Greater Personal Health Agency Is Associated With Greater Patient Receptiveness to Mindset Exercises

Abstract

Among 203 patients presenting for musculoskeletal specialty care between November 2023 and January 2024, we measured the relationship of openness to mindset exercises such as cognitive behavioral therapy (training the mind to default to healthier thoughts and feelings about bodily sensations) with levels of personal health agency accounting for other personal factors. Factors associated with greater openness to mindset exercises in linear regression included greater personal health agency (RC = 0.17), younger age (RC = −0.030), and 4-year college education (RC = 1.5). In a second linear regression, greater personal health agency was associated with older age (RC = 0.053), greater trust in the clinician (RC = 0.25), injury diagnosis (RC = 1.8), less distress regarding symptoms (RC = −0.25), less unhelpful thinking regarding symptoms (RC = −0.43), and retirement (RC = −1.7). In cluster analysis, we found that increasingly lower openness to mindset exercises was associated with increasingly worse levels of distress and unhelpful thoughts, lower personal health agency, and slightly varying social health and trust in clinician. The finding that greater responsibility for one's health, including openness to mindset exercises, corresponds with a healthy understanding and emotional response to bodily sensations, greater social security, and greater trust in the clinician directs specialists to prioritize building trust, gently reorienting common misconceptions about bodily sensations, and assistance with social stressors.