Predictors of proficient technique and successful lesion detection in breast self-examination

Seventy-three women attending a health fair completed a questionnaire that measured demographic and health history variables, knowledge, and current practice of breast self-examination (BSE), Multidimensional Health Locus of Control (MHLC; Wallston, Wallston, & DeVellis, 1978), and components of the Health Belief Model (HBM; Rosenstock, 1974) in relation to breast cancer and BSE. These variables formed the basis of a conceptual model of BSE behavior that was examined by having each woman participate in a behavioral trial with a breast model in which her BSE technique and ability to detect simulated tumors was assessed. Regression analyses revealed that self-confidence in the efficacy of BSE was the best single predictor of proficient BSE. Powerful others HLC, knowledge of correct BSE behaviors, and chance HLC, respectively, also contributed significantly to the variance in performance. As anticipated, successful lesion detection was most strongly associated with more proficient BSE technique and higher frequency of BSE practice in the past six months. Internal HLC scores were not predictive of either behavioral measure. Similarly, except for perceived efficacy of BSE, HBM variables showed no strong relationships to observed behavior.     

A comparison of two multidimensional health locus of control instruments

This study examined the factor structure, internal consistency reliability, and construct validity of the multidimensional health locus of control (MHLC) instruments developed by K.A. Wallston, B.S. Wallston, and DeVellis (1978) and Lau (Lau, 1982; Lau & Ware, 1981). Both measures were administered to a sample of Veterans Administration (VA) medical outpatients (N = 181). Only minimal evidence of convergence was found between corresponding scales of the two MHLC instruments. Low convergent validity appears attributable to the poor internal consistency reliability of the Lau-Ware subscales. Moreover, results of factor analysis largely supported the a priori factor structure of the K.A. Wallston et al. (1978) MHLC instrument but failed to support the factor structure of the Lau-Ware instrument. Health locus of control (HLC) dimensions that emerged from simultaneous factor analysis of both instruments were most consistent with a three-dimensional typology (i.e., Personal Control, Professional Control, and Chance) rather than the four-dimensional typology proposed by Lau (Lau, 1982; Lau & Ware, 1981). Implications for HLC conceptualization and measurement are discussed.     

The relationship between instrumental and expressive traits,health behaviors,and perceived physical health

Relations between instrumental and expressive traits, health behaviors, and self-reported physical health were examined among young adults. Individuals (169 men, 167 women) completed two measures of instrumental and expressive traits, the Bem Sex Role Inventory (BSRI) and the Personal Attributes Questionnaire (PAQ). Ethnic background of the sample included 72% European Americans, 13% Latin Americans, 6% Asian Americans, 5% African Americans, less than 1% Native American, and 4% did not specify a particular category. Expressive traits from the BSRI, and expressive and instrumental traits from the PAQ were associated with health behaviors, after controlling for neuroticism. Neuroticism explained 43% of the variance in perceived physical health. Separation of individuals into four groups on the basis of instrumental and expressive traits showed that androgynous individuals reported significantly better health practices than other individuals providing support for the androgyny model.     

A Comparison of Two Multidimensional Health Locus of Control Instruments

This study examined the factor structure, internal consistency reliability and construct validity of the multidimensional health locus of control (MHLC) instruments developed by K. A. Wallston, B. S. Wallston, and DeVellis (1978) and Lau (Lau, 1982; Lau & Ware, 1981), Both measures were administered to a sample of Veterans Administration (VA) medical outpatients (N = 181). Only minimal evidence of convergence was found between corresponding scales of the two MHLC instruments. Low convergent validity appears attributable to the poor internal consistency reliability of the Lau-Ware subscales. Moreover, results of factor analysis largely supported the a priori factor structure of the K. A. Wallston et at. (1978) MHLC instrument but failed to support the factor structure of the Lau-Ware instrument, Health locus of control (HLC) dimensions that emerged from simultaneous factor analysis of both instruments were most consistent with a three-dimensional typology (i.e., Personal Control, Professional Control and Chance) rather than the four-dimensional typology proposed by Lau (Lau, 1982; Lau & Ware, 1981). Implications for HLC conceptualization and measurement are discussed.     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition.     

