Gerontologists are increasingly interested in the notion of perceived personal control because such perceptions can be threatened by age-related changes such as declining health and the loss of loved ones. Although a great deal is known about the central role of perceived control in healthy, successful aging, less is known about its potential role in specific contexts such as the use of health services. Our study examined the link between perceived control and patterns of health service use among older individuals with arthritis. We assessed perceived control during an interview, using both a domain-specific and a global measure, and considered health service use in the subsequent year. Even after statistically adjusting for age and morbidity, individuals who perceived low levels of control subsequently were found to use more health services than their high-control counterparts; they visited their physicians more often, had more laboratory tests, and stayed longer in the hospital. This was true, however, only for individuals who had also reported that their arthritis restricted the things they were able to do. Various interpretations are considered, including the possibility that patients with low perceived control are inefficient users of health services or that patients with high perceived control experience a deficiency in health care.

The students demonstrated good theoretical knowledge about responsive behaviors, but the lack of personal experience in managing such behaviors left the students feeling ill-prepared and distressed. Incorporating the opportunity to experience behaviors in a supported environment, such as in simulation, could reduce student distress and increase their sense of competency. [J Nurs Educ. 2017;56(10):623-627.].

Bachelor of Nursing students (BN) placed in long-term care encounter residents who exhibit challenging behaviors. Students are often inadequately prepared to manage these behaviors, and this is a source of distress for students. This study explored whether enhancing and restructuring theoretical and clinical courses resulted in student nurses feeling better prepared to manage residents' challenging behaviors and improve their levels of distress. This study was conducted in two phases with 116 BN students (first phase) and 99 students (second phase) where the course on older adults was restructured. The findings of this study indicated that students who felt less prepared experienced greater distress by residents' behaviors than those who felt better prepared. Scheduling a theoretical course on the care of older adults prior to the clinical course placement, as well as offering an online learning module focused on responsive behaviors, significantly increased students' feelings of preparedness to manage residents' complex behaviors.

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