title: The Relationship of Health Locus of Control and Health-Related Quality of Life in the Chronic Phase After Traumatic Brain Injury.
abstract: OBJECTIVE
  To study health locus of control (HLC) after moderate to severe traumatic brain injury (TBI) compared with norm values and in relation to health-related quality of life (HR-QoL) over time.
  
  
  METHODS
  Three level-1 trauma centers.
  
  
  METHODS
  Individuals with moderate to severe TBI (N = 85).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Multidimensional health locus of control scales including internal control (Internal-HLC), control attributed to physicians (Physician-HLC) or to chance (Chance-HLC) and sickness impact profile-68 including physical and psychosocial HR-QoL.
  
  
  RESULTS
  One to 3 years after TBI, Internal-HLC, and Chance-HLC significantly declined, whereas Physician-HLC remained stable. Total and psychosocial HR-QoL did not change over time, but physical HR-QoL improved. Three years after TBI, Internal-HLC (P < .001), and Physician-HLC (P < .001) were significantly lower and Chance-HLC (P < .001) significantly higher than norm values. Chance-HLC was independently related to total (β = .321, P < .001) and psychosocial HR-QoL (β = .258, P < .001), adjusted for baseline characteristics, functional, and cognitive outcome.
  
  
  CONCLUSIONS
  After TBI, HLC may change over time and may be different from healthy adults. The external Chance-HLC orientation has a negative relationship with HR-QoL. Future research focused on the effect of rehabilitation programs for improving the balance in internal and external locus of control is needed.
authors.affiliation: Rijndam Rehabilitation Center and Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Wielenga-Boiten
authors.forename: Majanka H
authors.initials: MH
authors.lastname: Heijenbrok-Kal
authors.forename: Gerard M
authors.initials: GM
authors.lastname: Ribbers
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D001930:Brain Injuries / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D007389:Internal-External Control; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D011788:Quality of Life; D012016:Reference Values; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult