The Open Nursing Journal




ISSN: 1874-4346 ― Volume 13, 2019
RESEARCH ARTICLE

Improvement in Diabetic Control Belief in Relation to Locus of Control



Yusran Haskas1, *, Suryanto2, Suarnianti1
1 Department of Nursing, Nani Hasanuddin Health Sciences Institute, Makassar, South Sulawesi Indonesia
2 Department Personality and Social Psychology, Airlangga University, Surabaya, East Java, Indonesia

Abstract

Background:

Adherence to diabetes control is important to determine an individual’s ability to maintain treatment focus of Diabetes Mellitus . The Locus of Control thereby assesses the behavior of an individual to diabetes control.

Objective:

The aim of this study was to analyze the pathways of diabetes control beliefs based on the variable locus of control in the integration of locus of control theory and the theory of planning behavior on diabetes mellitus control behavior.

Methods:

This study was carried out as an explanatory research with a cross-sectional design. The sampling technique was consecutive. The sample size was determined using multivariate numerical analytic one-time predictive concept framework and 143 respondents at 8 locations were recruited by a random lottery method. Demographic data analysis of respondents was done using statistical software, namely IBM Statistics SPSS using a Chi-square statistical test. The proposed hypothesis was tested by the bivariate analysis of variance to assess the effect of causal variables.

Results:

The results of this study indicate that locus of control affects diabetic control beliefs (ρ = 0.05; α = 0.06; b = 0.16; b2 = 0.03; F = 3.91) in the diabetes mellitus control behavior.

Conclusion:

The findings of this study suggest a need to consistently provide positive information and support as a locus of control to guard a strong intention to control diabetes mellitus.

Keywords: Behavior, Diabetes mellitus, Diabetic control belief, Locus of control.


Article Information


Identifiers and Pagination:

Year: 2019
Volume: 13
First Page: 123
Last Page: 128
Publisher Id: TONURSJ-13-123
DOI: 10.2174/1874434601913010123

Article History:

Received Date: 19/02/2019
Revision Received Date: 16/04/2019
Acceptance Date: 17/04/2019
Electronic publication date: 31/05/2019
Collection year: 2019

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© 2019 Haskas et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Department of Nursing, Nani Hasanuddin Health Sciences Institute, Makassar, South Sulawesi Indonesia;
E-mail: yusranhaskas@stikesnh.ac.id





1. INTRODUCTION

The locus of control refers to an individual’s perception where he accepts the outcomes of events in his life as part of his own behavior or characteristics. Thus, the locus of control has a strong relationship with an individual’s behavior [1Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr 1966; 80(1): 1-28.[http://dx.doi.org/10.1037/h0092976] [PMID: 5340840] ]. Diabetes Mellitus (DM) is considered a medical condition with an annual increase in its prevalence. For example, in 2014, 8.5% of adults aged 18 years and older were having diabetes. In 2016, diabetes was a direct cause of 1.6 million deaths, and in 2012, a high blood glucose level was the cause of another 2.2 million deaths [2WHO. Fact-Sheets Diabetes [Internet] World Health Organization 2018. https://www.who.int/news-room/fact-sheets/detail/diabetes]. Therefore, controlling the disease at the global level is of utmost importance. The current estimated number of individuals with diabetes worldwide is approximately 364 million [3WHO. Media centre Obesity and overweight 2011; 2-5.]. Empirical evidence shows that individuals with a chronic form of the disease and receiving inadequate care have a low quality of life with poor clinical and psychological outcomes [4Martínez YV, Prado-Aguilar CA, Rascón-Pacheco RA, Valdivia-Martínez JJ. Quality of life associated with treatment adherence in patients with type 2 diabetes: a cross-sectional study. BMC Health Serv Res 2008; 8: 164.[http://dx.doi.org/10.1186/1472-6963-8-164] [PMID: 18667076] , 5Hernandez-Tejada MA, Lynch CP, Strom JL, Egede LE. Effect of perceived control on quality of life in indigent adults with type 2 diabetes. Diabetes Educ 2012; 38(2): 256-62.[http://dx.doi.org/10.1177/0145721711436135] [PMID: 22316644] ]. da Silva et al., (2018) [6Silva JAD, Souza ECF, Echazú Böschemeier AG, Costa CCMD, Bezerra HS, Feitosa EELC. Diagnosis of diabetes mellitus and living with a chronic condition: Participatory study. BMC Public Health 2018; 18(1): 699.[http://dx.doi.org/10.1186/s12889-018-5637-9] [PMID: 29871637] ] described DM to be one of the most serious chronic diseases in the world on the basis of its prevalence, economic and social effects, and the negative impact on the quality of life of affected people. This implies that changes in lifestyle habits, especially those related to eating, physical activity, and constant self-care, can play a major role in combating this illness. However, these aspects require greater personal autonomy and self-motivation.

