Health locus of control as perceived by students in Podkarpacie

Health locus of control as perceived by students in Podkarpacie

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Health locus of control as perceived by students in Podkarpacie province
(Umiejscowienie kontroli zdrowia w ocenie studentów województwa
podkarpackiego)
B Stawarz¹,D, M Lewicka2,A, M Sulima2,B, I Brukwicka¹,E, H Wiktor2,F
Abstract – Introduction. The development of civilisation and rapid
urban, technological and information-related changes are connected
to the changes of people’s lifestyle in well-developed societies.
Young people are often insufficiently interested in their health and
make no attempts to protect it. Finding out what students think about
health is important because of the role their opinion plays as far as
their health-related behaviour is concerned.
The purpose of the paper was to estimate the health locus of control
among the students residing in the Podkarpacie province.
Materials and methods. The study involved 690 students from the
Podkarpacie province. The interviews were conducted using an original questionnaire and a standardized research tool – the Multidimensional Health Locus of Control scale (MHLC) was used. The results
obtained were statistically analysed.
Results. The general analysis of the MHLC in the studied group of
students has shown that the mean value of internal health locus of
control was 25,05 points and exceeded the mean powerful others
(18,28 points) and chance scores (18,21 points) in the studied group
of students.
Conclusions. The majority of students indicate an internal health
locus of control. Age and sex have no influence of the health locus of
control in any of the three dimensions. The university and major are
significant as far as students’ health locus of control is concerned,
especially in the cases of powerful others and chance loci. Internal
health locus of control and the awareness of the effectiveness of
one’s actions are relevant influences on assuming health-oriented
attitudes by students. Therefore it is important to popularize the
knowledge on health promotion and preventive care, for instance as
elective courses at all kinds of universities.
własnego autorstwa oraz standaryzowanego narzędzia badawczego Wielowymiarowej Skali Umiejscowienia Kontroli Zdrowia (MHLC).
Uzyskane wyniki badań poddano analizie statystycznej.
Wyniki. Analiza ogólna wyników badania umiejscowienia kontroli
zdrowia (MHLC) w grupie badanych studentów wykazała, że średnia
wartość wewnętrznego umiejscowienia kontroli zdrowia wynosiła
25,05 punktów i była większa aniżeli średnia wartość (18,28 punktów) wpływu innych oraz przypadku (18,21 punktów) w grupie badanych studentów.
Wnioski. Studenci przejawiają w większości wewnętrzne umiejscowienie kontroli zdrowia. Płeć i wiek nie warunkują umiejscowienia
kontroli zdrowa w żadnym z trzech wymiarów. Uczelnia i kierunek
studiów mają istotny wpływ poziom umiejscowienia kontroli zdrowia
wśród studentów, zwłaszcza w zakresie wpływu innych lub przypadku. Wewnętrzne umiejscowienie kontroli zdrowia, poczucie własnej
skuteczności, pozostają nie bez znaczenia na podejmowanie zachowań prozdrowotnych przez studentów. Dlatego istotne jest popularyzowanie wiedzy z zakresu promocji zdrowia i profilaktyki na przykład w ramach zajęć fakultatywnych we wszystkich typach uczelni.
Słowa kluczowe - zdrowie, kontrola zdrowia, student.
Author Affiliations:
1. The Bronisław Markiewicz State School of Higher Technical and
Economical, Jarosław,
2. Department of Obstetrics, Gynecology and ObstetricalGynecological Nursing Faculty of Nursing and Health Sciences,
Medical University, Lublin.
Key words - health, health locus of control, student.
Authors’ contributions to the article:
Streszczenie – Wstęp. Rozwój cywilizacji, dynamika zmian urbaniza-
cyjnych, technologicznych i informacyjnych wiąże się ze zmianami w
sposobie i stylu życia ludzi w społeczeństwach rozwiniętych. Ludzie
młodzi okazują zbyt małe zainteresowanie zdrowiem, jego ochroną i
wzmacnianiem. Poznanie poglądów studentów na temat zdrowia jest
istotne ze względu na rolę, jaką odgrywają one w kształtowaniu zachowań związanych ze zdrowiem.
Celem pacy było określenie poziomu umiejscowienia kontroli zdrowia wśród studentów województwa podkarpackiego.
Materiał i metody. Badaniami objęto 690 studentów z województwa
podkarpackiego. Badania przeprowadzono z zastosowaniem ankiety
A. The idea and the planning of the study
B. Gathering and listing data
C. The data analysis and interpretation
D. Writing the article
E. Critical review of the article
F. Final approval of the article
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Correspondence to:
Dr Barbara Stawarz The Bronisław Markiewicz State School of
Higher Technical and Economical, Jarosław, Ostrów 109, PL-37-550
Radymno, Poland, e-mail: [email protected]
I. INTRODUCTION
he development of civilisation and rapid urban, technological and information-related changes are connected to the
changes of people’s lifestyle in well-developed societies.