Posttraumatic stress disorder and physical health symptoms among women seeking help for relationship aggression.

This study examined associations between intimate partner aggression and physical health symptoms among a sample of help-seeking women experiencing relationship aggression (N = 388). Using a structural equation modeling framework, the authors found posttraumatic stress disorder (PTSD) symptoms to fully mediate the associations of both physical and psychological aggression with physical health symptoms. The influence of PTSD symptoms on physical health symptoms was partially mediated by anger/irritability. Results were consistent with studies from other trauma groups suggesting that PTSD is pivotal with respect to explaining the effects of trauma on health.     

The health of employed women and men: work,family, and community correlates

Research into clarifying the relationship between social roles and health has increasingly focused on studying the particular circumstances in which occupying multiple roles may enhance or diminish well‐being. This study examined the association between a general measure of well‐being—self‐rated health—and the perceived quality of work, family and community in a sample of employed urban‐dwelling Canadians in a mid‐size city, and whether the nature of the association differed for men and women. Few gender differences were found in the perceived quality of work, family and community. However, men and women differed significantly in the specific type of quality measures associated with general health. For women, satisfaction with one's partner/spouse and in the money available to meet basic family needs had a stronger association with self‐rated health. For men, the significant correlates were satisfaction with family relationships (other than one's partner) and the community physical environment. For both women and men, a more socially cohesive community was associated with better self‐rated health. Copyright © 2006 John Wiley & Sons, Ltd.     

Measuring health beliefs on the Internet: A comparison of paper and Internet administrations of the Multidimensional Health Locus of Control Scale

A growing number of studies have supported the use of unidimensional psychometric test instruments administered via the Internet; however, support for the use of multidimensional scales is weak. The present study compares paper and Internet administrations of the Multidimensional Health Locus of Control (MHLC) Scale (Wallston & Wallston, 1981). In terms of reliabilities and factor structures, the Internet data were found to be at least as good as the paper data. MHLC scores were comparable for paper and Internet administrations, although the Internet sample scored significantly lower on the Powerful Others subscale. Overall, the results show that administration of the MHLC Scale via the Internet can produce data comparable to that obtained by pen-and-paper methods. However, it is concluded that generalization of these findings beyond the psychometric test instrument and sampling procedures used here is not warranted.     

Self-perception of health and fitness among French and Tunisian men and women

This work examines the effects of sex and culture on physical self-perceptions. The aim was to compare the perception of physical fitness of French and Tunisian men and women. 400 individuals ages 20 to 35 years assessed their own fitness, endurance, strength, flexibility, body composition, and health according to specific category scales by completing a questionnaire. In general, the Tunisian group rated themselves higher than the French group. It appears that perceived physical fitness was related mainly to perceived endurance for both groups. Some disparities were observed between the two nationalities. Analysis showed an interaction between sex and culture (French vs Tunisian). For French men and women and Tunisian men, perceived physical fitness was more associated with perceived endurance, whereas for Tunisian women, perceived physical fitness was more strongly associated with flexibility. These data show that self-perception of physical fitness is a dimension which varies between individuals from different cultures.     

Factorial structure of two health belief measures among older adults.

Confirmatory factor analysis of Wallston's Multidimensional Health Locus of Control Scale and Krantz's Health Opinion Survey was conducted using 197 nondiabetic and 171 diabetic older adults. Qualified support was found for the 3-factor structure of the Wallston measure when applied to older adults. The Krantz model provided a less-than-adequate representation of the older sample's data. When the items from these 2 measures were combined, a 4-factor structure was found. Multisample simultaneous factor analyses using LISREL revealed that the factor structures of the Wallston and the Krantz measures fit the diabetic and the nondiabetic samples fairly equivalently. Despite the similarities in factor structures, diabetic individuals reported greater belief in powerful others and less desire for behavioral involvement in the health-care process than did nondiabetics.     

