The Effect of Health Value on Health Locus of Control - Research Paper Example

The affect of Health Value on Health Locus of Control The research study surveyed a group of individuals to establish a co-relation between two variables – health value and health locus of control (HLOC). The results and findings established that higher HLOC scores indicated high internal locus of control and that high health value strongly correlated with evidence of high internal LOC. The introduction to the research study explores the significance attached to these two variables and the theoretical considerations that have helped in understanding the role played by HLOC in improving clinical practices. Introduction Individual beliefs and perceptions have a significant influence on their health. Research studies and works in this direction have proved that these beliefs affect individual behaviour in terms of their eating habits, medication routine or following their doctors’ instructions. Such behavioural aspects also have a strong impact on the individual’s physiological system and its effects on the immune system or cardiovascular systems. Research evidence has also supported the belief that the patient’s health conditions are also influenced by the beliefs and perceptions of the health professionals. The health professionals’ belief impacts the nature of treatment adopted and the way it impacts the patient’s own perception on his health condition and subsequent health behaviour (Broome and Llewelyn, 1995). The theoretical approaches and research findings over the decades have sought to explain the impact of such variables on individual health behaviour and the extent to which it predicts health outcomes. Different models have sought to explain health related behaviours and among these models the locus of control has been the focus of much research. The locus of control refers to “the degree to which individuals perceive events in their lives as being a consequence of their own actions, and thereby controllable (internal control), or as being unrelated to their own behaviour, and therefore beyond personal control (external control)” (Bahar, 1988, p45). The work on health locus of control (HLOC) has been inspired by Rotter who conceptualized the measurement scale to evaluate individual behaviour or expectancy in different dimensions. These dimensions include internality, powerful others and chance (Broome and Llewelyn, 1995). The internal HLOC relates to the individual belief that their health outcomes is attached to their health behaviour and hence it can be controlled, powerful others HLOC indicates that individual health is dependent on the behaviour of others within the immediate environment and over which there is very little control, and chance HLOC relates to the belief that health outcomes are determined by chance (Keedy, 2009). Individual health related behaviour according to the LOC concepts explain that people in general are guided by their expectancies that conform to the belief that reinforcements are directly related to their own behaviour, reinforcements are guided by powerful other factors, and thirdly that reinforcements are driven by chance (Keedy, 2009). The key emphasis of this conceptual model is that individuals displaying high internal HLOC are more likely to engage in behaviour that they perceive will control their health as opposed to individuals displaying high external HLOC or belief that health outcomes are beyond their control. The HLOC scales are used to measure generalized expectancies that reflect individual response and reactions to health related situations. Individual behaviour is controlled by these expectancies that help in predicting different health related behaviours that include alcoholism, diabetes, dental health, and preventive health care. The concept of health value refers to the “degree to which an individual values health in comparison to other important life values” (Brown, 2007, p6). The health value parameter has been much neglected in research field assuming that individuals in general place high value to health. However Lau, Hartman, and Ware in their research studies on the theoretical considerations of health value (1986) observed that health value plays an important role in determining individual health related behaviour. Their research findings indicate that high health value scores are directly linked to positive health behaviour and consciousness of the fact that such behaviour can be controlled through preventive or restrictive measures. The research findings have established a positive correlation between women who strongly believe that they are in control of their own health were more likely to go for regular health checkups rather than those who believed in chance determining their health outcomes (Lau et al., 1986). The studies by Brown (2007) and Lau et al., (1986) have established the positive implications of health value in driving positive health related behaviours. These studies have asserted that the “belief that one’s own health is controllable, either by oneself or others, together with a high value on health, is more likely to be associated with engaging in health