Health Locus of Control and Learned Helplessness in Cardiac Pacemaker Recipients

Abstract

Having lost control of heart rate and rhythm, pacemaker recipients depend on battery-driven mechanical devices for life support. They rely on health professionals for complex care. This loss of control and dependence may influence control beliefs. The relationships among, and the individual effects of health locus of control (HLC), age, and length of time paced on learned helplessness (LH) in cardiac pacemaker recipients were investigated.

HLC refers to beliefs about origins of health control, including (a) internal control by personal causation (IHLC), (b) external control by chance (CHLC), and (c) external control by powerful others (PHLC). The Multidimensional Health Locus of Control Scale-Form A (MHLCS-Form A) was used to assess HLC. Learned helplessness (LH) results when previous experience with uncontrollability leads to beliefs that future efforts at control will also prove fruitless. Consequences can include impaired cognition, reduced motivation, depressed affect, and lowered self-esteem. LH was measured using the Learned Helplessness Scale (LHS). Age and length of time paced were reported on the General Information Inventory

Responding to a mail survey in this descriptive, cross-sectional study, were 124 cardiac pacemaker recipients (56.5% male, age M = 72.18 years, SD = 12.38) paced an average of 5.1 years (SD = 4.2). Pearson correlations identified relationships between CHLC and LH (r = 33, p =.000), PHLC and LH (r = 30, p =.001), and age and LH (r =.25, p = .005). Time paced and LH were not related. Similarly, multiple regression analysis showed CHLC (β = .24, p = .008) and PHLC (β = .22, p = .022) making unique contributions to variance in LH. The individual effect of age on LH approached statistical significance (β = .17, p = .054).

Respondents believed themselves to control their health, while acknowledging the role of powerful others. As a group, they were not helpless. The UMLCS-Form A (α = .75) and the LHS (α = .92) demonstrated acceptable reliability in this sample. Ancillary analyses demonstrated relationships among a number of demographic and health related variables. Research must continue to add to nursing knowledge of psychologic responses in this ever-increasing patient population.