers may be an early psychological correlate of preclinical dementia.

The Influence of Selected Psychological Factors on Medication Adherence in Patients with Chronic Diseases

Background: Insufficient adherence to treatment is a relevant problem. This study aims to determine the impact of health locus of control, stress coping style and level of mindfulness on medication adherence in patients with a chronic illness. Methods: The study included 768 people. The diagnostic survey involved the use of: Medication Adherence Questionnaire (MAQ), Multidimensional Health Locus of Control Scale (MHLC), The Coping Inventory for Stressful Situations (CISS), and The Mindful Attention Awareness Scale (MAAS). Results: Participants were divided into two subgroups, i.e., adherent (n = 219) and non-adherent (n = 549). We observed significant differences between the subgroups in age, BMI, sex, place of residence, education, and for all MHLC subscales, two CISS subscales and MAAS. The identified medication adherence variables were: female gender (OR = 1.55), BMI (OR = 0.95), MHLC/Internal (OR = 0.95), CISS/Emotional (OR = 1.03), MAAS (OR = 0.97). Conclusions: A strong internal health locus of control, a higher level of mindfulness and a lower level of emotional-stress coping style increase the likelihood of adherence with medication recommendations in patients with chronic diseases.

Evaluation of the predictors of oral health-related quality of life among 3-5-year-old children with dental trauma.

This study evaluated the influence of socio-demographic, clinical, and parental psychological factors on oral health-related quality of life (OHRQoL) and determined their predictors in preschool-aged children with traumatic dental injury (TDI). The study sample consisted of 324 dyads of children and their parents attending the Clinics of Pediatric Dentistry at Istanbul University. After clinical examination, the Sense of Coherence (SOC), Generalized Self-Efficacy Scale, Early Childhood Oral Health Impact Scale, and Multidimensional Health Locus of Control Scale-MHLC questionnaires were administered to the parents. The statistical analyses included Spearman correlation coefficients, Mann-Whitney U tests, Kruskal-Wallis tests, multiple linear regression, and confirmatory factor analysis. Having mixed TDI, a non-nuclear family, fewer children, and weak parental SOC were important predictors of worse overall OHRQoL and its sections of child and family. Lower internal health locus of control and dental pain due to TDI were predictors of worse overall OHRQoL and child impact, respectively. Consideration of these predictors may help oral health professionals to develop prevention and treatment programs for TDI and oral health literacy programs for families.

The Mediating Influence of the Unified Theory of Acceptance and Use of Technology on the Relationship Between Internal Health Locus of Control and Mobile Health Adoption: Cross-sectional Study.

BackgroundMobile health (mHealth) as an innovative form of information and communications technology can efficiently deliver high-quality health care by enhancing communication and health management, reducing costs, and increasing access to health services. An individual’s internal health locus of control (HLOC) is found to be associated with the behavioral intent to adopt mHealth. However, little is known about the underlying mechanism of this association.ObjectiveThe primary objective of this study was to test the mediation influence of the Unified Theory of Acceptance and Use of Technology (UTAUT) on the relationship between internal HLOC and the behavioral intention to use mHealth.MethodsA total of 374 responses were collected from Malaysian adult users of mHealth, using convenience and snowball sampling methods. Partial least squares structural equation modeling was used to analyze the data. Data were collected for variables, including demographics, internal HLOC, and modified UTAUT constructs (ie, performance expectancy, effort expectancy, and social influence).ResultsThe results showed that there was no direct relationship between internal HLOC and the behavioral intention to use mHealth (β=−0.039, P=.32). The indirect relationship between internal HLOC and the intent to adopt mHealth was supported, indicating that the UTAUT constructs performance expectancy (β=0.104, P<.001), effort expectancy (β=0.056, P=.02), and social influence (β=0.057, P=.002) mediated this relationship. The results showed full mediation, with total variance explained at 47.2%.ConclusionsThis study developed an integrative model, where a health-related disposition (internal HLOC), mHealth-related beliefs (performance expectancy and effort expectancy), and normative pressure (social influence) were combined to explain the underlying mechanism of the behavioral intent to adopt mHealth. The results showed that the intention to adopt mHealth is mediated by the influence of UTAUT factors, while HLOC has no direct effect on adoption intention. The findings provide insights into augmenting mHealth adoption among the public by enhancing the perceived benefits of mHealth, helping design more effective and user-friendly mHealth tools, and capitalizing on social normative influence to adopt mHealth. This study utilized the constructs of the UTAUT model to determine the intention to use mHealth. Future research should focus on other health- and technology-related theories to ascertain other possible factors influencing the behavioral intent of mHealth adoption.

