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| 2. |
- Andersén, Åsa, et al.
(författare)
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Predictors of self-efficacy in women on long-term sick leave
- 2015
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Ingår i: International Journal of Rehabilitation Research. - 0342-5282 .- 1473-5660. ; 38:4, s. 320-326
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Tidskriftsartikel (refereegranskat)abstract
- Self-efficacy has been shown to be related to sick leave and to be a predictor of return to work after sickness absence. The aim of this study was to investigate whether factors related to sick leave predict self-efficacy in women on long-term sick leave because of pain and/or mental illness. This cross-sectional study uses baseline data from 337 Swedish women with pain and/or mental illness. All included women took part in vocational rehabilitation. Data were collected through a sick leave register and a baseline questionnaire. General self-efficacy, sociodemographics, self-rated health, anxiety, depression, view of the future, and social support were measured and analyzed by univariate and multivariate linear regression analyses. The full multivariate linear regression model, which included mental health factors together with all measured factors, showed that anxiety and depression were the only predictive factors of lower self-efficacy (adjusted R-2 = 0.46, P < 0.001) and explained 46% of the variance in self-efficacy. The mean scores of general self-efficacy were low, especially in women born abroad, those with low motivation, those with uncertainties about returning to work, and women reporting distrust. Anxiety and depression are important factors to consider when targeting self-efficacy in vocational rehabilitation.
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| 3. |
- Andersén, Åsa, 1975-, et al.
(författare)
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Strengthened General Self-Efficacy with Multidisciplinary Vocational Rehabilitation in Women on Long-Term Sick Leave : A Randomised Controlled Trial
- 2018
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Ingår i: Journal of occupational rehabilitation. - : Springer Science and Business Media LLC. - 1053-0487 .- 1573-3688. ; 28:4, s. 691-700
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To investigate the effects of two vocational rehabilitation interventions on self-efficacy, for women on long-term sick leave ≥ 1 year due to chronic pain and/or mental illness. Methods This study uses data from a randomised controlled trial consisting of two phases and comprising 401 women on long-term sick leave. They were allocated to either (1) a multidisciplinary team assessment and multimodal intervention (TEAM), (2) acceptance and commitment therapy (ACT), or (3) control group. Data were collected through repeated measurements from self-reported questionnaires before intervention, 6 and 12 months later and registry data. Data from measurements of general self-efficacy, sociodemographics, anxiety and depression were analysed with linear regression analyses. Results During the intervention period, the women in the TEAM group’s self-efficacy mean increased from 2.29 to 2.74. The adjusted linear regression model, which included group allocation, sociodemographics, self-efficacy pre-treatment, anxiety and depression showed increased self-efficacy for those in the TEAM intervention at 12 months (B = 0.25, 95% CI 0.10–0.41). ACT intervention had no effect on self-efficacy at 12 months (B = 0.02, 95% CI − 0.16 to 0.19). The results in the adjusted model also showed that higher self-efficacy at pre-treatment was associated with a higher level of self-efficacy at 12 months (B = 0.68, 95% CI 0.54–0.81). Conclusion A multidisciplinary team assessment and multimodal intervention increased self-efficacy in women on sick leave for an extremely long time (mean 7.8 years) who had a low mean level of self-efficacy prior to inclusion. Thus, self-efficacy needs to be addressed in vocational rehabilitation.
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| 4. |
- Bentham, James, et al.
(författare)
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A century of trends in adult human height
- 2016
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Ingår i: eLIFE. - : eLife Sciences Publications Ltd. - 2050-084X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3– 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8– 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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| 5. |
- Bixby, H., et al.
(författare)
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Rising rural body-mass index is the main driver of the global obesity epidemic in adults
- 2019
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 569:7755, s. 260-4
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Tidskriftsartikel (refereegranskat)abstract
- Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
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| 14. |
- Bellavia, Andrea, et al.
