Spiritual health locus of control and breast cancer beliefs among urban African American women.

The present study examined the relationship between spiritual health locus of control, breast cancer beliefs, and mammography utilization among a sample of 1,227 African American women from urban public health centers. Spiritual health locus of control was conceptualized as having an active and passive dimension, empowering individuals in their health beliefs and behaviors or rendering them to rely on a higher power (e.g., God) to determine their health outcomes, respectively. The active dimension was negatively associated with perceived benefits of mammography and positively associated with perceived barriers to mammography. The active and passive spiritual dimensions are distinct from internal and external health locus of control. Further study of their associations with other health-related beliefs and behaviors is warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of health locus of control beliefs and expectations of treatment efficacy in adjustment to cancer.

Examined the effects of health locus of control beliefs (self-, doctor, and chance control) and expectations of treatment efficacy on short-term psychological adjustment in 137 18–86 yr old newly diagnosed cancer patients. The role of these beliefs and expectations in moderating the relation between perceived and actual disease severity and depression was also examined. Ss completed an intake questionnaire assessing the perceived severity of illness, the amount of pain or discomfort they were experiencing, how sad or depressed they were, and expectations about complying with medication instructions; Ss also completed items from Rotter's Internal–External Locus of Control Scale, the Multi-Dimensional Health Locus of Control Scale, and the Self-Rating Depression Scale. The relation between perceptions of disease severity and depression was weaker for Ss who believed that they could personally control their health and for those who held positive expectations about the effects of complying with medical treatment. Similar patterns were found when disease severity was defined in terms of prognosis for survival. Strong negative correlations between self-control/treatment expectations and depression were found for Ss who perceived that their illness was severe. The results for chance and doctor control were less consistent. The stability of health control beliefs and treatment expectations over the course of a serious long-term illness is discussed. (34 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Origins of health locus of control beliefs.

Explored the origins of health locus of control (HLC) beliefs using a multidimensional HLC battery that was administered to 270 undergraduates. A structural equations analysis showed that beliefs in Self-Control Over Health were positively related to early health habits involving self-care and medical professionals and negatively related to prior family experiences with sickness. Beliefs in Provider Control Over Health were positively related to early health habits involving medical professionals and negatively related to prior sickness experiences in one's family. Beliefs in Chance Health Outcomes were positively related to prior sickness experiences. None of these dimensions of HLC were affected by recent sickness experiences, supporting a view of HLC beliefs as fairly stable individual-difference measures developed relatively early in life. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of a community health center intervention on breast cancer screening among Hispanic American women

OBJECTIVE: A multiple component intervention in a community health center is presented, and its effect on breast cancer screening participation by Hispanic American women between the ages of 45 and 75 years is discussed. DATA SOURCES/STUDY SETTING: In 1990, data were collected through a retrospective audit (at least as far back as 1987) of community health center medical records, as well as from a client referral log. The health center, located in a small Massachusetts city, primarily serves clients of Latino heritage. STUDY DESIGN: The study used a nonexperimental pretest-posttest intervention design to document clients' screening activities. To control for uneven length of enrollment, aging of the population, and sporadic utilization, the unit of analysis chosen for the principle study variables was an "eligible year." DATA COLLECTION: Variables of interest included screening (clinical breast exam and mammography), periodicity of screening, and compliance with referrals. PRINCIPAL FINDINGS: Postintervention, considerably greater screening mammography occurred among all age groups, more women had at least one screening mammogram during the period, more clinical breast exams included a mammogram referral, and the compliance rate improved. The rate of clinical breast exam did not significantly improve, showing a downward trend.     

Hispanic cultural health beliefs and folk remedies

Cultural awareness of health care practices and beliefs is increasing, but knowledge regarding Hispanic folk remedies and health care practices and beliefs is limited. This study used a focus group interview format for an open discussion of folk remedies and the health and illness practices of the participants. Eleven Hispanic women participated in a group interview that addressed the question, How do Hispanic health beliefs affect health care practices? Specifically, what actions are taken to treat symptoms of illness or injury? Qualitative data analysis of the 75 symptom and treatment statements was completed, and data were grouped according to symptom and complexity of treatments. This resulted in a rich compilation of remedies that Hispanics use in home treatments, with the emergence of a pattern comparable to the nursing process. This information adds to the current knowledge base of cultural health practices and provides a basis for continued research.     