Use of health locus of control on self-management and HbA1c in patients with type 2 diabetes.

AimTo assess the effects of health locus of control‐based education programme (HLCEP) on self‐management, health locus of control and glycated haemoglobin (HbA1c) among type 2 diabetes mellitus (T2DM).DesignQuasi‐experimental study.MethodsThe study recruited 120 T2DM participants from May–September 2020. The control group received one‐week in‐hospital care and 12‐week follow‐up. The intervention group received additional HLCEP. The self‐management and the health locus of control were measured by using the Summary of Diabetes Self‐care Activities and the Multidimensional Health Locus of Control at baseline and the 4th and 12th week after discharge. The HbA1c was collected at baseline and the 12th week after discharge. The generalized estimating equation analysis was performed to assess the intervention effects.ResultsThe intervention group has statistically significantly higher scores on the overall level of self‐management, dietary management, foot care, medication management and internal health locus of control, while a lower HbA1c level than the control group.

Relationships among the Internal Health Locus of Control, Mental Health Problems, and Subjective Well-Being of Adults in South Korea.

The purpose of this study was to confirm the relationship between internal health locus of control, mental health problems, and subjective well-being in adults during the prolonged COVID-19 pandemic. In particular, the mediating effect of mental health problems on the relationship between internal health locus of control and subjective well-being was examined. A cross-sectional descriptive design was conducted via online survey. The participants were 600 adults over 20 years of age living in South Korea. The collected data were analyzed using hierarchical regression analysis and SPSS Process Macro (Model 4). As a result of the study, the internal health locus of control had a significant negative effect on mental health problems. In addition, in the process of the internal health locus of control affecting subjective well-being, the mediating effect of mental health problems was significantly shown. In the period of an infectious disease pandemic such as COVID-19, it is necessary to establish a strong internal health locus of control of individuals and to promote monitoring and treatment introduction for those with a low internal health locus of control. In addition, it was discussed that controlling mental health problems can improve subjective well-being, which is life satisfaction and happiness.

The COVID-19 Pandemic: Role of Coping Humor and Internal Health Locus of Control on Social Dysfunction and Anxiety &amp; Depression

The concerns about the impact of social distancing on mental health have been widely discussed. This study aimed to know the predictive effect of coping humor and Internal Health Locus of Control (Internal HLoC) on social dysfunction and anxiety &amp; depression during the implementation of the COVID-19 social distancing agenda. This study was also intended to assess the effect of humor content on coping humor. A quantitative approach was used as the method ofthe study with 243 online-recruited participants, and PLS-SEM analysis was applied to find out the predictive effect in this study. The results and conclusions showed that anxiety &amp; depression predict social dysfunction (β = 0.584, t-value = 11.93, f2 = 0.563). It was found that coping humor was able to directly increase the Internal HLoC (β = 0.187, t-value = 2.60, f2 = 0.036) and indirectly decrease social dysfunction (β = -0.144, t-value = 2.85) and anxiety &amp; depression (β = -0.070, t-value = 2.42). Humor content unrelated to the issue of COVID-19 directly increase the coping-humor level (β = 0.266, t-value = 4.13,f2= 0.076), and indirectly increase Internal HLoC (β = 0.050, t-value = 2.07), and decrease anxiety &amp; depression level (β = -0.046, t-value = 2.20). On the other hand, Internal HLoC directly decrease levels of social dysfunction (β = -0.233, t-value = 4.126, f2 = 0.089) and anxiety &amp; depression (β = -0.373, t-value= 7.84, f2 = 0.161).

The dark side of the quarantine: night eating, sleep quality and the health locus of control in women