(författare)
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Time-based measures of treatment effect : reassessment of ticagrelor and clopidogrel from the PLATO trial
- 2017
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Ingår i: Open heart. - : BMJ. - 2053-3624. ; 4:2
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Treatment effects to binary endpoints using time-to-event data in randomised controlled trials are typically summarised by reporting HRs derived with Cox proportional hazard models. Alternative and complementary methods include summarising the between-treatment differences on the metric time scale, quantifying the effect as delay of the event (DoE). The aim of this study was to reassess data from the PLATO study expressing the effects as the time by which the main outcomes are delayed or hastened due to treatment.METHODS: PLATO was a randomised controlled double-blind multicentre study (n=18,624), conducted between 2006 and 2008, which demonstrated superiority of the antiplatelet treatment ticagrelor over clopidogrel in reducing risk of several cardiovascular events. In the present study, four of the main PLATO outcomes were reassessed by calculating the time by which an event may be delayed due to the treatment.RESULTS: The effects of ticagrelor, as compared with clopidogrel, consisted of a substantial delay of the evaluated outcomes, ranging from 83 to 98 days over 400-day follow-up. The Delay of Events Curves showed that the effects progressively increased over time, and the significant findings were concordant with those presented in the original PLATO study.CONCLUSIONS: This study confirmed evidence of a beneficial effect of ticagrelor over clopidogrel, and provided the magnitude of such effects in terms of delayed event time. Investigating time-to-event data with a percentile approach allows presenting treatment effects from randomised controlled studies as absolute measures of the time by which an event may be delayed due to the treatment.TRIAL REGISTRATION NUMBER: PLATO (www.clinicaltrials.gov; NCT00391872); Results.
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| 15. |
- Berglund, Erik, et al.
(författare)
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Active Traveling and Its Associations with Self-Rated Health, BMI and Physical Activity : A Comparative Study in the Adult Swedish Population
- 2016
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 13:5
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Tidskriftsartikel (refereegranskat)abstract
- Active traveling to a daily occupation means that an individual uses an active way of traveling between two destinations. Active travel to work or other daily occupations offers a convenient way to increase physical activity levels which is known to have positive effects on several health outcomes. Frequently used concepts in city planning and regional planning today are to create environments for active commuting and active living. Even then, little research has focused on traveling modes and subjective health outcomes such as self-rated health (SRH). This study aimed to explore and investigate associations between travel mode and health-related outcomes, such as self-rated health (SRH), body mass index (BMI) and overall physical activity, in an adult population in Sweden. A cross-sectional study was conducted in a randomly selected population-based sample (n = 1786, age 45-75 years); the respondents completed a questionnaire about their regular travel mode, demographics, lifestyle, BMI and SRH. Chi-square tests and logistic regressions found that inactive traveling was associated with poor SRH, a greater risk of obesity or being overweight and overall physical inactivity. In addition, lifestyle factors, such as choice of food and smoking habits, were associated with SRH, BMI and overall physical activity.
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| 16. |
- Berglund, Erik, et al.
(författare)
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Adherence to and beliefs in lipid-lowering medical treatments : A structural equation modeling approach including the necessity-concern framework
- 2013
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 91:1, s. 105-112
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThis study attempts to identify a structure among patient-related factors that could predict treatment adherence in statin patients, especially with regards to the necessity-concern framework.Methods414 Swedish patients using statins completed a questionnaire about their health, treatment, locus of control, perception of necessity-concern and adherence. The data were handled using a structural equation modeling approach.ResultsPatients that reported high perceptions of necessity to treatment seemed to adhere well, and side effects appear to affect adherence negatively. Disease burden, cardiovascular disease experience and high locus of control seem to have mediating effects on adherence.ConclusionThis study provides support for the hypothesis that health- and treatment-related factors, as well as locus of control factors, are indirectly associated with treatment adherence via their association with mediating factor necessity.Practice implications:This study highlights the importance of considering patients' beliefsabout medications, disease burden, experience of cardiovascular events and locus of control as these factors are associated with adherence behavior to statin treatment. This study also emphasizes more generally the importance of an approach targeting necessity and concern when communicating with and treating patients with lipid-lowering medication. (
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| 17. |
- Berglund, Erik, 1980-
(författare)
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Adherence to drug treatment and interpretation of treatment effects
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Suboptimal adherence to medical treatments is prevalent across several clinical conditions and can lead to treatment failure. Adherence is a far from fully explored phenomenon and there is little knowledge about how patients interpret treatment effects. Commonly used treatment evaluation measures are often relative measures, which may be difficult for lay people and patients to understand.The overall aim of this thesis was to investigate factors with relevance to adherence, to estimate treatment effects with the time-based Delay of Event (DoE) measure in anticoagulant preventive treatments, and to explore how lay people responded to the DoE measure, as compared with established measures, regarding treatment decisions and effect interpretation.A quantitative population-based cross-sectional design was used for Study I. Study II used data from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) clinical trial and estimated effects as DoEs. Studies III and IV were carried out as randomised survey experiments.The results showed that general adherence behaviour was associated with both environmental and social factors. Estimations of DoE showed that stroke or systemic embolism was delayed 181 (95% CI 76 to 287) days through twenty-two months of apixaban use, as compared with warfarin use. The delay of major and intracranial bleeding was 206 (95% CI 130 to 281) and 392 (95% CI 249 to 535) days, respectively, due to apixaban use for twenty-two months, as compared with warfarin use. Presenting preventive treatment effects as DoEs to lay people was associated with high willingness to initiate treatment and positive views on treatment benefits and willingness to pay for treatment.Non-optimal adherence was partly associated with modifiable factors and it might be possible to increase adherence by managing these factors. Estimations of DoEs in preventive treatments gave information on effects regarding delay of different outcomes; the estimation also provides tools that might be useful for interpreting and communicating treatment effects in clinical decision-making. Lay people seemed to react rationally to variations in DoE magnitude; a higher proportion accepted treatment when the magnitude was greater.