The role of personality factors in predicting the reported physical health symptoms of Turkish college students

This study investigates the role of optimism, health control beliefs, perceived health competence, and medical help-seeking variables in predicting the frequency of reported physical symptoms. A total of 345 college students (207 male and 138 female) were presented with the Life Orientation Test, Multidimensional Health Locus of Control, Perceived Health Competence Scale, and Physical Symptom Checklist. Separate stepwise multiple regression analyses were applied to the data obtained from males, females, and the total group of students. Results showed that optimism, medical help seeking, chance health locus of control, and internal health locus of control predicted the reported physical symptom scores of the total sample. Also revealed were the different patterns for males and females. While optimism and internal health locus of control best predicted physical health for males, optimism and chance health locus of control best predicted the physical health symptoms of females.     

Later life health optimism,pessimism and realism: Psychosocial contributors and health correlates

Prior research has established positive outcomes of health optimism (appraising one's health as good despite poor objective health (OH)) and negative outcomes of health pessimism (appraising health as poor despite good OH), yet little is known about their contributors. We examined the role of psychosocial factors (life event stress, depression, dispositional optimism, perceived social support) in health realism (appraising health in accordance with OH), optimism and pessimism among 489 older men and women. We then accounted for the psychosocial factors when examining multiple health correlates of health realism, optimism and pessimism. Controlling for age, gender and income, regression results indicate that depression and social support were associated with less health optimism, while dispositional optimism was associated with greater health optimism among those in poor OH. Dispositional optimism was associated with less health pessimism and life event stress was associated with greater pessimism among those in good OH. Beyond the effects of the psychosocial factors, structural equation model results indicate that health optimism was positively associated with healthy behaviours and perceived control over one's health; health pessimism was associated with poorer perceived health care management. Health optimism and pessimism have different psychosocial contributors and health correlates, validating the health congruence approach to later life well-being, health and survival.     

Later life health optimism, pessimism and realism: psychosocial contributors and health correlates

Prior research has established positive outcomes of health optimism (appraising one's health as good despite poor objective health (OH)) and negative outcomes of health pessimism (appraising health as poor despite good OH), yet little is known about their contributors. We examined the role of psychosocial factors (life event stress, depression, dispositional optimism, perceived social support) in health realism (appraising health in accordance with OH), optimism and pessimism among 489 older men and women. We then accounted for the psychosocial factors when examining multiple health correlates of health realism, optimism and pessimism. Controlling for age, gender and income, regression results indicate that depression and social support were associated with less health optimism, while dispositional optimism was associated with greater health optimism among those in poor OH. Dispositional optimism was associated with less health pessimism and life event stress was associated with greater pessimism among those in good OH. Beyond the effects of the psychosocial factors, structural equation model results indicate that health optimism was positively associated with healthy behaviours and perceived control over one's health; health pessimism was associated with poorer perceived health care management. Health optimism and pessimism have different psychosocial contributors and health correlates, validating the health congruence approach to later life well-being, health and survival.     

Religiosity, health, and well-being among Kuwaiti personnel

In a sample of 424 Kuwaiti personnel (219 men, 205 women; M age = 37.6 yr., SD = 8.9; M age = 33.4 yr., SD = 7.9, respectively), self-ratings of religiosity were significantly and positively correlated with the self-ratings of physical health, mental health, and happiness, as well as the Oxford Happiness Inventory, the Love of Life Scale, and the Satisfaction with Life Scale among men and women. Principal components analysis of the correlation matrix yielded only one salient factor labeled "Well-being, health and religiosity" that explained 52.7% and 56.5% of the variance for men and women, respectively. Religiosity is an important element in the lives of the majority of the present sample of Kuwaiti Muslim employees.     

Trauma and Health Symptoms in a Community Sample: Examining the Influences of Gender and Daily Stress

Although there is a rich body of literature on trauma and health, limited research has investigated the variables of gender, trauma symptoms, physical health, mental health, and daily stress together in a community sample. Considering the deleterious effects of trauma on health, our overarching inquiry was whether trauma symptoms can predict overall mental and physical health with attention to gender and daily stress as potential moderators. Participants (n = 103; 50.5% women) completed self-report measures of trauma symptoms, mental health, physical health, and daily stress, along with demographic information. Trauma symptoms predicted 25.2% of the variance in general health symptoms. Gender significantly added to the variance accounted for, but daily stress was not significant in the model. Trauma symptoms predicted 37.1% of the variance in mental health symptoms. Daily stress significantly added to the model, but gender did not. Results are interpreted through the integration of family stress theory and feminist frameworks, adding to the literature by further illuminating the relationships between gender, daily stress, health symptoms, and trauma in a community sample.     