Acculturation and breast cancer screening among Hispanic women in New York City

Surfactant protein D (SP-D), which has structural homology to C-type lectin binding regions, may play a role in host defense and has no known surfactant function. Because other surfactant proteins have been shown to be increased after prolonged periods of hyperoxia, we sought to evaluate the early effects of hyperoxia (95% O2) on expression of SP-D in the adult male rat lung. Animals were exposed to air or to 12, 36, or 60 h of 95% O2. Northern blot analysis of total lung RNA revealed marked SP-D mRNA increases at 12 h 95% O2 compared with air-exposed controls, with decreasing expression to near that of air-exposed animals by 60 h. Semiquantitative in situ RNA hybridization demonstrated parallel results, with increased numbers of labeled alveolar epithelial (AE) and bronchiolar epithelial (BE) cells at 12 h and increased intensity of labeled alveolar cells, compared with air-exposed controls. After 60 h of exposure to 95% O2, mRNA label intensity in AE and BE was decreased to levels near those seen in air-exposed animals. In contrast, Western blotting showed a decline in total lung SP-D with 95% O2 exposure, beginning at 12 h and continuing at 36 and 60 h, respectively. Semiquantitative immunohistochemistry demonstrated a decline in AE labeling parallel to the total lung Western blot results, but labeled total BE cell numbers increased (P = 0.10). Hyperoxia had differential effects on SP-D abundance in AE and BE cells, and therefore may influence the availability of SP-D to bind microbial pathogens in the airways depending on cell type and location.     

Abuse, health locus of control, and perceived health among HIV-positive women.

This study of 230 predominantly poor Hispanic and African American women aged 25 to 61 years living with HIV/AIDS in New York City revealed high levels of both sexual (39%) and physical (44%) trauma before the age of 16. Both types of early trauma were correlated with later trauma, and all forms of trauma were significantly associated with current perceived health. In multivariate analyses controlling for relevant covariates, the Powerful Others and Internal Control subscales of the Multidimensional Health Locus of Control Scales (K. A. Wallston, B. S. Wallston, & R. DeVellis, 1978) acted as independent predictors of perceived health rather than (as hypothesized) mediators of the association between trauma and perceived health. Findings underscore the importance of addressing trauma and perceptions of control over one's physical health in the provision of health services to HIV-positive women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of control and health beliefs.

Conducted 2 experiments with a total of 335 nonacademic university staff to investigate relationships among beliefs about personal control over events, control of health, perceptions of disease, and health-related practices. Questionnaire responses indicate that general expectancy for control was related to beliefs in the efficacy of actions, while measures of health control were related to taking action. A revised measure of control that distinguished expectancy and motivation yielded higher relationships between general and health content, and proved useful in understanding health beliefs and behavior. Results are discussed relative to the meaning of control for health and illness. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in the academic locus of control beliefs of young children.

Conducted a statistical combination on past research examining gender differences in the locus of control beliefs of elementary school children. The review revealed that 235 females tended to score more internally than 200 males in total- and failure-outcome locus of control, as measured by the Intellectual Achievement Responsibility (IAR) Questionnaire. A new administration of the IAR (210 males, 215 females) revealed significantly more female internality for both success and failure outcomes—but only at the end of the school year. Also, females cited effort as the cause of success more often than males. These results are at odds with those found in studies that manipulated success and failure events. Possible reasons for the reversal are discussed. The results suggest (a) greater female internality exists in elementary school, but the gender difference is small; (b) the roots of lesser female adult achievement behavior may not be found in elementary school belief systems; and (c) it may be improper to conclude that young females express a helplessness pattern of attributions with regard to the achievement domain. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Knowledge, beliefs, attitudes, and cancer screening among inner-city African-American women

