Changing perceived control in patients with physical disabilities: An intervention study with patients receiving rehabilitation

Abstract

Physiotherapy patients' perceptions of personal control over recovery (during rehabilitation) have been shown to be predictive of their progress. An experimental letter, consisting of the routine appointment letter plus some paragraphs designed to increase perceived control, was sent to 39 randomly selected patients prior to their first appointment. The remaining 32 control patients received the routine letter only. Approximately one week after each patient's first appointment, all patients were interviewed. The group to whom the experimental letter had been sent were found, on average, to have significantly higher levels of perceived control and tended to be more satisfied with information than the control group. There were no significant differences between groups on accuracy of expectations of physiotherapy. It is suggested that this type of communication given prior to treatment might lead to patients making better and faster progress with recovery. However, this possibility needs to be investigated by further study.

Psychological preparation for patients undergoing day surgery

“…Moreover, many studies have emphasised the various aspects of psychosocial care and information provision required alongside modern surgical practices (French 1979, Reading 1982, Schoessler 1989, Yount and Schoessler 1991, Lonsdale and Hutchison 1991, Johnston et al 1992, Kratz 1993, Fareed 1994, Gould and Wilson-Barnett 1995, Goodman 1997, Motyka et al 1997, Bradshaw et al 1999, Fellowes et al 1999.…”

“…Over many years, a large number of studies have been undertaken in order to demonstrate how specific factors can influence post-operative outcomes (Mathews and Ridgeway 1984, Hathaway 1986, Suls and Fletcher 1985, Suls and Wan 1989, Devine 1992, Johnston et al 1992, De Groot 1997a. All the approaches utilised within the studies below have evolved directly from the psychological coping approaches already mentioned i.e.…”

“…Likewise Johnston et al (1992) demonstrated how the perception of control could be manipulated by the addition of a few sentences on a routine appointment letter i.e. patients perceived greater health control once it was granted.…”

“…In a further review by Scheier and Carver (1992) coping and optimism were positively correlated with a problem solving approach and the acceptance of the reality of an uncontrollable healthcare situation. Johnston et al (1992) studied 71 patients undergoing rehabilitation dividing them into two groups. Participants in group one were sent a routine appointment letter whereas participants in group two were sent the same routine letter although with an additional few paragraphs designed to increase control and thereby raise expectations.…”

“…A number of more recent studies have further established that in a healthcare situation, locus of control beliefs may be more susceptible to environmental manipulation, especially the powerful others aspect (Johnston et al 1992, Avis 1994, Halfens 1995) (Chapter 2). In a study by Johnston et al (1992) of 71 patients experiencing rehabilitation, individual health control was observed to be directed by staff and not a spontaneous response by patients.…”