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

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.

[1]  A. O'Leary,et al.  Self-efficacy and health. , 1985, Behaviour research and therapy.

[2]  S. Kaplan,et al.  Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease , 1989, Medical care.

[3]  J. Ware.  SF-36 health survey: Manual and interpretation guide , 2003 .

[4]  A. Bandura.  Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[5]  J. Rotter.  Generalized expectancies for internal versus external control of reinforcement. , 1966, Psychological monographs.

[6]  C Vallbona,et al.  Patient exposition and provider explanation in routine interviews and hypertensive patients' blood pressure control. , 1987, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[7]  S. Kaplan,et al.  Expanding patient involvement in care. Effects on patient outcomes. , 1985, Annals of internal medicine.

[8]  J. Kulik,et al.  Health care involvement preferences and social-emotional recovery of male coronary-artery-bypass patients. , 1991, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[9]  D. Boninger,et al.  The consideration of future consequences: Weighing immediate and distant outcomes of behavior. , 1994 .

[10]  C. Turner,et al.  Type of hemodialysis and preference for behavioral involvement: interactive effects on adherence in end-stage renal disease. , 1990, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[11]  G. Chapman,et al.  [Medical decision making]. , 1976, Lakartidningen.

[12]  C Lenfant,et al.  NHLBI funding policies. Enhancing stability, predictability, and cost control. , 1994, Circulation.

[13]  T. Seeman,et al.  Health behavior and personal autonomy: a longitudinal study of the sense of control in illness. , 1983, Journal of health and social behavior.

[14]  H. Brachinger,et al.  Decision analysis , 1997 .

[15]  I. Rosenstock,et al.  The Role of Self-Efficacy in Achieving Health Behavior Change , 1986, Health education quarterly.

[16]  B. Gage,et al.  The Effect of Stroke and Stroke Prophylaxis With Aspirin or Warfarin on Quality of Life , 1996 .

[17]  H. Levenson.  Activism and Powerful Others: Distinctions within the Concept of Internal-External Control , 1974 .

[18]  Automated utility assessment of global health , 1996, Quality of Life Research.

[19]  Harold C. Sox,et al.  Variation in Patient Utilities for Outcomes of the Management of Chronic Stable Angina: Implications for Clinical Practice Guidelines , 1995 .

[20]  D K Owens,et al.  A computer-based interview to identify HIV risk behaviors and to assess patient preferences for HIV-related health states. , 1994, Proceedings. Symposium on Computer Applications in Medical Care.

[21]  George W. Torrance,et al.  Social preferences for health states: An empirical evaluation of three measurement techniques , 1976 .

[22]  S. Sapp,et al.  Reliability and Validity of a Brief Version of Levenson's Locus of Control Scale , 1993 .

[23]  John E. Ware,et al.  Expanding Patient Involvement in Care , 1985 .

[24]  M. F. Fuller,et al.  Practical Nonparametric Statistics; Nonparametric Statistical Inference , 1973 .

[25]  M. Weinstein,et al.  Clinical Decision Analysis , 1980 .

[26]  V. Gecas.  The Social Psychology of Self-Efficacy , 1989 .

[27]  B. Littenberg,et al.  Assessing the preferences of patients with psoriasis. A quantitative, utility approach. , 1995, Archives of dermatology.

[28]  W Sumner,et al.  U-titer: a utility assessment tool. , 1991, Proceedings. Symposium on Computer Applications in Medical Care.

[29]  Douglas K. Owens,et al.  A Method for Estimating the Cost- Effectiveness of Incorporating Patient Preferences into Practice Guidelines , 1994, Medical decision making : an international journal of the Society for Medical Decision Making.