Predictors and Outcomes

John Henryism was assessed by the patient’s responses to the Portuguese version of the 12-item John Henryism Active Coping (JHAC) Scale. The Portuguese version of the scale was derived through translation and back translation of the English version by the scale’s developer (SAJ) and the senior author (AAL) of the current study. The Cronbach alpha, a measure of internal consistency reliability, was .704 for the Portuguese version of the JHAC Scale. This alpha coefficient is comparable to those reported in studies in the United States and Europe.2,4,8,9 Response options ranged from “completely true” (score = 5) to “completely false” (score = 1). The total JHAC score was determined by summing scores obtained for each of the 12 questions.4 Total scores can vary from a low of 12 to a high of 60. In our current study, the median score of 52 was used to categorize patients as high or low on John Henryism. This median score is similar to those reported in US community-based studies.2,17

Perceived General Health (GH) assessed in the present study is part of both the mental and physical dimensions of health-related quality of life.18 The GH score was determined using the patient’s responses for the 5 items of the version 1 of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).19 For item 1, patients were asked to choose one option that represented their general health: excellent, very good, good, fair or poor. For items 2 to 5, the patients were asked to choose the option (definitely true, mostly true, don’t know, mostly false and definitely false) that best described their perceived health status in relation to the following health-related statements: item 2) I seem to get sick a little easier than other people; item 3) I am as healthy as anybody I know; item 4) I expected my health to get worse; item 5) My health is excellent. The response for each item was scored. For items 1, 3 and 5, the scores were 100 for definitely true, 75 for mostly true, 50 for don’t know, 25 for mostly false and 0 (zero) for definitely false. For items 2 and 4, the scores followed an inverse order. The total general health score was determined by summing up the score for each item and dividing by 5. Total GH scores ranged from 0 to 100, with higher scores indicating better perceived GH.