Quality of Life Research

, Volume 6, Issue 1, pp 0–0

Effect of locus of control and consideration of future consequences on time tradeoff utilities for current health

  • R. M. Handler
  • L. M. Hynes
  • R. F. NeaseJr.
  • Susan Preston-Martin
Article
  • 83 Downloads

Abstract

Comments from subjects undergoing utility assessment suggest that personality traits may affect responses. We sought to describe the association between time-tradeoff utility for current health and measures of two personality traits: (1) perceived control over one's life and (2) concern over immediate vs. future outcomes. One hundred subjects were recruited from the cafeteria of a large tertiary care hospital. Time-tradeoff utilities were assessed for current health relative to perfect health and death. Subjects also completed two previously validated scales, the Locus of Control (LOC), and Consideration of Future Consequences (CFC) instruments. The interview failure rate was less than 3%. The correlation between LOC score and utility for current health was modest (Spearman's ρ =0.196, p=0.071), but increased substantially when subjects unwilling to trade were excluded (Spearman's ρ =0.33, p=0.0043). The CFC scale was weakly correlated with utility for current health (Spearman's ρ =0.12, p=0.2676). The Consideration of Future Consequences scale explains little of the variation in time-tradeoff utilities. In contrast, Locus of Control appears to partially explain the variation in time-tradeoff utilities for current health, even after controlling for health status.