Krampen (1996), states that control beliefs are similar to the idea of ​​locus of control. This is in line with a study [7Krampen G. Replik zu Rezension des IPC-Fragebogens zu Kontrollüberzeugungen 1996.] which suggested that the locus of control is one type of control beliefs. Locus of control refers to the place where the control originates, either internally in an individual or externally. From this statement, the researcher argues that the concept of locus of control is independent. Locus of control plays a role when individuals predict various factors that can support the creation of behavior; this includes both internal and external factors. Besides, the existing supporting factors shape individual control beliefs.

Control beliefs come from contingency expectations theory in action and represent subjective expectations that the possibility of action will succeed in certain situations [8Wallston K. Conceptualization and Operationalization of Perceive d Control 2001.http://scholar.google.com/scholar?hl=en&btnG=Search& q=intitle:Conceptualization+and+Operationalization+of+Perceive+d+Control#0]. Control beliefs are individual beliefs about the existence of factors that can facilitate or hinder the implementation of behavior [9Ajzen I. Nature and operation of attitudes. Annu Rev Psychol 2001; 52(1): 27-58. http://www.annualreviews.org/doi/10.1146/annurev. psych.52.1.27 [Internet].[http://dx.doi.org/10.1146/annurev.psych.52.1.27] [PMID: 11148298] ]. In general, control belief is a relatively stable personality characteristic as it reflects an individual's belief that he can overcome the difficult demands [10Spering M, Wagener D, Funke J. Brief report: The role of emotions in complex problem-solving. Cogn Emotion 2005; 19(8): 1252-61.[http://dx.doi.org/10.1080/02699930500304886] ]. The indicators used in measuring confidence control (control belief) is controlled belief strength and control belief power. An example of item control belief strength is that “I believe that my performance will be better in the coming months”. An example of control belief power (linked to the level of demand) could be stated as “I believe that if I am required to improve performance at a high level in the coming month, it will be very difficult for me to do” [11Ajzen I. Laws of human behavior : Symmetry , compatibility. 2014.].

Several earlier studies have highlighted the controversy over opinions regarding the similarity of types of locus of control and control beliefs in DM [12Haskas Y. Determinan locus of control pada theory of planned behavior dalam perilaku pengendalian diabetes melitus 2016.]. Seeman & Evans (1962) [13Seeman M, Evans JW. Alienation and learning in a hospital setting. Am Sociol Rev 1962; 27(6): 772.http://www.jstor.org/stable/2090405 ?origin=crossref [Internet].[http://dx.doi.org/10.2307/2090405] ] conducted research supporting a relationship between the locus of control for DM and health behavior. The study reported that individuals who actively sought information related to health had an internal locus of control. The individuals suffering from tuberculosis had an internal locus of control and a better understanding of their conditions. Moreover, these patients showed a tendency to frequently ask their doctors and nurses questions about their health conditions as compared to individuals having an external locus of control. Therefore, the main objective of the present study was to prove that the locus of control is independent and not a type of control belief. Moreover, using a combination of the locus of control theory and the theory of planning behavior on control of DM, we analyzed diabetic control beliefs based on the variable locus of control.

