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Health locus of control and cardiovascular risk factors in veterans with type 2 diabetes

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Abstract

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 LOC Scale. Clinical outcomes were glycosylated hemoglobin A1c (HbA1c), systolic and diastolic 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 associations 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.

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Acknowledgments

This study was supported by Grant #TRP 04-038 (PI: Leonard Egede) funded by the VHA Health Services Research and Development (HSR&D) program.

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Authors and Affiliations

  1. Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, USA

    Cheryl P. Lynch & Leonard E. Egede

  2. Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Joni S. Williams, Cheryl P. Lynch, Delia Voronca & Leonard E. Egede

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  1. Joni S. Williams
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Correspondence to Leonard E. Egede.

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Williams, J.S., Lynch, C.P., Voronca, D. et al. Health locus of control and cardiovascular risk factors in veterans with type 2 diabetes. Endocrine 51, 83–90 (2016). https://doi.org/10.1007/s12020-015-0677-8

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  • DOI: https://doi.org/10.1007/s12020-015-0677-8

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