Young people are often insufficiently interested in their health
and its protection. An important and yet difficult task before
health education is to make young people realize that it is in
their power to change their lifestyles and health behaviour
[1,2,3].
One of the objectives higher education institutions have to
bear in mind is to propagate the benchmarks of health-oriented
behaviour of students. Graduates, often finding themselves in
leading positions in various aspects of social life, greatly contribute to the shaping of people’s attitudes towards health [4].
Finding out what students think about health is important because of the role their opinion plays as far as their healthrelated behaviour is concerned. Health behaviour can change
within a lifetime and often within the course of studying as
well. As reported in literature, the young people who begin
their studies usually have positive ideas about health behaviour, often thanks to their parents, schools and mass media.
Yet, in order to “fit in” an academic environment, students
often assume common customs, neglecting health-oriented
behaviour in favour of negative habits [5].
Defining the level of health locus of control is an important
factor in assessing higher education students’ health-oriented
awareness. What is more, it is helpful in planning the actions
aimed at encouraging students to assume the desired model of
behaviour.
T
The purpose of the paper was to estimate the health locus of
control among the students residing in the Podkarpacie province.
II. MATERIALS AND METHODS
The research involved 690 students from Podkrpacie province, studying at the following schools:
1. The State Higher Vocational School in Krosno (n=223;
32,32%),
21
2. The Bronisław Markiewicz State Higher School of
Technology and Economics in Jarosław (n=117;
16,96%),
3. The East European State Higher School in Przemyśl
(n=157; 22,75%) and
4. Rzeszów University of Technology (n=193; 27,97%).
The Bioethics Committee of the Medical University of Lublin approved the study. All of the interviewees consented
voluntarily to fill in the questionnaire after they were informed
that the results would be used for scientific purposes only and
their anonymity is guaranteed. The questionnaire was composed of an original survey, prepared in order to be able to
characterize the interviewed students as well as standardized
research tools - the Multidimensional Health Locus of Control
scale (MHLC) by Kenneth A. Wallston, Barbara S. Wallston
and Robert DeVellis (adapted to Polish by Zygfryd Juczyński)
[6]. The Multidimensional Health Locus of Control Scale
(MHLC) allows to separate the interviewed into groups according to the locus of control over health as perceived by
each person. MHLC is a self-descriptive tool including 18
statements in three dimensions of the control over one’s
health:
 internal (I) – the control over my health is dependent
on myself,
 powerful others (O) – my health is dependent on the
influence of others, especially medial staff,
 chance (C) – health is dependent on chance and other
external factors.
The interviewed express their attitude towards the presented
statements by means of a 6-grade scale: from “strongly disagree” (1 point) to “strongly agree” (6 points). The results obtained are calculated separately for each of the three scales
(they are added up). Therefore, the result range in each of the
scales is 6-36 points; the higher the score, the stronger the belief that a given factor influences health. The normalized
scores are the basis for comparisons. The reliability of MHLC
in the Polish version calculated using Cronbach’s alpha is 0,74
for the internal control(I), 0,69 for chance (C) and 0,54 for
powerful others (O).
The results obtained were analysed statistically. The significance level of p<0,05 was assumed to indicate statistically
significant differences and correlations. The database and statistical analysis were prepared using STATISTICA 9.0 software (StatSoft, Poland).
III. RESULTS
Table 1 presents the general analysis of the findings of the
research on health locus of control among the tested students.
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Table 1. Mean values of the MHLC scale in the studied group
of students
Locus of control
M
Min
Max
SD
Internal
25,05
6,00
36,00
5,071
Powerful others
18,28
6,00
34,00
5,523
Chance
18,21
6,00
36,00
5,701
The study has shown that the mean value of internal health
locus of control was 25,05 points and exceeded the mean value
(18,28 points) of powerful others and chance (18,21 points) in
the studied group of students. On the basis of the results obtained it was observed that the interviewed group perceived the
health locus of control as predominantly internal.
The analysis of the correlation between the health locus of
control (MHLC) and sex, age and a subjective health estimation of the students under research was presented in Table 2.
Table 2. The correlation between the health locus of control
(MHLC) and sex, age and a subjective health estimation of the
students under research
Women
Men
Locus of
control
M
SD
Internal
25,01
4,89
Powerful
others
18,39
5,53
Chance
18,13
5,62
Locus of
control
up to 21 y.o.
M
SD
Internal
25,51
5,01
Powerful
others
18,29
5,53
Chance
18,07
Locus of
control
5,72
very good /
good
M
SD
Internal
25,30
4,83
Powerful
others
18,39
5,65
Chance
18,40
5,57
M
25,1
5
17,9
8
18,4
2
21 y.o.