Effects of alcohol abuse and familial alcoholism on physical health in men and women

Detoxified alcoholic men (n = 76) and women (n = 72) and nonalcoholic control men (n = 50) and women (n = 51) were given a structured interview that assessed five categories of physical health: medical history, alcohol-related disorders, trauma history, drug use history, and, for females, female-related disorders. Approximately half the subjects in each group were family history positive for alcoholism. Significant differences between alcoholics and controls were found for all five categories; family history effects were significant for four of the five categories, and sex differences were present in two categories. The results indicate that (a) alcoholics suffer pervasive physical health difficulties, (b) a family history of alcoholism is predictive of health problems in both alcoholics and controls, (c) the effects of alcohol abuse and family history of alcoholism on health appear to be independent and additive, and (d) women may be more "illness prone" than men and exhibit an increased vulnerability to the adverse effects of alcoholism.     

The other way around: does health predict perceived support?

The aim in this study was to identify predictors of perceived social support before and after cataract surgery. We hypothesized that physical (comorbidity and visual acuity) and mental (depressive symptoms) health indicators would be directly and indirectly (through actually received support) associated with perceived support. One hundred and thirty-six cataract patients (69% women; mean age = 71.6 years) completed questionnaires before and after cataract surgery. Results showed that received support partially mediated the association between depressive symptoms and perceived support. However, mental and physical health variables were also directly associated with perceived support. We conclude that health status might feedback to perceptions of available support.     

Physical fitness, body image, and locus of control in college freshman men and women

This study examined the relations among physical fitness, body image, and locus of control. The Hall-Physical Fitness Test Profile, the Winstead and Cash Body Self-relations Questionnaire (BSRQ) and the Nowicki-Strickland Locus of Control Scale were administered to 243 freshmen. Women were significantly more positive about their physical appearance than men. Men were more positive about their physical fitness than women. Men were more physically fit than women. Men and women scoring in the internal direction viewed the physical fitness domain of their body image positively. Unlike men, internally oriented women had more positive perceptions of the health aspect of their body image. Physically fit men and women had positive attitudes toward the physical fitness component of their body image. Physically fit men differed from physically fit women in that men were more internal and held more positive attitudes toward the physical health dimension of their body images.     

Some correlates of health locus of control among multicultural individuals

The relationship of locus of control to depression, anxiety, hostility, and physical health was assessed in a sample of multicultural college students (N = 162). Powerful Others Health Locus of Control was correlated with depression, anxiety, hostility, and recent physical symptoms while Chance Health Locus of Control (CHLC) was correlated with all of the above as well as chronic physical symptoms and major health problems. When controlling for a variety of health risk factors (viz., age, sex, body mass, exercise, smoking, salt, alcohol, and caffeine), only CHLC remained significant in the physical health models. Results support the cognitive model of mental health which emphasize the importance of adaptive beliefs. Specifically, they suggest that issues about control are related to negative affect and indicate that the often-cited relationship of an external locus of control to depression and anxiety also holds for hostility. The findings do not, however, support the view that anxiety and depression are associated with different types of external locus of control but rather suggest a unified set of locus of control beliefs underlying the three types of negative affect. In addition, evidence is provided for the external validity of the Multidimensional Health Locus of Control (MHLC) Scales with respect to mental health. Further, the results indicate that belief about one’s health may play a significant role in one’s physical health and that the health behavior model of the relationship between locus of control and physical health is insufficient to explain the relationship. As the Chance and Powerful Others MHLC scales were not related to health habits in this sample but were related to mental health (viz., depression, anxiety, and hostility), locus of control beliefs may be related to physical health via their relationship with mental health.