2. METHODS

The present investigation was an explanatory study with a cross-sectional design and was conducted from June 2015 to August 2015. The sample size was comprised of 122 respondents using the multivariate numerical analytic one-time predictive concept framework [14Dahlan S. Gerbang memahami epidemiologi, biostatistik, dan metodologi penelitian: Metode MSD (multiaksial sopiyudin dahlan) 2014.]. However, considering various errors, including incomplete responses, the sample size was increased by 20% and finally, 143 respondents were recruited. Sampling was performed using the consecutive sampling technique. Consecutive sampling refers to the selection of samples in a sequential manner and is based on research criteria to obtain the desired sample size or until the research period ends [15Currier DP. Elements of research in physical therapy 1984.]. The inclusion criteria were people with type 2 Diabetes Mellitus (DM), patients with new type 2 diabetes (<6 months from the onset of symptoms until being diagnosed), patients who have had type 2 DM (≥6 months from symptoms to diagnosis), and those having complications of type 2 DM. The data were collected at eight locations including three hospitals in Makassar City and five Primary Health Care centers in Makassar City. The site selection, especially for primary health care centers, was performed by random lottery. The research instrument used in the present study was a structured questionnaire with closed questionnaire patterns. Individuals with DM who previously agreed and signed an informed consent participated in the study and attempted the questionnaire.

The questions on the locus of control variables were obtained from a modified locus of control scale DM instrument [1Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr 1966; 80(1): 1-28.[http://dx.doi.org/10.1037/h0092976] [PMID: 5340840] ], which is overall items modified according to DM instrument, based on research requirements which including among others internal items (skill, abilities, and effort) and external items (powerful others and chance items). The locus of control served as the original source control that played a role when individuals predicted various factors that supported the confidence in control diabetes mellitus which sufferers. The instrument consists of 15 numbers with 5 numbers internal items which if answered agree to be given a score of 10 points (0 = disagree, 10 = agree) and external items as many as 10 numbers which if answered agree to be given a score of 5 points (0 = disagree, 5 = agree). The measurement results are interpreted internal locus of control if the total score internal items are higher than external items while interpreted as an external locus of control if the total external items score are higher than internal items. The questionnaire for the diabetic control beliefs instrument itself measures the respondents' beliefs about whether or not to carry out DM control behavior with the strength of control beliefs indicators, which is a strong belief that respondents can exercise DM control behavior. The measurement results are interpreted strongly if the total score of the respondents' answers is in the range of 43-102 points and is said to be weak if the total score of the respondent's answers is in the range under 43 points.

Questions on other variables were prepared with reference to the theoretical concepts, which were tested for validity and reliability. The validity of the research instrument was confirmed by correlating each item score and the total score using Pearson’s product moment correlation analysis (n = 31, r table at α (0.05) = 0.36 and α (0.01) = 0.46). Where the test decision from the analysis is if r count is greater than r table then the item has validity and if r count is smaller than r table then the item is declared invalid. The invalid items were rejected, and the validity was tested again using Cronbach’s alpha (α = 0.50–0.70, moderate reliability; α > 0.7, sufficient reliability; and α > 0.80, all items are reliable and internally consistent). The respondent's data were demographically analyzed using the statistical software, IBM Statistics SPSS, in the form of frequency distribution analysis. The analysis was presented in a tabular form. The hypothesis testing was conducted using a chi-square statistical test with α = 0.06, with the intention that the chance of error in measurement was six times or 6% of the total measurement.

