The purpose of this study was to test the idea that adaptiveness of control perceptions derives from individuals being able to achieve an acceptable level of control in relation to what is preferred in a given situation. The hypothesis for this study was that preference, level, and acceptability of control vary by target of the control effort, e.g. control of symptoms, treatment, or disease course. In addition, two research questions were examined: (a) does acceptability of control explain more of the variation in adjustment and quality of life than preference or level of control; and (b) what factors do individuals identify as influencing acceptability of control. A cross-sectional design with a non-probability sample of 87 individuals who had undergone coronary artery bypass surgery during the previous 10-17 months was used. Measurement included: perceptions of preference, level, and acceptability of control (three 10-point Cantril ladders for each target); adjustment (selected subscales of the SF-36); mood (Profile of Mood States), quality of life (three Cantril ladders); and clinical and sociodemographic characteristics (self-report).
Using repeated measures analysis of variance to test the hypothesis, it was found that perceived level of control of treatment and disease course were significantly greater than perceived control of symptoms. Acceptability of perceived control of treatment was significantly higher than acceptability of perceived control of symptoms.
The first research question was examined using hierarchical multiple regression. Both acceptability and level of control captured the same variance in the emotional measures and general health depending on which was entered first. However, in the analyses with the functional measures and quality of life, level and acceptability of control were both significant, indicating that each contributed unique explanatory information.
Regarding the second research question, content analysis of participant interviews revealed several predominate factors that influence control perceptions: level of participation in decision-making, quality of provider-patient relationships, capacity to participate in treatment regimens, and personal faith. This study highlights the importance of interventions that assist individuals to maintain acceptable perceptions of control in order to minimize the emotional impact of stressful events and promote general well being and quality of life during recovery.
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