title: Health locus of control and cardiovascular risk factors in veterans with type 2 diabetes.
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.
authors.affiliation: Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA. stromjl@musc.edu.
authors.forename: Joni S
authors.initials: JS
authors.lastname: Williams
authors.affiliation: Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, USA. lynchcp@musc.edu.|Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA. lynchcp@musc.edu.
authors.forename: Cheryl P
authors.initials: CP
authors.lastname: Lynch
authors.affiliation: Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA. voronca@musc.edu.
authors.forename: Delia
authors.initials: D
authors.lastname: Voronca
authors.affiliation: Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, USA. egedel@musc.edu.|Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA. egedel@musc.edu.
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D012648:Self Care / Q000523:psychology / Q000592:standards; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: Cardiovascular disease risk factors; Diabetes; Diabetes outcomes; Health locus of control; Quality of life; Veterans