M
SD
24,7
4,94
2
18,2
5,37
4
18,3
5,55
5
average
M
25,0
6
18,1
5
17,5
8
SD
Statistical analysis
SD
t
P
5,55
0,32
0,75
5,50
0,88
0,38
5,93
0,60
0,55
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of male students was 25,15 and exceeded that of female students, which amounted to 25,01 points. The mean value of
powerful others was 18,39 points in the studied group of female students, which was more than in the case of men (17,98
points). Meanwhile the mean value of the chance locus of control was higher in the case of men (18,42 points) than that of
women (18,13 points). In the course of statistical analysis, no
statistically significant differences pertaining to the locus of
control dimensions were found (p>0,05).
What is more, the research indicates that the mean value of the
internal locus of control among the interviewed students of no
more than 20 years old was 25,51 points, while it amounted to
24,72 points in the age group of 21 and to 24,82 points above
21 years of age. At the same time, the mean value of powerful
others locus was 18,29 points in the group of no more than 20
years of age, 18,24 points among the interviewed who were 21
years old and 18,32 points in the age group above 21. Finally,
the mean value of the chance locus of control was higher in the
group of exactly 21 years of age (18,35 points) than in the
group below 21 (18,07 points) and over 21 (18,24 points). No
statistically significant differences between the dimensions of
the health locus of control were observed (p>0,05).
On the basis of the research conducted it was noted that the
mean value of internal locus of control among the students
under research who rated that their health as very good or
good was 25,30 points and was higher than in the case of students who claimed they were of average health (25,06 points)
and those who perceived their health as poor or very poor
(24,60 points). This difference did achieve the level of statistical significance (p<0,00003).
Table 3 presents the correlation between the health locus of
control (MHLC) and the university and major of the students
The Bronisław
over 21
M
SD
Statistical
analysis
24,82
5,27
F=1,77; p=0,17
18,32
5,71
F=0,01; p=0,99
18,24
5,86
poor / very
poor
M
SD
East Europe-
Markiewicz
Rzeszów
an State
State Higher
Locus of
University of
Higher
School of
control
Technology
School in
Technology
Przemyśl
and Economics
F=0,15; p=0,86
Statistical
analysis
5,01
24,60
5,67
F=0,66;
p=0,00003
5,36
18,61
5,92
F=0,74; p=0,48
5,55
20,20
6,01
F=17,88;
p<0,000001
As the analysis of the authors’ research implies, the mean
value of internal health locus of control in the studied group
State Higher
Vocational
School in
Krosno
in Jarosław
Internal
Powerful
others
Chance
Locus of
M
SD
M
SD
M
SD
M
SD
24,76
4,89
24,94
5,27
25,11
4,83
25,35
5,22
17,50
5,43
17,84
5,50
19,03
5,11
18,88
5,74
18,85
5,36
17,88
6,00
16,68
4,68
18,69
6,11
technical
medical
humanities
management
control
M
SD
M
SD
M
SD
M
SD
Internal
25,23
5,91
25,37
5,05
25,17
4,92
24,72
4,84
19,61
5,99
18,59
5,29
17,74
5,31
17,88
5,54
18,79
6,05
16,48
4,79
18,12
5,88
19,15
5,79
Powerful
others
Chance
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On the basis of the research, it was observed that the mean
value of internal health locus of control among the participants studying at the Rzeszów University of Technology was
24,76 points, for the East European State Higher School in
Przemyśl it was 24,94 points, for the students of the Bronisław
Markiewicz State Higher School of Technology and Economics in Jarosław it amounted to 25,11 points and finally for
those attending the State Higher Vocational School in Krosno
it was 25,35 points. These differences were not statistically
significant (p>0,05). What is more, the findings of the study
indicate that the mean value of the internal locus of control in
the group of medical students was 25,37 points, which was a
higher score that that obtained in the group of technical students (25,23 points), humanities students (25,17 points) and
management students (24,72 points). That difference was not
statistically significant, either.
IV. DISCUSSION
Health locus of control is basically a belief in the ability or
inability of influencing one’s health. It has significant impact
on one’s health behaviour. It is believed that the internal health
locus of control is advantageous as far as health-oriented behaviour is concerned. People who claim the health locus of
control is internal usually make health-related decisions independently, more often undertake preventive actions aimed at
improving and retaining health and have a greater sense of
responsibility for their condition [6].
The results of the original research indicate that the selected
group of students (both male and female) was dominated by
those who perceive health locus of control as internal, which
means those people are more aware of their responsibility for
their own health. The mean value of the internal health locus
of control was 25,05 points and was higher than the value of
powerful others (18,28 points) and chance (18,21 points). The
mean values of the Multidimensional Health Locus of Control
in the research are close to those obtained by Naszydłowska et
al. [7,8] and those obtained in Polish studies [6].
