Positivity and Health Locus of Control: Key Variables to Intervene on Well-Being of Cardiovascular Disease Patients

Bárbara Luque; Naima Z Farhane-Medina; Marta Villalba; Rosario Castillo-Mayén; Esther Cuadrado; Carmen Tabernero

doi:10.3390/jpm13050873

Positivity and Health Locus of Control: Key Variables to Intervene on Well-Being of Cardiovascular Disease Patients

J Pers Med. 2023 May 22;13(5):873. doi: 10.3390/jpm13050873.

Authors

Bárbara Luque^{1

2}, Naima Z Farhane-Medina^{1

2}, Marta Villalba², Rosario Castillo-Mayén^{1

2}, Esther Cuadrado^{1

2}, Carmen Tabernero^{1

3

4}

Affiliations

¹ Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain.
² Department of Psychology, University of Cordoba, 14071 Cordoba, Spain.
³ Institute of Neurosciences of Castilla y León (INCYL), University of Salamanca, 37007 Salamanca, Spain.
⁴ Department of Social Psychology and Anthropology, University of Salamanca, 37005 Salamanca, Spain.

Abstract

Psychological well-being is a good predictor of several health outcomes in cardiovascular disease patients (adherence, quality of life, and healthy behaviors). The perception of health control and a positive orientation seem to have a beneficial effect on health and well-being. Therefore, the aim of this study was to investigate the role of the health locus of control and positivity in the psychological well-being and quality of life of cardiovascular patients. A total of 593 cardiac outpatients completed the Multidimensional Health Locus of Control Scale, the Positivity Scale and the Hospital Anxiety and Depression Scale at baseline (January 2017) and 9 m later (follow-up; n = 323). A Spearman rank correlation coefficient and a structural equation modeling approach were determined to explore the relationships between those variables both cross-sectionally and longitudinally. A cross-sectional correlation analysis at baseline revealed that the internal health locus of control and positivity were negatively associated with anxiety (r_s = -0.15 and -0.44, ps < 0.01) and depression (r_s = -0.22 and -0.55, ps < 0.01) and positively associated with health-related quality of life (r_s = 0.16 and 0.46, ps < 0.01). Similar outcomes were found at follow-up and in longitudinal correlations. According to the path analysis, positivity was found to be negatively associated with anxiety and depression level at baseline (β = -0.42 and -0.45, ps < 0.001). Longitudinally, positivity was negatively associated with depression (β = 0.15, p < 0.01) and together with the internal health locus of control, was positively associated with health-related quality of life (β = 0.16 and 0.10, respectively, ps < 0.05). These findings suggest that focusing on the health locus of control and especially positivity may be crucial in enhancing the psychological well-being of patients in the context of cardiac care. The potential impact of these results on future interventions is discussed.

Keywords: cardiovascular disease (CVD); health locus of control; health-related quality of life; positivity; psychological well-being.

Abstract

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