promoting behaviours than believing one’s health is uncontrollable and placing a low value on health” (Broome and Llewelyn, 1995, p5). The works of Stein, Smith and Wallston (1984) reviews the measurement of HLOC and its implications in cross-cultural environment indicate that health behaviours, beliefs and outcomes are strongly co-related to cultural beliefs. The cultural environment shapes the expectancy of individuals in context of health, illness, treatment and recovery. Religious sentiments strengthen the belief that individual behaviour cannot control health outcomes since it is God who decides the fate of individuals. Similarly, areas having less developed health care services will display a trend toward self-reliance and increased belief in the role of fate, chance or luck in determining health outcomes (Stein et al., 1984). Evidences of the role of religion, faith and HLOC in predicting health related behaviour associated with smoking and drug abuse were substantiated by the works of Willis, Wallston and Johnson (2001). The findings indicate that while religious beliefs and supported positive behaviour outcomes in context of smoking and drug abuse, other considerations also played an important role in predicting behavioural outcomes. These considerations involved perception of control, self-efficacy, coping strategies and strong internal locus of control. An effective intervention strategy hence should be effectively integrated with religious and spiritual beliefs to reduce smoking, alcoholism, and drug abuse (Willis et al., 2001). Over the years a number of research studies have focused on analyzing the utility and contribution of the HLOC scales of measurement in defining health behaviours and its implications on clinical practice. Rock, Meyerowitz, Maisto, and Wallston (1987) studied the inter-relationship between the six multidimensional HLOC clusters and its implications on clinical practices. The research findings suggest theoretical foundation of the six clusters identified as pure internal (high internal, low chance and powerful others), double external (high chance, and powerful others and low internal), pure chance (high chance, low internal and powerful others), yea sayer (high on all scales), nay sayer (low on all scales), and believer in control (high internal and powerful others, low chance). Rock et al., (1987) felt that these six clusters can provide the means for a more meaningful and accurate prediction of health related behaviours. The clusters provided reliable data that confirms the existence of these six clusters. Another study by Kenneth Wallston, Barbara Wallston, Shelton Smith and Carolyn Dobbins (1987) investigated the role of perceived control on health outcomes. The research findings indicate that there is a complex relationship between perceived control and individual health outcomes. Wallston et al., define perceived control as the “belief that one can determine one’s own internal states and behaviour, influence one’s environment, and/or bring about desired outcomes” (p5). The study infers that perceived control alone cannot predict any health related behavioural outcome. It works in conjunction with other dimensions that have some influence over the perceived control factor. Internal HLOC takes into account other components such as health value and other behavioural or outcome expectancy that determines individual health related behaviour. Research hypothesis Based on the review of existing research works and theoretical arguments, this study proposes the following hypothesis – High scores in the measurement of health locus of control indicate higher internal locus of control. Null hypothesis – High scores on chance and powerful others indicate lower locus of control. Research aims and rationale The review of existing research studies and conceptual models used in health psychology highlight the significance of the concept of health locus of control in defining and predicting individual health related behaviour. Individual health value and locus of control can provide the health practitioners with positive guidelines on delivering effective health care services. This research study aims to explore the impact of high scores on health locus of control parameters. Method The findings and analysis of the research hypothesis was based on primary data collected using questionnaires. The responses to the questionnaires were then analyzed using statistical analytical tools such as SPSS and Anova. The findings from this analysis formed the basis for further discussion and observations in the research context. Participants 10 undergraduate from different departments all from Bedfordshire university 4(men) and 6 (women) gave informed consent and participated in filling the questionnaire. Materials The questionnaire was based on a scale developed by Wallston (1978) in his works “Development of the multidimensional health locus of control (MHLC) scale”. The questionnaire was designed to determine the way in which different people view certain important health related issues. Each item is a belief statement with which the participants may agree or disagree. The questionnaire comprises of 18 