Decision support techniques patient preferences quality of life 

References

  1. 1.
    Howard RA. Decision analysis. Applied decision theory. In: Hertz DB, Melese J, eds. Proceedings of the Fourth Internation Conference on Operations Research.New York, NY: Wiley-Interscience, 1966: 55–71.Google Scholar
  2. 2.
    Weinstein M, Fineberg H, et al. Clinical Decision Analysis. Philadelphia, PA: Saunders, 1980.Google Scholar
  3. 3.
    Sox H, Blatt M, Higgins M, Marton K. Medical Decision Making. Boston, MA: Butterworths, 1988.Google Scholar
  4. 4.
    Torrance GW. Social preferences for health states. An empirical evaluation of three measurement techniques. Socio-Econ Planning 1976; 10: 129-136.Google Scholar
  5. 5.
    Nease RF Jr, Kneeland T, O'Connor G, et al. Variation in patient utilities for outcomes of the management of chronic stable angina. Implications for clinical practice guidelines. JAMA 1995; 273: 1185-1190.Google Scholar
  6. 6.
    Zug K, Littenberg B, Baughman R, et al. Assessing the preferences of patients with psoriasis. A quantitative, utility approach. Arch Dermatol 1995; 131: 561-568.Google Scholar
  7. 7.
    Nease R, Hynes L, Littenberg B, Tosteson A, Sumner W, Owens D. Variation in patient preferences for outcomes associated with the management of mild hypertension: Implications for practice guidelines. Abstracts of the Eleventh Annual Meeting of the Association for Health Services Research and Foundation for Health Services Research [abstract]. San Diego, California, 1994: 25.Google Scholar
  8. 8.
    Nease R, Birkmeyer J, Wong J et al. Tailoring practice guidelines to the individual. The importance of patient specific estimates of risk and benefit in elective coronary artery bypass graft surgery [abstract]. Circulation 1994; 90: 1-91.Google Scholar
  9. 9.
    Nease RF Jr, Owens DK. A method for estimating the cost-effectiveness of incorporating patient preferences into practice guidelines. Med Decis Making 1994; 14: 382-392.Google Scholar
  10. 10.
    Sanders G, Owens D, Padian N, Cardinalli A, Sullivan A, Nease R. A Computer-based Interview to Identify HIV Risk Behaviors and to Assess Patient Utilities for HIV-related Health States. Washington DC: Hanley & Belfus, Inc, 1994: 20-24.Google Scholar
  11. 11.
    Gage BF, Cardinalli AB, Owens DK. The effect of stroke and stroke prophylaxis with aspirin or warfarin on quality of life. Arch Int Med (in press).Google Scholar
  12. 12.
    Nease RF Jr, Tsai R, Hynes LH, Littenberg B. Automated utility assessment of global health. Qual Life Res 1996; 5: 175-182.Google Scholar
  13. 13.
    Alexander N, Hynes L, Nease, RF, Littenberg B. What patients say during time tradeoff utility assessments: Potential confounders of utilities. In press.Google Scholar
  14. 14.
    Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall, 1986.Google Scholar
  15. 15.
    Gecas V. The social psychology of self-efficacy. Ann Rev Sociol 1989; 15: 291-316.Google Scholar
  16. 16.
    O'Leary A. Self-efficacy and health. Behav Res Therapy 1985; 23: 437-451.Google Scholar
  17. 17.
    Seemam M, Seeman TE. Health behavior and personal autonomy. A longitudinal study of the sense of control in illness. J Health Social Behav 1983; 24: 144-160.Google Scholar
  18. 18.
    Strecher VJ, DeVellis BE, Becker MH, Rosenstock IM. The role of self-efficacy in achieving health behavior change. Health Education Quarterly 1986; 13: 73-91.Google Scholar
  19. 19.
    Greenfield S, Kaplan S, Ware JE. Expanding patient involvement in care. Ann Inter Med 1985; 102: 520-528.Google Scholar
  20. 20.
    Orth JE, Stiles WB. Patient exposition and provider explanation in routine interviews and hypertensive patients' blood pressure control. Health Psychol 1987; 6: 29-42.Google Scholar
  21. 21.
    Greenfield S, Kaplan SH, Ware JE, Yano EM, Frank HJ. Patients' participation in medical care. Blood sugar control and quality of life in diabetes. J Gen Int Med 1988; 3: 448-457.Google Scholar
  22. 22.
    Kaplan SH, Greenfield S, Ware JE. Assessing the effects of physician-patient interactions in the outcomes of chronic disease. Med Care 1989; 27: S110-S127.Google Scholar
  23. 23.
    Christenson AJ, Smith TW, Turner CW, Holman JM, Gregory MC. Type of hemodialysis and preferences for behavioral involvement: interactive effects on adherence in end-stage renal disease. Health Psychol 1990; 9: 225-236.Google Scholar
  24. 24.
    Mahler HIM, Kulik JA. Health care involvement preferences and social-emotional recovery of male coronary artery bypass patients. Health Psychol 1991; 10: 399-408.Google Scholar
  25. 25.
    Howard RA. Decision analysis in systems engineering. In: Miles RF, ed. Systems Concepts: Lectures on Contemporary Approaches to Systems. New York, NY: John Wiley & Sons, 1973.Google Scholar
  26. 26.
    Sumner W, Nease RF, Littenberg B. U-titer: A utility assessment tool. Proceedings of the Fifteenth Annual Symposium on Computer Applications in Medical Care.Washington, DC, 1991: 701-705.Google Scholar
  27. 27.
    Sapp SG, Harrod WJ. Reliability and validity of a brief version of Levenson's locus of control scale. Psychol Rep 1993; 72: 539-550.Google Scholar
  28. 28.
    Strathman A, Gleicher F, Boninger DS, Edwards CS. The consideration of future consequences: weighing immediate and distant outcomes of behavior. J Personal Social Psychol 1994; 66: 742-752Google Scholar
  29. 29.
    Levenson H. Activism and powerful others. Distinctions within the concept of internal-external control. Psychol Rep 1974; 38: 377-383.Google Scholar
  30. 30.
    Rotter J. Generalized expectancies for internal versus external control of reinforcement. Psychol Monog 1966; 80: No. 609.Google Scholar
  31. 31.
    Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston, MA: Nimrod Press, 1993.Google Scholar
  32. 32.
    Conover WJ. Practical Nonparametric Statistics. New York, NY: Wiley, 1980.Google Scholar

Copyright information

© Chapman and Hall 1997

Authors and Affiliations

  • R. M. Handler
    • 1
  • L. M. Hynes
    • 1
  • R. F. NeaseJr.
    • 1
  • Susan Preston-Martin
    • 1
  1. 1.Laboratory for Medical Decision Sciences, Division of General Medical Sciences, Department of Internal MedicineWashington University School of MedicineSt. LouisUSA

Personalised recommendations