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| 18. |
- Berglund, Erik, et al.
(författare)
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Effects of apixaban compared with warfarin as gain in event-free time : a novel assessment of the results of the ARISTOTLE trial
- 2020
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 27:12, s. 1311-1319
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A novel approach to determine the effect of a treatment is to calculate the delay of event, which estimates the gain of event-free time. The aim of this study was to estimate gains in event-free time for stroke or systemic embolism, death, bleeding events, and the composite of these events, in patients with atrial fibrillation randomized to either warfarin or apixaban in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial (ARISTOTLE).DESIGN: The ARISTOTLE study was a randomized double-blind trial comparing apixaban with warfarin.METHODS: Laplace regression was used to estimate the delay in time to the outcomes between the apixaban and the warfarin group in 6, 12, 18 and 22 months of follow-up.RESULTS: The gain in event-free time for apixaban versus warfarin was 181 (95% confidence interval 76 to 287) days for stroke or systemic embolism and 55 (-4 to 114) days for death after 22 months of follow-up. The corresponding gains in event-free times for major and intracranial bleeding were 206 (130 to 281) and 392 (249 to 535) days, respectively. The overall gain for the composite of all these events was a gain of 116 (60 to 171) days.CONCLUSIONS: In patients with atrial fibrillation, 22 months of treatment with apixaban, as compared with warfarin, provided gains of approximately 6 months in event-free time for stroke or systemic embolism, 7 months for major bleeding and 13 months for intracranial bleeding.
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| 19. |
- Berglund, Erik, et al.
(författare)
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Health and wellbeing in informal caregivers and non-caregivers : a comparative cross-sectional study of the Swedish a general population
- 2015
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Informal caregiving by relatives is a great resource for individuals as well as for society, but the caregiving role is associated with health problems for the caregiver. This study aimed to compare caregivers' self-rated health, number of recent days with poor health and psychological wellbeing with that of non-caregivers in a general Swedish population. Methods: From 2004 to 2013, 90,845 Swedish people completed a postal questionnaire about their health, number of recent days with poor health during last month, psychological wellbeing and if they were performing caregiving or not. Descriptive statistics, chi-square analysis, ANOVA, logistic regressions and negative binomial regression models were used to investigate associations between being a caregiver or not and health and wellbeing. Negative binomial regression was used to assess the relation between caregiver status and recent days with poor health or functioning. Results: Eleven percent reported having a caregiving role. Caregivers reported poorer self-rated health compered to non-caregivers, also in adjusted models; odds ratio (OR): 1.07 with a 95 % confidence interval (CI): 1.01-1.13. Caregivers also reported lower psychological wellbeing compared to non-caregivers; OR: 1.22, CI: 1.15-1.30. Caregiving status was associated with more recent days with poor physical health and more recent days with poor mental health. Conclusions: This study suggests that caregivers have worse perceptions in self-rated health and psychological wellbeing compared with non-caregivers, indicating that the role of caregiver is adversely associated with health. This association also appears in terms of reporting days of poor health in the last month. The underlying mechanism of these associations, including the potential detrimental health effects of being a caregiver, needs to be investigated in longitudinal studies.
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| 20. |
- Berglund, Erik, et al.
