title: Patients' perceived control over their health care: an outcome assessment of their psychological adjustment to renal failure.
abstract: Previous research has sometimes produced conflicting results regarding patients' psychological adjustment to end-stage renal disease (ESRD). It is generally accepted that treatment outcomes vary across treatment modality, with successful transplant patients reporting a higher subjective quality of life than patients on center hemodialysis. Hemodialysis and transplantation therapies vary in many ways, including the intrusiveness of treatment on all aspects of the patient's life. In the present study, 65 individuals being treated for ESRD with center hemodialysis or a renal transplant were assessed for health locus of control, for generalized control over 11 life dimensions, and for beliefs about control over specific aspects of treatment for ESRD. The study also included indicators of psychological adjustment. The results indicated that control over life dimensions, which includes control over illness, is a significant factor in psychological adjustment. Beliefs that one can comply specifically with diet and fluid restrictions were related to treatment outcome. These data suggest that interventions designed to increase patients' perception of control are likely to have a positive impact on the qualitative aspect of treatment.
authors.affiliation: Psychology Program, Penn State Harrisburg, Middletown 17057, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Bremer
authors.forename: D
authors.initials: D
authors.lastname: Haffly
authors.forename: R M
authors.initials: RM
authors.lastname: Foxx
authors.forename: A
authors.initials: A
authors.lastname: Weaver
mesh_terms: D000223:Adaptation, Psychological; D005260:Female; D006801:Humans; D007389:Internal-External Control; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D006435:Renal Dialysis / Q000523:psychology*; D017749:Total Quality Management