3. RESULTS

Table 1 shows the results of the validity and reliability tests of the questionnaire used. Out of a total of 18 questions on the locus of control, there were 2 invalid questions with a reliability value of 0.81. In contrast, among questions on diabetic control beliefs, 1 invalid question from 18 questions had a reliability value of 0.89. These results demonstrated that the distribution of socio-demographic factors of the respondents was in the locus of control dimension (Table 2). The frequency distribution data analysis showed that most respondents belonged to the age group of 46 to 55 years (35.7%). Out of these, 52.4% were males, had a high school education (45.5%), and were suffering from DM for more than five years (48.3%). Most of the respondents (55.9%) did not experience DM complications. Moreover, some respondents (88.1%) were more likely to have an internal locus of control.

Table 3 shows the results related to age groups. It could be concluded that with increasing age, patients with DM developed a higher internal locus of control and tended to be stable in the 46 to 65 years of age group. This reflected a higher percentage of respondents having an internal locus of control as compared to those having an external locus of control. Regarding the gender, the internal locus of control was higher in men (92.0%) as compared to an external locus of control; similarly, in women, the internal locus of control was higher (83.8%) as compared to an external locus of control.

Based on the highest level of education, the percentage of respondents showed that the higher the education, they tend to have a higher internal locus of control compared to an external locus of control. Based on the duration of DM, the percentage of respondents suffering from DM >5 years was higher in the internal locus of control (91.3%) compared to an external locus of control (8.7%). It can be concluded that the longer a person suffers from DM, the more likely he is to have an internal locus of control. Regarding the presence or absence of complications, the percentage of respondents who had not experienced severe complications was higher for the internal locus of control (90.0%) compared to the external locus of control (10.0%).

The data shown in Table 4 suggest that the locus of control affects the diabetic control beliefs (ρ = 0.05; b = 0.16; b2 = 0.03; F = 3.91). Thus, it could be concluded that the locus of control had a direct effect on the diabetic control beliefs in DM control behavior with a total effect on diabetic control beliefs. The frequency distribution data showed that 99.2% of patients with an internal locus of control orientation and 100% of patients with an external locus of control orientation had strong control beliefs.

Table 1
The results of validity and reliability tests.


Table 2
The frequency distribution of respondents' characteristics (n = 143).


Table 3
The dimensions of locus of control based on age, gender, highest education, duration of diabetes, and complications (n = 143).


Table 4
The distribution of respondents based on the locus of control on diabetic control beliefs in DM patients.


4. DISCUSSION

The results presented in this article lead to the conclusion that socio-demographic factors affect locus of control. This finding is in line with previous research that locus of control is influenced by various factors, namely, age [14Dahlan S. Gerbang memahami epidemiologi, biostatistik, dan metodologi penelitian: Metode MSD (multiaksial sopiyudin dahlan) 2014., 15Currier DP. Elements of research in physical therapy 1984.], environment [16Peng TA. Finite groups with pro-normal subgroups. 1967; 232-4.], past experience [17Crandall VC, Katkovsky W, Crandall VJ. Children’S beliefs in their own control of reinforcements in intellectual-academic achievement situations. Child Dev 1965; 36(1): 91-109.[http://dx.doi.org/10.2307/1126783] [PMID: 14296800] , 18Bandung SA, Bandung SA. Page 1 1. System 2010; 3-4.], and culture [1Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr 1966; 80(1): 1-28.[http://dx.doi.org/10.1037/h0092976] [PMID: 5340840] , 19Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 1971; 32(2): 271-5.[http://dx.doi.org/10.1016/0030-4220(71)90230-1] [PMID: 5284110] ]. Someone who has an external locus of control believes that their behavior is caused by some external factors [20Price E. Novicki strickland locus of control scales 1973., 21Baken D, Stephens C. More dimensions for the multidimensional health locus of control: confirmatory factor analysis of competing models of the structure of control beliefs. J Health Psychol 2005; 10(5): 643-56.[http://dx.doi.org/10.1177/1359105305055310] [PMID: 16033786] ]. Levenson (1972) [22Levenson H. Distinctions within the concept of internal-external control: Development of a new scale. Proc 80th Annu Conv Am Psychol Assoc 1972.] divided the external control center into two types: powerful-others and opportunities (chance) mainly by fate, opportunity, and luck.