statements. The respondents were asked to provide their opinion to these statements by selecting one of the options given next to these statements. The options provided a scale of measurement that ranges from strongly disagree (1), moderately disagree (2), slightly disagree (3), slightly agree (4), moderately agree (5) and strongly agree (6). The more strongly the respondent agrees with a statement, the higher will be the score and the more strongly the respondent disagrees with the statement, the lower will be the score. The research used another scale to determine the respondents’ health value on the basis of the works of Lau, Hartman and Ware (1986). The scale used four statements where the respondent had to choose from seven scales ranging from strongly agree (1) to strongly disagree (7). Procedure The questionnaire was distributed among students of Bedfordshire University Luton campus. The sampling unit comprised of 10 participants of which 4 were male and 6 were female. The selection of the sampling unit was random and they were apprised of the research study aims and objectives before gaining their consent to be a part of this study. They had the option of withdrawing from the sampling unit any time. The participants were asked to sign the questionnaire indicating their consent to be a part of this research study. The health locus of control questionnaire was administered first, and the participants were asked to fill it as quick as they could possibly do it and not to waste any time on any statement. Then health value questionnaire was administered and the same instructions as was given during the first one were done. Once the questionnaires were filled the researcher collected the forms and thanked the participants for contributing to the research study. Results The descriptive statistics which are depicted by the tables show two values of health groups, one is the low health group and the other one is the high health group. The mean is calculated on both the low and high health group. Standard deviation depicted by Sigma is the amount of variation which occurs from the mean or average value. The mean is the average value calculated on the sample population who have filled up the questionnaire. The standard deviation is calculated as a square root of the variance where variance is calculated by the average of the squared differences from the mean. The importance of standard deviation as a result of the sample 10 people’s values is that the degree of variation from the average can be an important factor in the prediction of theories like the Health Locus of Control. Gender Percent Valid Percent Cumulative Percent 45.6 45.6 45.6 54.4 54.4 100.0 100.0 100.0 With a minimum age group of 16 and a maximum of 70, the mean calculated was 27.99 with a sigma of 8.738. Lower the standard deviation, higher the chances of it being close to the mean or average value which is a positive statistical mark indicating that the sample population agree to certain parameters. Descriptive Statistics N Minimum Maximum Mean Std. Deviation Age 90 16 70 27.99 8.738 Valid N (listwise) 90 For example the low health value group amongst males are greater than the female value indicating that the female population are closer to the mean value. Similarly the high health value group females have a lesser sigma value than their male counterparts indicating a similar view point. The other factor of Pearson’s Correlation indicates the positive or negative linear relationship between the variables. The result of the report between the age and health value correlation have been depicted in two divisions, one being the Pearson’s correlation and the other being the Sigma value. Descriptive Statistics Dependent Variable: Internal HLOC Health Value Group Gender Mean Std. Deviation N Low Male 24.7200 5.28772 25 Female 24.6800 3.67106 25 Total 24.7000 4.50510 50 High Male 27.1875 5.50417 16 Female 25.1250 4.71180 24 Total 25.9500 5.07861 40 Total Male 25.6829 5.44261 41 Female 24.8980 4.17455 49 Total 25.2556 4.78190 90 The health value depicts a positive linear relationship while the internal HLOC has a negative linear relationship as compared to the age. In relation to the health value, Pearson correlation and Sigma has a positive linear value and closer sigma value. Tests of Between-Subjects Effects Dependent Variable: Internal HLOC Source Type III Sum of Squares df Mean Square F Sig. Corrected Model 75.580a 3 25.193 1.106 .351 Intercept 56174.295 1 56174.295 2465.366 .000 Health Value Group 46.060 1 46.060 2.021 .159 Gender 24.003 1 24.003 1.053 .308 Health Value Group * Gender 22.211 1 22.211 .975 .326 Error 1959.543 86 22.785 Total 59441.000 90 Corrected Total 2035.122 89 The last correlation in relation to the internal HLOC has a pearson correlation of negative linear value with age and closer to mean value of Sigma for Health Value. Correlations Age Health Value Internal HLOC Age Pearson Correlation 1 .208* -.021 Sig. (1-tailed) .025 .423 N 90 90 90 HealthValue Pearson Correlation .208* 1 .140 Sig. (1-tailed) .025 .095 N 90 90 90 InternalHLOC Pearson Correlation -.021 .140 1 Sig. (1-tailed) .423 .095 N 90 90 90 *. Correlation is significant at the 