On the basis of their research, Naszydłowska et al. [7] observed that students’ health locus of control was exclusively
internal (MHLC M=28,61). It is also worth noticing that in
their opinion, chance (M=15,65) had something to do with
their health less frequently than powerful others (18,76). Similar results were obtained by Naszydłowska et al. [8] in the
research of 2005. The majority of the students interviewed by
the authors had internal health locus of control (women
M=28,53; men M=28,39). Both men and women believed that
their health is predominantly dependent on themselves rather
than powerful others (women M=17,32; men M=19,18) or
chance (women M=15,91; men M=16,72). The Polish studies,
23
in which 97 students participated, showed that the health locus
of control is mostly internal [6]. Powerful others (M=18,76)
and chance (M=15,65) were less significant in numbers. In his
study of the correlation between health locus of control and
age, Juczyński [6], observed that people aged between 18 and
25 were mostly inclined to believe in internal health locus of
control (MHLC M=28,55). Similar results were obtained by
Łukasik [9] – the mean value of internal health locus of control (MHLC) was 22,66 points. In the study of Mojs et al. [10],
the the mean value of internal health locus of control was
27,67 points. The results obtained by all other authors remain
consistent with the findings of the authors of the present paper,
in which internal health locus of control was dominant in the
age group up to twenty (M=25,51), in the 21 age group
(M=24,72) and over 21 age group (M=24,82).
Czarnecka and Cierpiałkowska [11] observed on the group
of 80 students attending different universities in Poznań that
people who perceived health locus of control as internal got
lower scores in relation to external locus of control (chance).
Similar results were obtained by Penar–Zadarko et al. [12].
457 students of higher education institutions based in the Podkarpackie region participated in their research. Internal health
locus of control was predominant. Age, sex and major were
factors conditioning the internal health locus of control in the
studied group of students. The mean value of the internal
health locus of control among women was 27 points and was
significantly lower (p=0,0007) than the 29 points obtained in
relation to men. Meanwhile the mean value of MHLC was 28
points in the age group of 19 to 20 and was significantly higher
(p=0,0047) than the 27 points obtained in the group over 20
years of age. The mean value of MHLC in the group of nursing students was 27 points and was significantly lower
(p=0,0032) than the mean of 28,5 points obtained among the
students of obstetrics. On the basis of the findings of the present research it was observed that age, sex and major did not
modify (p>0,05) internal health locus of control. The results of
this study are not consistent with the findings of Penar–
Zadarko at al. [12].
As the research by Kolarczyk et al. [13] indicates, 36,1% of
the students under research claimed their health was very
good, 50,0% stated in was good, for 13,1% their health was
not good and for 0,8% it was poor. In the study of the authors’,
26,38% of students claimed to have very good health, 57,83%
claimed to have good health, while 13,91% assessed their
health as average and 1,85% claimed it was poor. The subjective health assessment of the students who participated in the
research was significant as far as the internal locus of control
is concerned, as it was in the case of those who claimed their
health was good or very good than those who assessed their
health as poor or very poor. Meanwhile the chance locus of
control was higher in the case of students who claimed their
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health was poor or very poor than in the case of those who
claimed they were of average health.
V. CONCLUSIONS
1. The health locus of control as perceived by students is
predominantly internal.
2. Age and sex do not impact the health locus of control
in any of the three dimensions. At the same time, the
subjective health self-assessment is significant as far
as the level of internal health locus of control is concerned; it was higher among students who perceived
their health as very good or good than in the group
who thought to be of poor and very poor health.
3. The university and major significantly influence students’ health locus of control, especially as powerful
others or chance dimensions are concerned.
4. Internal health locus of control and self-efficacy have
an impact on students’ health-oriented behaviour.
Therefore it is important to popularize the knowledge
on health promotion and preventive care, for instance
as elective courses at all kinds of universities.
VI. REFERENCES
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XVI, 199: 385–388.
[2] Kiełbasiewicz–Drozdowska I, Pluta B, Wiza A. Prozdrowotny styl życia w samoocenie studentów. Część II. Rangowanie elementów prozdrowotnego stylu życia. Annales
UMCS 2005; LX, suppl. XVI, 200: 389–390.
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[12] Penar–Zadarko B, Zadarko E, Binkowska–Bury M, Januszewicz P. Rozpowszechnienie palenia tytoniu wśród studentów a umiejscowienie kontroli zdrowia. Prz Lek 2009;
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[13] Kolarczyk E, Łyszczarz J, Jaworska–Szyc J. Samoocena
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