(författare)
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Housing Type and Neighbourhood Safety Behaviour Predicts Self-rated Health, Psychological Well-being and Frequency of Recent Unhealthy Days : A Comparative Cross-sectional Study of the General Population in Sweden
- 2017
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Ingår i: Planning practice + research. - : Taylor & Francis Group. - 0269-7459 .- 1360-0583. ; 32:4, s. 444-465
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed at analysing associations among housing type, neighbourhood safety behaviour, self-rated health (SRH), psychological well-being and unhealthy days in the general population. From 2004 to 2013, 90,845 Swedes completed a questionnaire about their health, number of days with poor health, psychological well-being, housing type, and whether they refrained from going out based on perception of neighbourhood safety. People not living in private housing and those who did not go out for safety reasons reported lower SRH and psychological well-being and higher frequency of recent unhealthy days and days without work capacity due to poor health.
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| 21. |
- Berglund, Erik, et al.
(författare)
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Length of time periods in treatment effect descriptions and willingness to initiate preventive therapy : a randomised survey experiment
- 2018
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Ingår i: BMC Medical Informatics and Decision Making. - : BMC. - 1472-6947. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background Common measures used to describe preventive treatment effects today are proportional, i.e. they compare the proportions of events in relative or absolute terms, however they are not easily interpreted from the patient's perspective and different magnitudes do not seem to clearly discriminate between levels of effect presented to people. Methods In this randomised cross-sectional survey experiment, performed in a Swedish population-based sample (n=1041, response rate 58.6%), the respondents, aged between 40 and 75years were given information on a hypothetical preventive cardiovascular treatment. Respondents were randomised into groups in which the treatment was described as having the effect of delaying a heart attack for different periods of time (Delay of Event,DoE): 1month, 6months or 18months. Respondents were thereafter asked about their willingness to initiate such therapy, as well as questions about how they valued the proposed therapy. ResultsLonger DoE:s were associated with comparatively greater willingness to initiate treatment. The proportions accepting treatment were 81, 71 and 46% when postponement was 18months, 6months and 1month respectively. In adjusted binary logistic regression models the odds ratio for being willing to take therapy was 4.45 (95% CI 2.72-7.30) for a DoE of 6months, and 6.08 (95% CI 3.61-10.23) for a DoE of 18months compared with a DoE of 1month. Greater belief in the necessity of medical treatment increased the odds of being willing to initiate therapy. ConclusionsLay people's willingness to initiate preventive therapy was sensitive to the magnitude of the effect presented as DoE. The results indicate that DoE is a comprehensible effect measure, of potential value in shared clinical decision-making.
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| 22. |
- Berglund, Erik, et al.
(författare)
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Living environment, social support and informal caregiving are associated with healthcare seeking behaviour and adherence to medication treatment : a cross-sectional population study
- 2019
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Ingår i: Health and social care in the community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 27:5, s. 1260-1270
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Tidskriftsartikel (refereegranskat)abstract
- Despite the well-known associations between local environment and health, few studies have focused on environment and health care utiliza-tion, for instance health care seeking behaviour or adherence. This study was aimed at analysing housing type, behaviour based on perceived local outdoor safety, social support, informal caregiving, demographics, socioeconomics, and long-term illness, and associations with health-seeking and adherence behaviours at a population level. This study used data from the Swedish National Public Health Survey 2004–2014, an annually repeated, large sample, cross-sectional, population-based sur-vey study. In all, questionnaires from 100,433 individuals were returned by post, making the response rate 52.9% (100,433/190,000). Descrip-tive statistics and multiple logistic regressions were used to investigate associations between explanatory variables and the outcomes of refrain-ing from seeking care and non-adherence behaviour. Living in rented apartment, lodger, a dorm or other was associated with reporting refrain-ing from seeking care (adjusted OR 1.16, 95% CI 1.00–1.22), and non-adherence (adjusted OR 1.22; 95% CI 1.13–1.31). Refraining from go-ing out due to a perceived unsafe neighbourhood was associated with refraining from seeking care (adjusted OR 1.59, 95% CI 1.51–1.67) and non-adherence (adjusted OR 1.26, 95% CI 1.17–1.36). Social support and status as an informal caregiver was associated with higher odds of refraining from seeking medical care and non-adherence. This study suggests that living in rental housing, refraining from going out due to neighbourhood safety concerns, lack of social support or informal care-giver status are associated with lower health-seeking behaviour and non-adherence to prescribed medication.
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| 23. |
- Berglund, Erik, et al.
