The Role of Perceived Control for the Perception of Health by Patients with Persistent Mental Illness

Perceived control has been found to be of significance for patients with psychiatric disorders and may be regarded as an aspect of empowerment. Moreover, a sense of control has been identified as important for occupational performance, both in empirical research and in occupational therapy theory. This study aimed at investigating factors that might be of importance for perceived control: sociodemographic, clinical, and well-being variables. Another aim was to investigate whether perceived control served as a mediator between clinical variables, in terms of psychopathology, and well-being variables, in terms of perceived health. Sociodemographic data were collected from 177 subjects, most of them with psychosis diagnoses. They were also assessed regarding perceived control (locus of control and self-mastery) and different aspects of health and well-being. The findings showed that both clinical and well-being variables were consistently related to both aspects of perceived control. Moreover, the roles of self-mastery and locus of control as mediators of perceived health were identified. The results also identified some important sociodemographic factors that might promote a sense of control and empowerment, mainly educational level and friends. This study provided detailed knowledge of the role of perceived control for well-being among people with mental disorders. Strategies for how occupational therapists may promote a sense of control in this group are discussed.

[1]  A. Antonovsky The structure and properties of the sense of coherence scale. , 1993, Social science & medicine.

[2]  A. Sourander,et al.  Predictors of Subjective Quality of Life in Schizophrenic Patients Living in the Community. a Nordic Multicentre Study , 1999, The International journal of social psychiatry.

[3]  M. Rosenberg Society and the adolescent self-image , 1966 .

[4]  M. Lieberman,et al.  The stress process. , 1981, Journal of health and social behavior.

[5]  M. Bäckström,et al.  Personality and self‐variables: important determinants of subjective quality of life in schizophrenia out‐patients , 2003, Acta psychiatrica Scandinavica.

[6]  J. Rotter Generalized expectancies for internal versus external control of reinforcement. , 1966, Psychological monographs.

[7]  A. Antonovsky,et al.  The sense of coherence concept and its relation to personality traits in Swedish samples. , 1992, Scandinavian journal of caring sciences.

[8]  J. Overall,et al.  The Brief Psychiatric Rating Scale , 1962 .

[9]  P. Huxley,et al.  Quality of Life and Mental Health Services , 1997 .

[10]  L. Hansson,et al.  The validity of Antonovsky's Sense of Coherence measure in a sample of schizophrenic patients living in the community. , 2001, Journal of advanced nursing.

[11]  K. Baron The Model of Human Occupation , 1987 .

[12]  J. Korkeila,et al.  Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: A Nordic multicentre study , 2005, Quality of Life Research.

[13]  Douglas G. Altman,et al.  Practical statistics for medical research , 1990 .

[14]  M. Eklund Perceived control: how is it related to daily occupation in patients with mental illness living in the community? , 2007, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[15]  Gary Kielhofner,et al.  Model of human occupation : theory and application , 1985 .

[16]  G. Moddeman,et al.  Unraveling the Mystery of Health , 1995 .

[17]  S. Rosenfield Factors contributing to the subjective quality of life of the chronic mentally ill. , 1992, Journal of health and social behavior.

[18]  T. Hogan,et al.  Quality of life in chronically mentally ill patients in day treatment , 1990, Psychological Medicine.

[19]  D. J. Lee Society and the Adolescent Self-Image , 1969 .

[20]  M. Eklund,et al.  The Importance of Work as Compared to Other Forms of Daily Occupations for Wellbeing and Functioning Among Persons with Long-Term Mental Illness , 2004, Community Mental Health Journal.

[21]  F. Holloway Quality of life and mental health services. , 1999, The International journal of social psychiatry.

[22]  Thomas E. Smith,et al.  Quality of life in schizophrenia: contributions of anxiety and depression , 2001, Schizophrenia Research.

[23]  T. Björkman,et al.  Quality of life in people with severe mental illness. Reliability and validity of the Manchester Short Assessment of Quality of Life (MANSA) , 2005, Nordic journal of psychiatry.

[24]  M. King The Theory and Practice of Group Psychotherapy, 4th ed , 1996 .

[25]  M. Eklund,et al.  Relationships between satisfaction with occupational factors and health-related variables in schizophrenia outpatients , 2001, Social Psychiatry and Psychiatric Epidemiology.

[26]  S. Evans,et al.  Application and Results of the Manchester Short Assessment of Quality of Life (Mansa) , 1999, The International journal of social psychiatry.

[27]  H. Björvell,et al.  Coping ability and functional status in a Swedish population sample. , 1993, Scandinavian journal of caring sciences.

[28]  G. Marshall,et al.  Optimism, self-mastery, and symptoms of depression in women professionals. , 1990, Journal of Personality and Social Psychology.

[29]  M. Eklund,et al.  The Tree Theme Method in Psychosocial Occupational Therapy: A Case Study , 2006, Scandinavian journal of occupational therapy.

[30]  M. Eklund Therapeutic factors in occupational group therapy identified by patients discharged from a psychiatric day centre and their significant others , 1997 .

[31]  A. Bengtsson-tops Mastery in patients with schizophrenia living in the community: relationship to sociodemographic and clinical characteristics, needs for care and support, and social network. , 2004, Journal of psychiatric and mental health nursing.

[32]  I. Melle,et al.  Global Assessment Scale and Health-Sickness Rating Scale: Problems in Comparing the Global Functioning Scores Across Investigations , 1993 .

[33]  W. Coster,et al.  Competency beliefs and occupational role behavior among adolescents: explication of the personal causation construct. , 1997, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[34]  J. Fleiss,et al.  The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. , 1976, Archives of general psychiatry.