JMIR Publications

ABSTRACT

Background:

According to Globocan 2012, bladder cancer ranks 12th among the top 20 common cancers in China. Bladder cancer is 5 to 6 times more prevalent in men than in women in China. The locus of control construct can mediate health status and outcomes, and it has proved helpful in predicting and explaining specific health-related behaviors. However, it has never been used to investigate the health beliefs about bladder cancer treatment.

Objective:

This study aims to identify latent groups of Chinese males regarding their attitudes and beliefs about bladder cancer treatment, which represents a leading cause of death among Chinese male populations in recent years.

Methods:

We designed a 4-section questionnaire (1) Section 1: age, gender, and education; (2) Section 2: the communicative subscale of the All Aspects of Health Literacy Scale (AAHLS) [17]; (3) Section 3: the eHealth Literacy Scale (eHEALS) [18]; and (4) Section 4: the Multidimensional Health Locus of Control Scale (MHLC) Form C [20]. We hypothesized that the participants’ status of health belief and self confidence measured by the MHLC Form C could be closely associated with information collected through Sections 1-3. We recruited 444 Chinese male patients at Qilu Hospital. We then invited them to complete the translated Chinese version of the Multidimensional Health Locus of Control (MHLC) Form C questionnaire which contained Internal, Chance, Doctor, and Other People subscales. Finally, we used latent class analysis (LCA) to identify subgroups of males based on their categorical responses to the MHLC scale items which were 18 in total.

Results:

We identified two subgroups which were defined as low and moderate self-efficacy groups which represented 75% and 25% of the total sample. People in the low self-efficacy cluster (Cluster 1, 75%) were less likely to believe in their own capability or doctors’ advice to achieve better optimal outcomes in bladder cancer prevention and treatment. Chinese males in the moderate self-efficacy cluster (Cluster 2, 25%) had distinct psychological traits. They had stronger beliefs in their own capability to manage one’s health and moderate to high levels of trust in health and medical professionals and the importance of adherence to their advice to achieve better health outcomes. 4 factors contributing to low self-efficacy were identified, including (1) limited education (Year 6 to 12), (2) over 44 years old, (3) limited communicative health literacy, and (4) limited digital health literacy. These contributing factors can provide some implications for clinical practice, health education, medical research, and health policy-making.

Conclusions:

This was the first study investigating the attitudes and beliefs about bladder cancer treatment among Chinese male populations.