The patients with diabetes mellitus are more likely to have an internal locus of control. This finding indicates that DM patients consider themselves to have the greatest influence on DM control, so policies and strategies for DM control should be emphasized more on DM patients' involvement in controlling actions related to their disease. Although so far no method or treatment has been found that can cure diabetes, normal glycemic levels can be achieved by diet, exercise, and anti-diabetic drugs. The control method is very specific for each patient, thus the success of the treatment program depends on a patient. This is in line with the results of a study that shows that the perception of control of the disease will affect the patient cure rate [23Williams JS, Lynch CP, Voronca D, Egede LE. Health locus of control and cardiovascular risk factors in veterans with type 2 diabetes. Endocrine 2016; 51(1): 83-90.[http://dx.doi.org/10.1007/s12020-015-0677-8] [PMID: 26148703] ].

The results obtained show that the locus of control is variable and has a causal effect on diabetic control beliefs that are defined and measured not as a trait but as a place of control in DM patients regarding their ability to control DM. Therefore, the overall reflection of patient characteristics can lead them to the dominant internal locus of control because it will be more selective to choose the information that enters and controls DM behavior. Therefore, the results of this study prove that the locus of control is independent, this is in contrast to the earlier opinions about the locus of control, which, in the context of social learning theory, states that locus of control is one type of personality trait [1Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr 1966; 80(1): 1-28.[http://dx.doi.org/10.1037/h0092976] [PMID: 5340840] ].

Based on this, it can be concluded that locus of control is independent and not a type of personality traits or control beliefs. The control center has an impact that plays an important role in a variety of domains of a person's life, including health, happiness, job satisfaction, and life as a whole, and to a large extent also influences the career and vocation they choose [24O’Driscoll M, Jeggo PA. The role of double-strand break repair - insights from human genetics. Nat Rev Genet 2006; 7(1): 45-54.[http://dx.doi.org/10.1038/nrg1746] [PMID: 16369571] ]. In addition, the findings of this study are also supported by the research showing that age, gender, ethnicity, socioeconomic status, mood, personality traits, and knowledge influence individual attitudes and behavior toward something [25Hussain ST, Lei S, Akram T, Haider MJ, Hussain SH, Ali M. Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. J Innov Knowl 2016; 1-7.http://linkinghub.elsevier.com/retrieve/pii/S2444569X16300087]. Therefore, the locus of control is the place where the formation of control beliefs occurs in an independent dimension. In the behavioral theory, it is explained that the background factors are basically the characteristics present in a person, which, in the Kurt Lewin model, are categorized as the aspects of O (organism) [25Hussain ST, Lei S, Akram T, Haider MJ, Hussain SH, Ali M. Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. J Innov Knowl 2016; 1-7.http://linkinghub.elsevier.com/retrieve/pii/S2444569X16300087].

The locus of control affects diabetes control beliefs (ρ = 0.05). The frequency distribution data showed that 99.2% of patients with an internal locus of control orientation have strong control beliefs and 100% of patients with an external locus of control orientation have strong control beliefs. This means that the locus of control orientation does not distinguish the sufferer's control beliefs, but it is different from the source of the belief support. The individual differences at the level of how they generalize beliefs about the ability of their actions are related to the results they get [26Lent CRW, Brown SD, Hackett G, Greenhaus EJH, Callanan GA. Encyclopedia of career development social cognitive career theory 2015; 751-5.].

