Confirmatory factor analysis of the Japanese Health Locus of Control scales among people with musculoskeletal disorders.
Sayaka Nemoto, Takahiro Miki, Yu Kondo and 1 others
PMID 36628135WHAT IT FOUND
The 25-item Japanese Health Locus of Control scale works better as five separate factors (internal, family, professional, chance, supernatural) than as a simple internal-versus-external split in patients with musculoskeletal pain.
However, it only met two of four statistical criteria for a good fit.
Key findings
01The 5-factor structure model satisfied two criteria of acceptable fit, whereas the 2-factor model did not meet the criteria.
02The study suggests that health locus of control in this population is not a simple binary of internal versus external, but involves distinct external factors like family, professionals, chance, and supernatural beliefs.
03The scale's validity was limited to patients with musculoskeletal disorders and no comorbidities, and the authors suggest its use should currently be restricted to this group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The 5-factor model only met two of four statistical criteria for acceptable fit, meaning the structure is not fully validated. Participants were already undergoing physical therapy, so their beliefs about health control may have been influenced by prior therapeutic education, limiting generalizability to untreated patients. The study only included patients with musculoskeletal disorders and no comorbidities, so the scale's validity for patients with other conditions (e.g., chronic disease, mental health issues) is unknown. The sample was recruited from two specific clinics in Japan, which may limit applicability to other cultural or healthcare contexts.
Declared interests
The authors declared no conflicts of interest and no funding sources.
The easy way to misread this
Do not assume the 25-JHLC scale is a fully validated or definitive tool for assessing health locus of control in all musculoskeletal patients. The 5-factor structure only partially met statistical standards for fit, and the study was limited to a specific population of Japanese patients without comorbidities who were already in physical therapy.