0.05 level (1-tailed). Discussion It can be discussed based on the results that with the Low and High Value Age group the female population were having a view point which correlates closely with the average value that the Internal HLOC has a greater impact on the belief of people that the perceptions of the people as regards to their internal factors for assessing health is correct. The health value has a positive linear relationship with age and internal HLOC which is a positive interpretation of the statistical value as compared to the theory. Age has a negative linear correlation with the Internal HLOC while Health Value has a positive correlation. It can be inferred from these discussions that closer the values are to +1 or -1 indicates that there is a strong positive or negative correlation between the variables. If values between two variables are strong in a positive linear relationship then the value of Y axis would increase as the value of X axis increases. This indicates a stronger relation to the prediction made. Internal HLOC has been strongly associated with positive health value and this reflects the viewpoint that individuals with strong internals have a more positive mindset when it comes to adopting favourable behaviour for positive health outcomes. Such individuals realize the control they can have over their health conditions rather than leave the situation to chance or powerful others. While these findings validate the research hypothesis that high scores in the measurement of health locus of control indicate higher internal locus of control, it also proves the validity of the null hypothesis that high scores on chance and powerful others indicate lower locus of control. However, health value and HLOC determinants do not always play a positive role in inducing positive health behaviour outcomes, as suggested by the research works of Bennett et al. (1998). The findings of this research revealed that despite the awareness of potential dangers of excessive consumption of alcohol, men and women increased their consumption. Such risky behaviour suggests that health locus of control provides little explanation to the wide variations in the alcohol consumption patterns of men and women. The observations and claims made by the research studies and practitioners in this context reveal that there are many grey areas that require more in-depth investigation. While the measurement scales of HLOC claim to define their health related behaviour and outcomes, practical evidence suggest differently. The variations in individual behaviour and expectancies make it difficult to predict behavioural outcomes. “It is simplistic to believe that health locus of control beliefs will ever predict very much of the variance in health behaviour by itself. The health locus of control scales are not the magic panacea many people believe they are” (Wallston and Wallston, 1981, p236). References Bahar, S. 1988, Health behaviour – emerging research perspectives, Plenum Press. Bennett, P.et al., 1988, Beliefs about alcohol, health locus of control, value for health and reported consumption in a representative population sample, Health Education Research: Theory and Practice, Vol 13, no 1.pp 25-32 Broome, A.K. and Llewelyn, S. 1989, Health psychology: processes and applications, 2nd ed., Champan and Hall. Brown, H.M. 2007, Self-efficacy and health value among undergraduates following a lifetime fitness course, ProQuest. Keedy, H.N. 2009, Health locus of control, self efficacy, and multidisciplinary intervention of chronic back pain, Thesis - University of Iowa. Lau, R.R., Hartman, K.A., Ware, J.E. 1986, Health as a value: methodological and theoretical considerations, Health Psychology, 5(1), 25-43. O’Donnell, M.P. 2002, Health promotion in the workplace, Thomson Learning. Rock, D.L., Meyerowitz, B.E, Maisto, S.A., and Wallstone, K.A. 1987, The derivation and validation of six multidimensional health locus of control clusters, Research in nursing and health, 10, 185-195. Stein, M. andWallsston, K. A. 1983, Biofeedback and locus of control: some considerations for research, American journal of clinical Biofeedback, 6, 40-45. Stein, M., Smith, M., and Wallston, K. A. 1984, Cross-cultural issues in health locus of control beliefs, Psychological studies, 29,112-116. Wallston, K.A. and Wallston, B.S. 1981, Health locus of control scales, Research with the locus of control construct, vol 1, 189-243. Wallston, K.A. 1978, Development of the multidimensional health locus of control (MHLC) scale Health Education Monographs, 6,161-70. Wallston,B.S., Wallstone, K.A, Kaplan, G.D., and Maides, S.A. 1976, The development and validation of the health related locus of control (HLC) scale, Journal of consulting and clinical Psychology, 44, 580-585. Wallston, K. A., Wallstone, B.S., Smith, S., and Dobbins, C. 1987, Perceived control and health, Current Psychological Research and Review, 6, 5-25. Wills, A. S., Wallston, K. A., and Johnson, K. 2001, Tobacco and alcohol use among adult : Exploring religious faith, locus of health control, and coping strategies as predictors, In t. plant and A. Sherman (Eds.) Faith and health, Guilford. Appendices Read More