Patients' Perceived Control Over Their Health Care: An Outcome Assessment of Their Psychological Adjustment to Renal Failure

Previous research has sometimes produced conflict ing results regarding patients' psychological adjustment to end-stage renal disease (ESRD). It is generally ac cepted that treatment outcomes vary across treatment modality, with successful transplant patients reporting a higher subjective quality of life than patients on cen ter 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 as sessed for health locus of control, for generalized con trol over 11 life dimensions, and for beliefs about con trol over specific aspects of treatment for ESRD. The study also included indicators of psychological adjust ment. The results indicated that control over life dimen sions, 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.