This finding also supports the development of new ideas because it proves that locus of control is different from control beliefs, so an interesting issue is a concept that the locus of control is a place that accommodates various supporting sources for the creation of behaviors originating from internal and external environment in DM sufferers and determines the patients' confidence in DM control. This answers the controversy over previous opinions regarding the link between locus of control and control beliefs, whether the locus of control is a type of control beliefs or rather a place of control [7Krampen G. Replik zu Rezension des IPC-Fragebogens zu Kontrollüberzeugungen 1996.]. Control beliefs are similar to the idea of ​​locus of control [8Wallston K. Conceptualization and Operationalization of Perceive d Control 2001.http://scholar.google.com/scholar?hl=en&btnG=Search& q=intitle:Conceptualization+and+Operationalization+of+Perceive+d+Control#0].

The locus of control can affect individual behavior related to health, including risky health behaviors and adherence to health care recommendations [27Bonichini S, Axia G, Bornstein MH. Validation of the parent health locus of control scales in an Italian sample. Ital J Pediatr 2009; 35(1): 13.[http://dx.doi.org/10.1186/1824-7288-35-13] [PMID: 19490604] ]. Previous research shows that individuals who actively seek information related to health are individuals who have an internal locus of control [28Jhis 1. 1962; 10: 14.]. The individuals, who have an internal locus of control that is more independent and more resilient, have strong endurance and are more resistant to dealing with social influences [28Jhis 1. 1962; 10: 14.], more able to delay gratification, not easily affected, and more able to deal with failure [29Jain S, Singh AP. Locus of control in relation to cognitive complexity. J Indian Acad Appl Psychol 2008; 34(1): 107-13.].

The previous studies that were almost similar to this one were focused on the effect of perceived control and locus of control for cortisol and subjective responses to control for cortisol (stress hormone) [30Bollini AM, Walker EF, Hamann S, Kestler L. The influence of perceived control and locus of control on the cortisol and subjective responses to stress. Biol Psychol 2004; 67(3): 245-60.[http://dx.doi.org/10.1016/j.biopsycho.2003.11.002] [PMID: 15294 384] ]. An intensive control for diabetic through medical nutrition therapy, exercise and medicine is necessary so that the blood sugar is well controlled and the occurrence of disease complications is prevented or delayed. Physicians, healthcare professionals, nurses, and nutritionists must be able to motivate patients and work together in tackling diabetes [31Mihardja L. Faktor yang Berhubungan dengan Pengendalian Gula Darah pada Penderita Diabetes Mellitus di Perkotaan Indonesia. 2009.].

The locus of control has an effect on diabetes control beliefs. It has implications that patients should be exposed more often to various factors that can be used as a source to strengthen control center, both internally and externally, so that the patient's confidence in being able to control DM is also strengthened. The internal dimension or external locus of control has an equally good role if it contains positive sources and will strengthen the patient's confidence to exercise control.

The locus of control is independent. The locus of control significantly affects an individual’s diabetic control beliefs in diabetes mellitus control behavior. The patients have a strong belief that they are able to control DM because there are various factors that can facilitate the creation of these behaviors that are accommodated in the locus of control; The locus of control factor comes from internal and external sources so that patients can predict these factors to increase their confidence in behavior control. Although some experts state that locus of control is a type of control belief [7Krampen G. Replik zu Rezension des IPC-Fragebogens zu Kontrollüberzeugungen 1996.].

CONCLUSION

The results of this study prove that the fundamental difference between locus of control and control beliefs is that locus of control is not a type of control belief but a determinant of control belief leading to the development of DM control behavior. Therefore, researchers assume that with an increase in the locus of control, there will also be an increase in diabetic control belief in the behavior of an individual controlling diabetes mellitus.

ETHICS APPROVAL AND CONSENT TO PARTICIPATE

Not applicable.

HUMAN AND ANIMAL RIGHTS

No animals/ humans were used for the studies that are basis of this research.

CONSENT FOR PUBLICATION

Individuals with DM who previously agreed and signed an informed consent participated in the study and attempted the questionnaire.