PurposeStaying at home for a prolonged period, the stress during COVID-19 quarantine may affect sleep quality, night eating behaviours of individuals. This paper aims to identify the relationship between night eating behaviour, sleep quality, perceptions of health locus of control in women during the pandemic.Design/methodology/approachAn anonymous, Web based, cross-sectional study was conducted for the duration of a month (April-May, 2020). The study evaluated the nutritional habits of the participants. Anthropometric measurements were noted. Night Eating Syndrome Questionnaire (NESQ), Pittsburgh Sleep Quality Index (PSQI), Multi-dimensional Health Locus of Control-A were used for data collection.FindingsWith a mean age of 33 ± 8 years, 529 women participated in the study. The mean NESQ score was 14.4 ± 4.7, PSQI score was 6.4 ± 2.9. Higher night eating scores were observed in participants with chance locus of control (CLC) perception when compared to participants with internal health locus of control (IHLC) perception (p < 0.05). Lower sleep quality was observed in obese participants compared to normal/overweight participants (p < 0.05). It was also found that night eating behaviours significantly predicted sleep quality (R = 0.36, R2 = 0.13; p < 0.01), explaining about 13.3% of total variance of sleep quality.Research limitations/implicationsOnly internet users and women participated in the study, and the questionnaire form was applied online; the information was obtained in the form of the participants' own statements.Practical implicationsIt was found that night eating behaviour significantly predicted sleep quality during the pandemic. It was also determined that the individuals with high chance locus of control perception had higher NES scores than the individuals with high internal locus of control perception.Originality/valueThe night eating behaviours significantly predict sleep quality, individuals with a high perception of CLC had a higher night eating score than individuals with high perception of IHLC during the pandemic.

Association between health locus of control and perceived stress in college student during the COVID-19 outbreak: a cross-sectional study in Iran

BackgroundThe COVID-19 pandemic as a global mental health crisis has affected everyone, including students. The present study aimed to determine and investigate the relationship between health locus of control and perceived stress in students of Bushehr University of Medical Sciences (southern Iran) during the outbreak of COVID-19.MethodsThe present cross-sectional study examined 250 students of Bushehr University of Medical Sciences. We performed simple random sampling and utilized the demographic information form, Multidimensional Health Locus of Control scale (MHLCS) by Wallston, and Perceived Stress Scale (PSS) by Cohen to collect data. We analyzed data using the SPSS, Pearson correlation coefficient, and the hierarchical regression model with an error level of 5%.ResultsThe mean perceived stress was 30.74 ± 8.09, and 92.4% of the students had moderate and high stress levels. Among the components of the health locus of control, the internal health locus of control (IHLC) had the highest mean in students (27.55 ± 3.81). Furthermore, the internal health locus of control (R = − 0.30, P < 0.001) had a significant inverse relationship, with perceived stress and the chance health locus of control (CHLC) (R = 0.30, P < 0.001) had a significant direct relationship. In the final regression model, the health locus of control and all the variables predicted 22.7% of the perceived stress variation in students during the COVID-19 period.ConclusionThe results indicated that the internal health locus of control was associated with a reduction of perceived stress, and the powerful others health locus of control (PHLC) was related to its increase in students during the COVID-19 pandemic. Given the uncertain future, in the present work, universities are suggested to design web-based educational interventions alongside the curriculum to further strengthen the internal health locus of control and thus help reduce their perceived stress.

Better Sleep and Less Pain? Sleep Training in Orthopedic Rehabilitation

There is high comorbidity between chronic pain and insomnia. Not only does chronic pain impair sleep, poor sleep quality can also exacerbate the sensation of pain. However, usually, the respective symptoms are treated separately. We evaluate a new cognitive behavioral sleep-pain-training aiming at improving symptoms of both insomnia and chronic pain in the setting of ambulant orthopedic rehabilitation. N=41 patients participated in the study (with 15 participants being enrolled in the control group). The training consists of 4 modules á 90min and was explicitly developed for patients suffering from chronic pain and comorbid insomnia. It includes several methods of cognitive behavioral therapy for the treatment of insomnia and pain (e. g., sleep hygiene, sleep restriction, sleep-pain-protocol, cognitive restructuring) and specifically addresses the relationship between the two. Sleep quality, sleep related thoughts (focusing, rumination), internal health locus of control, pain intensity (day and night) as well as pain related thoughts (pain related anxiety, pain related depression/helplessness) were assessed pre and post training by means of a questionnaire. Mixed ANOVAS revealed small (η²=: 0,010) to medium (η²=: 0,068) interaction effects for most dependent variables (sleep quality, sleep efficiency, focusing, rumination, internal health locus of control, average day and night pain, maximum night pain, pain related anxiety and pain related depression/helplessness) for the interaction of time and group. However, effects for rumination and average day pain were not significant. There was no interaction effect for maximum day pain. Effect sizes for single group analyses revealed medium (internal sleep locus of control: d=0,52) to large (sleep quality: d=1,73) significant effects for the training group and no (focusing: d=0,00) to small (maximum day pain: d=-0,43) and non-significant effects for the control group. The training analyzed in this study may constitute a complement to existing treatment possibilities for patients suffering from chronic pain and should be further evaluated in larger samples.