Three hundred twenty-one inner-city African-American women were interviewed to determine their knowledge, attitudes, and beliefs regarding cancer and cancer screening, and their cancer screening histories. The women were recruited from a variety of sources in Atlanta and were interviewed in their homes by trained lay health workers. Half of the subjects had an annual household income of < $15,000. About half had received a Pap smear and clinical breast examination within the year preceding the interviews. For women > 35 years old, 35% had received a mammogram within the recommended interval. Younger women and women with higher incomes were more likely than older women and those with lower incomes to have received a Pap test and clinical breast examination within the preceding year, but income was not significantly associated with mammography histories. In general, women who were more knowledgeable about cancer and its prevention were more likely to have been appropriately screened. However, various attitudes and beliefs regarding cancer generally were not associated with screening histories. We conclude that cancer screening programs for inner-city minority women should focus on improving knowledge levels among older women rather than attempting to alter attitudes and beliefs.     

The effects of health beliefs on screening mammography utilization among a diverse sample of older women

Screening mammography is particularly effective in detecting breast cancer in elderly women. Yet, although half of all breast cancers are diagnosed in older women, statistics show that women aged 65 and over tend to underutilize screening mammography. Prior research has used the constructs of the Health Belief Model to explore attitudes and beliefs relative to breast cancer screening. Prior studies have also identified health beliefs and concerns relative to screening mammography and race/ethnicity as some of the patient-related predictors of screening mammography utilization among younger women. This study uses the theoretical framework of the Health Belief Model to explore the effects of these variables on utilization in a multiracial, multiethnic, random sample of 1011 women, aged 65 and over. Race/ethnicity, belief that mammograms detect cancer, ease the mind, and provide accurate results; concern over the radiation, pain, and cost associated with receiving a mammogram; and other independent variables were tested as predictors of screening mammography utilization. Regression analysis identified that the belief that having a mammogram eases recipients minds was the most significant predictor of screening mammography utilization. None of the other health beliefs or health concerns were significant predictors. Race/ethnicity had no direct effects on utilization nor was it a confounder in the relationship between health beliefs, concerns and utilization. These results indicate that, along with emphasizing the importance of mammograms in early detection of breast cancer, stressing the reassurance that mammography brings recipients may be an effective health education strategy for elderly women of different racial/ethnic backgrounds.     

Fear of success and locus of control in young women.

Administered Rotter's Internal-External Control Scale and M. Horner's incomplete story lead designed to evoke achievement anxieties to 108 female undergraduates. The motive to avoid success was significantly positively associated with external control scores. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Update: cancer screening in women

Current cancer screening recommendations for women have been reviewed. Controversies have been identified. Many additional references are available upon request.     

Role ambiguity, locus of control, and work satisfaction.

Administered a questionnaire containing Rotter's Internal-External Control Scale, a measure of role ambiguity, and 2 measures of job satisfaction to 94 scientists and engineers employed in an electronics firm. Results indicate that locus of control was related to both role ambiguity and satisfaction and that locus of control provided a greater independent contribution to satisfaction than did role ambiguity. Implications for interpreting scores on measures of role ambiguity are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of PSA testing in multiphasic health screening

BACKGROUND: Although mass screening for prostate cancer does not meet the criteria for an effective screening programme, multiphasic screening which includes PSA testing is still being carried out. AIM: We decided to study and evaluate the usefulness of PSA testing in multiphasic health screening and at the same time establish age-specific ranges of normal PSA values in our local population. RESULTS: Six hundred and ninety five male patients who had their PSA levels tested during a multiphasic health screening from October 1992 to August 1995 were evaluated. Abnormal PSA levels were repeated and subjected to a DRE and TRUS biopsy if they were persistently high using age-specific PSA ranges. Our results showed 14 (4.1%) out of 695 patients who had an abnormal PSA of > 4 ng/mL. compared to 19 who had abnormal PSA levels using the age-specific PSA ranges. Of the patients who were < 40 yrs of age, no further investigations were done. Amongst those 80 years and older, none had abnormal age-specific PSA rates. No prostate cancers were picked up amongst all the patients investigated. Median age specific PSA values at the 95th percentile was calculated for each age group. A rise in the median PSA values with age was also noted. CONCLUSION: We recommend that in patients less than 40 years of age, PSA should not be carried out as the probability of prostate cancer is almost zero. Similarly, in patients who are 80 years and above and asymptomatic, such screening may not be indicated given the limited options available. Age-specific rates are a better way to reduce the negative biopsy rates in the age-groups that are amenable to curative treatment. With a local set of age-specific PSA ranges, we hope to increase the positive predictive value of PSA for prostate cancers in our local population until more specific and equally sensitive tests are made available.     

