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Locus of Control: Implications for Clinical Nursing Practice
Author(s) -
Shillinger Freda L.
Publication year - 1983
Publication title -
image: the journal of nursing scholarship
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.009
H-Index - 80
eISSN - 1547-5069
pISSN - 0743-5150
DOI - 10.1111/j.1547-5069.1983.tb01357.x
Subject(s) - conformity , negotiation , normative , locus of control , health care , psychology , social psychology , coercion (linguistics) , perception , norm (philosophy) , alliance , sociology , epistemology , political science , social science , philosophy , linguistics , neuroscience , law
Compliance, adherence, and a therapeutic alliance are terms that, when used in a health care context, refer to the process whereby a patient assumes the various tasks that comprise a therapeutic regimen. When a patient is said to be compliant there is the suggestion that he has been coerced; when he is said to be adherent it appears that he is conforming to some norm or standard set for him; when he forms an alliance it seems he has negotiated what it is he will do to care for himself. Coercion, conformity, and negotiation make up a continuum that varies in the degree to which a patient is active in the decisions being made about himself, or inversely, the degree to which others determine the patient's behavior (Barofsky 1978). All too often a person's experience with the health care system is coercive, thereby restricting the individual's need to freely direct and control his life affairs freely, which in turn leads potentially to noncompliance behaviors. Individuals perceptions of their control over the environment and its relationship to other areas of cognitive functioning and to behavior have aroused considerable interest. Health beliefs and behaviors, however, have received little attention as a specific area in which to investigate perceptions of control. Since many health actions depend on voluntary behaviors and many health programs are predicated on an assumption of controllability, patients'expectancies concerning control seem to be a worthwhile area for examination. Locus of control, an individual difference construct from social learning theory, has shown some promise in predicting and explaining specific health‐related behaviors. Yet compliance problems, being highly complex, are not easily reducible to a single simple explanation. This paper will review research demonstrating the utility of locus of control in understanding health behaviors. A method for incorporating the construct into the nursing process will be described. Using this framework as a basis, the author will explore methods of increasing client participation in treatment programs while maintaining a therapeutic alliance.