(författare)
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Multidisciplinary Intervention and Acceptance and Commitment Therapy for Return-to-Work and Increased Employability among Patients with Mental Illness and/or Chronic Pain : A Randomized Controlled Trial
- 2018
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 15:11
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Tidskriftsartikel (refereegranskat)abstract
- Background: People on long-term sick leave often have a long-lasting process back to work, where the individuals may be in multiple and recurrent states; i.e., receiving different social security benefits or working, and over time they may shift between these states. The purpose of this study was to evaluate the effects of two vocational rehabilitation programs, compared to a control, on return-to-work (RTW) or increased employability in patients on long-term sick leave due to mental illness and/or chronic pain. Methods: In this randomized controlled study, 427 women and men were allocated to either (1) multidisciplinary team management, i.e., multidisciplinary assessments and individual rehabilitation management, (2) acceptance and commitment therapy (ACT), or (3) control. A positive outcome was defined as RTW or increased employability. The outcome was considered negative if the (part-time) wage was reduced or ceased, or if there was an indication of decreased employability. The outcome was measured one year after entry in the project and analyzed using binary and multinomial logistic regressions. Results: Participants in the multidisciplinary team group reported having RTW odds ratio (OR) 3.31 (95% CI 1.39-7.87) compared to the control group in adjusted models. Participants in the ACT group reported having increased employability OR 3.22 (95% CI 1.13-9.15) compared to the control group in adjusted models. Conclusions: This study of vocational rehabilitation in mainly female patients on long-term sick leave due to mental illness and/or chronic pain suggests that multidisciplinary team assessments and individually adapted rehabilitation interventions increased RTW and employability. Solely receiving the ACT intervention also increased employability.
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| 24. |
- Berglund, Erik, et al.
(författare)
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Social and health-related factors associated with refraining from seeking dental care : A cross-sectional population study
- 2017
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 45:3, s. 258-265
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social inequities are considered to affect healthcare utilization, whereas less is known about the factors associated with refraining from seeking dental care. This study aimed to investigate whether people with no social support, long-term illness, caregiver burden and low socioeconomic status (SES) refrained from seeking dental care in higher proportion than the general Swedish population.Methods: This study used cross-sectional questionnaire data from repeated nationwide health surveys during 2004-2013 of a total of 90 845 people. The questionnaire included questions on demographic characteristics, social support, long-term illness, caregiving burden, SES and dental care-seeking behaviour. Descriptive statistics, chi-square tests, correlation analyses and logistic regressions were used to investigate associations between independent variables and dental care-seeking behaviour.Results: In the total sample, 15.1% of respondents reported refraining from seeking dental care. Having no emotional social support or having no instrumental social support was separately associated with reporting refraining from seeking dental care in adjusted multivariate models (odds ratio [OR] 1.26, 95% confidence interval [CI] 1.18-1.34 and OR: 1.89, 95% CI: 1.67-2.13, respectively). Having a long-term illness was associated with refraining from seeking dental care in adjusted models (adjusted OR: 1.43, 95% CI: 1.35-1.51). Furthermore, being an informal caregiver was associated with refraining from seeking dental care (adjusted OR: 1.15, 95% CI: 1.07-1.23). Low SES was associated with higher refraining from seeking dental care; the strongest association was with having financial problems (adjusted OR: 3.57, 95% CI: 3.19-4.00). Interaction effects were found between education level and SES, and between social support and long-term illness, and the outcome.Conclusions: The findings in this study imply that having no social support, having long-term illness, being informal caregiver or having financial problems are factors associated with reporting refraining from seeking dental care, on a population basis.
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| 25. |
- Berglund, Erik, et al.
(författare)
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The influence of locus of control on self-rated health in context of chronic disease : a structural equation modeling approach in a cross sectional study
- 2014
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14, s. 492-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Self-rated health is a robust predictor of several health outcomes, such as functional ability, health care utilization, morbidity and mortality. The purpose of this study is to investigate and explore how health locus of control and disease burden relate to self-rated health among patients at risk for cardiovascular disease. Methods: In 2009, 414 Swedish patients who were using statins completed a questionnaire about their health, diseases and their views on the three-dimensional health locus of control scale. The scale determines which category of health locus of control - internal, chance or powerful others - a patient most identifies with. The data was analyzed using logistic regression and a structural equation modeling approach. Results: The analyses showed positive associations between internal health locus of control and self-rated health, and a negative association between health locus of control in chance and powerful others and self-rated health. High internal health locus of control was negatively associated with the cumulative burden of diseases, while health locus of control in chance and powerful others were positively associated with burden of diseases. In addition, age and education level had indirect associations with self-rated health through health locus of control. Conclusions: This study suggests that self-rated health is positively correlated with internal locus of control and negatively associated with high locus of control in chance and powerful others in patients at high risk for cardiovascular disease. Furthermore, disease burden seems to be negatively associated with self-rated health.
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