Health locus of control and value for health in smokers and nonsmokers.

A representative sample of 11,401 persons completed a questionnaire, including measures of health locus of control, value for health, and smoking frequency. Smokers held stronger internal, chance, and powerful others beliefs than never smokers. Ex-smokers had lower scores on internal and chance dimensions and placed a higher value on their health than smokers. The interaction between chance health locus of control and value for health was a significant predictor of smoking status, suggesting that health value may moderate the relationship between health locus of control and smoking status. Within smokers, the health locus of control dimensions and value for health explained less than 1% of the variance in smoking frequency, with only the chance dimension emerging as a significant predictor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of sexuality in cervical cancer screening among Chinese women.

Objective: Chinese women have significantly lower rates of Papanicolaou (Pap) testing than Euro-Canadian women despite efforts to promote testing. Evidence suggests that Chinese women's reluctance to undergo Pap testing may be related to culture-linked discomfort with sexuality. The purpose of this study was to explore the role of sexuality in the interaction between acculturation and Pap testing. Design: Euro-Canadian (n = 213) and Chinese (n = 260) female university students completed a battery of questionnaires. Main Outcome Measures: Questionnaires assessing sexual knowledge, sexual function, acculturation, and Pap testing frequency. Results: Euro-Canadian women had significantly more accurate sexual knowledge, higher levels of sexual functioning, a broader repertoire of sexual activities, and higher Pap testing rates. Chinese women were more likely to cite embarrassment as a barrier to Pap testing. Heritage acculturation, but not mainstream acculturation, predicted Chinese women's Pap testing behavior. Mainstream acculturation was associated with more accurate sexual knowledge and greater sexual desire and satisfaction. Conclusion: The findings provide support for the hypothesis that low Pap testing rates in Chinese women may be associated with heritage acculturation, although the hypothesis that sexual function would predict Pap testing behavior was not supported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Observed maternal strategies and children's health locus of control in low-income Mexican Americans.

This study examined the relationship among mothers' health locus of control (HLOC) beliefs, their socialization strategies, and their children's HLOC beliefs in 80 low-income Mexican American families. Maternal socialization strategies were assessed from videotaped interactions of mothers and children engaged in a structured task. Factor analysis of the coded strategies yielded 4 factors: Tell Answer, Teaching, Clarify, and Reinforce. Findings indicated that maternal-health-internally scores negatively predicted mothers' use of the Tell Answer strategies and positively predicted their use of Teaching strategies. Mothers who believed that Powerful Others (e.g., health professionals) controlled their health were more likely to use the Tell Answer strategy. In contrast, mothers who believed that health was due to chance were less likely to use Teaching. Maternal use of Teaching strategies predicted children's internal HLOC, whereas maternal Tell Answer strategies predicted children's external HLOC. Findings suggest that mothers' HLOC beliefs influence the socialization strategies they use and that these strategies are associated with children's HLOC beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributions, beliefs about control, and adjustment to breast cancer.

Examined attributions for cancer and beliefs about control over cancer for their association with adjustment to breast cancer. 78 29–78 yr old females with breast cancer served as Ss. Ss were administered a battery of tests that included the Profile of Mood States, Rotter's Internal–External Locus of Control Scale, and the Rosenberg Self-Esteem Scale. Although 95% of the Ss made attributions for their cancer, no particular attribution (e.g., stress, diet) was associated with better adjustment. Analyses of attributions of responsibility for the cancer to the self, environment, another person, or chance yielded only a negative relation between adjustment and blaming another person. In contrast, both the belief that one could now control one's cancer and the belief that others (e.g., the physician) could now control the cancer were significantly associated with good adjustment. Of the different types of control, cognitive control was most strongly associated with adjustment, behavior control was less strongly associated with adjustment, and information control and retrospective control were unassociated with adjustment. (56 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)