AVAILABILITY OF DATA AND MATERIALS

The data were collected at eight locations including three hospitals in Makassar City and five Primary Health Care centers in Makassar City. The data supporting the findings of the article is available in the Universitat Trier at https://www.uni-trier.de/fileadmin/fb1/prof/PSY/KPW/1997_Replik_zur_Rezension.pdf [7Krampen G. Replik zu Rezension des IPC-Fragebogens zu Kontrollüberzeugungen 1996.] Mahwah, New Jersey London at http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Conceptualization+and+Operationalization+of+Perceive+d+Control#0 [8Wallston K. Conceptualization and Operationalization of Perceive d Control 2001.http://scholar.google.com/scholar?hl=en&btnG=Search& q=intitle:Conceptualization+and+Operationalization+of+Perceive+d+Control#0] University of Massachusetts at https://www. annualreviews.org/doi/10.1146/annurev.psych.52.1.27 [9Ajzen I. Nature and operation of attitudes. Annu Rev Psychol 2001; 52(1): 27-58. http://www.annualreviews.org/doi/10.1146/annurev. psych.52.1.27 [Internet].[http://dx.doi.org/10.1146/annurev.psych.52.1.27] [PMID: 11148298] ] George Mason University at 10.1080/02699930500304886 [10Spering M, Wagener D, Funke J. Brief report: The role of emotions in complex problem-solving. Cogn Emotion 2005; 19(8): 1252-61.[http://dx.doi.org/10.1080/02699930500304886] ] University of Massachusetts at https://www. researchgate. net/publication/264156930_Laws_of_human_behavior_Symmetry_compatibility_and_attitude-behavior_correspondence [11Ajzen I. Laws of human behavior : Symmetry , compatibility. 2014.] Encyclopedia of Career Development at 10.4135/978141 2952675.n261 [26Lent CRW, Brown SD, Hackett G, Greenhaus EJH, Callanan GA. Encyclopedia of career development social cognitive career theory 2015; 751-5.].

FUNDING

None.

CONFLICT OF INTEREST

The authors declare no conflict of interest, financial or otherwise.

ACKNOWLEDGEMENTS

Declared none.

REFERENCE

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[2] WHO. Fact-Sheets Diabetes [Internet] World Health Organization 2018. https://www.who.int/news-room/fact-sheets/detail/diabetes
[3] WHO. Media centre Obesity and overweight 2011; 2-5.
[4] Martínez YV, Prado-Aguilar CA, Rascón-Pacheco RA, Valdivia-Martínez JJ. Quality of life associated with treatment adherence in patients with type 2 diabetes: a cross-sectional study. BMC Health Serv Res 2008; 8: 164.[http://dx.doi.org/10.1186/1472-6963-8-164] [PMID: 18667076]
[5] Hernandez-Tejada MA, Lynch CP, Strom JL, Egede LE. Effect of perceived control on quality of life in indigent adults with type 2 diabetes. Diabetes Educ 2012; 38(2): 256-62.[http://dx.doi.org/10.1177/0145721711436135] [PMID: 22316644]
[6] Silva JAD, Souza ECF, Echazú Böschemeier AG, Costa CCMD, Bezerra HS, Feitosa EELC. Diagnosis of diabetes mellitus and living with a chronic condition: Participatory study. BMC Public Health 2018; 18(1): 699.[http://dx.doi.org/10.1186/s12889-018-5637-9] [PMID: 29871637]
[7] Krampen G. Replik zu Rezension des IPC-Fragebogens zu Kontrollüberzeugungen 1996.
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[9] Ajzen I. Nature and operation of attitudes. Annu Rev Psychol 2001; 52(1): 27-58. http://www.annualreviews.org/doi/10.1146/annurev. psych.52.1.27 [Internet].[http://dx.doi.org/10.1146/annurev.psych.52.1.27] [PMID: 11148298]
[10] Spering M, Wagener D, Funke J. Brief report: The role of emotions in complex problem-solving. Cogn Emotion 2005; 19(8): 1252-61.[http://dx.doi.org/10.1080/02699930500304886]
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[13] Seeman M, Evans JW. Alienation and learning in a hospital setting. Am Sociol Rev 1962; 27(6): 772.http://www.jstor.org/stable/2090405 ?origin=crossref [Internet].[http://dx.doi.org/10.2307/2090405]
[14] Dahlan S. Gerbang memahami epidemiologi, biostatistik, dan metodologi penelitian: Metode MSD (multiaksial sopiyudin dahlan) 2014.
[15] Currier DP. Elements of research in physical therapy 1984.
[16] Peng TA. Finite groups with pro-normal subgroups. 1967; 232-4.
[17] Crandall VC, Katkovsky W, Crandall VJ. Children’S beliefs in their own control of reinforcements in intellectual-academic achievement situations. Child Dev 1965; 36(1): 91-109.[http://dx.doi.org/10.2307/1126783] [PMID: 14296800]
[18] Bandung SA, Bandung SA. Page 1 1. System 2010; 3-4.
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Endorsements



"Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines."


Daniel Pesut
(Indiana University School of Nursing, USA)

"It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor."


Jacques Descotes
(Centre Antipoison-Centre de Pharmacovigilance, France)

"Publishing research articles is the key for future scientific progress. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community."


Patrice Talaga
(UCB S.A., Belgium)

"Open access journals are a novel concept in the medical literature. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. They are an outstanding source of medical and scientific information."


Jeffrey M. Weinberg
(St. Luke's-Roosevelt Hospital Center, USA)

"Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Indeed, the research articles span a wide range of area and of high quality. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals."


Debomoy K. Lahiri
(Indiana University School of Medicine, USA)

"Open access journals represent a major break-through in publishing. They provide easy access to the latest research on a wide variety of issues. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Articles are of uniformly high quality and written by the world's leading authorities."


Robert Looney
(Naval Postgraduate School, USA)

"Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets."


Richard Reithinger
(Westat, USA)

"Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers."


J. Ferwerda
(University of Oxford, UK)

"Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content."


Sean L. Kitson
(Almac Sciences, Northern Ireland)

"In principle, all scientific journals should have open access, as should be science itself. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. The articles are high standard and cover a wide area."


Hubert Wolterbeek
(Delft University of Technology, The Netherlands)

"The widest possible diffusion of information is critical for the advancement of science. In this perspective, open access journals are instrumental in fostering researches and achievements."


Alessandro Laviano
(Sapienza - University of Rome, Italy)

"Open access journals are very useful for all scientists as they can have quick information in the different fields of science."


Philippe Hernigou
(Paris University, France)

"There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Open access journals offer a good alternative for free access to good quality scientific information."


Fidel Toldrá
(Instituto de Agroquimica y Tecnologia de Alimentos, Spain)

"Open access journals have become a fundamental tool for students, researchers, patients and the general public. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. The articles are among the best and cover most scientific areas."


M. Bendandi
(University Clinic of Navarre, Spain)

"These journals provide researchers with a platform for rapid, open access scientific communication. The articles are of high quality and broad scope."


Peter Chiba
(University of Vienna, Austria)

"Open access journals are probably one of the most important contributions to promote and diffuse science worldwide."


Jaime Sampaio
(University of Trás-os-Montes e Alto Douro, Portugal)

"Open access journals make up a new and rather revolutionary way to scientific publication. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists."


Eduardo A. Castro
(INIFTA, Argentina)

"Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. The articles published in the open access journals are high quality and cover a wide range of fields."


Kenji Hashimoto
(Chiba University, Japan)

"Open Access journals offer an innovative and efficient way of publication for academics and professionals in a wide range of disciplines. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. I read Open Access journals to keep abreast of the recent development in my field of study."


Daniel Shek
(Chinese University of Hong Kong, Hong Kong)

"It is a modern trend for publishers to establish open access journals. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category."


Jih Ru Hwu
(National Central University, Taiwan)


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