Benyamini Yael, Nouman Hani, Alkalay Yasmin
a Bob Shapell School of Social Work, Tel Aviv University , Tel Aviv , Israel.
b Faculty of Social Sciences , Tel Aviv University , Tel Aviv , Israel.
Psychol Health Med. 2016 Jun;21(4):476-482. doi: 10.1080/13548506.2015.1123816. Epub 2015 Dec 30.
Illness perceptions were shown to be related to emotional and physical outcomes, as proposed by Leventhal's self-regulation model. These perceptions include the illness identity, its timeline, consequences, causes, and controllability, which later research found to include self-control and treatment control. The current study aimed to examine the role of a third type of perceived control: Control over the treatment procedures. We hypothesized that this type of control would be important for women undergoing infertility treatments, which are characterized by high uncertainty and low personal control. The sample included 194 Israeli women who were undergoing infertility treatments, 70% recruited in hospitals and the remainder in a fertility counseling center and website. All participants were married religious Jewish women, which added to the stress inherent in infertility. Study measures included the Illness Perception Questionnaire-Revised (IPQ-R), adapted to infertility, with an additional subscale assessing control over the procedure, and infertility-specific distress and well-being scales. Exploratory and confirmatory factor analyses supported the factor structure, including the distinct new subscale. A structural equations model showed that perceived consequences were most strongly related to distress and well-being. The three types of control were positively intercorrelated but differed in their associations with distress and well-being: Self-control over the problem and treatment control were unrelated to either measure while self-control over the procedure was related to greater well-being. These findings suggest that when control over the condition or the treatment outcomes is impossible, individuals may still benefit from control over external factors such as their health care. Healthcare providers can support them by seeking ways to increase their control over their treatment procedures, which may contribute to better psychological adjustment. Future studies should examine the role of perceived control over the procedures in other low-control situations (e.g., newly diagnosed cancer; aging-related declines).
如莱文索尔的自我调节模型所提出的，疾病认知被证明与情绪和身体结果相关。这些认知包括疾病身份、病程、后果、病因和可控性，后来的研究发现可控性包括自我控制和治疗控制。本研究旨在探讨第三种类型的感知控制的作用：对治疗程序的控制。我们假设这种控制类型对于接受不孕症治疗的女性很重要，因为不孕症治疗具有高度不确定性和低个人控制的特点。样本包括194名正在接受不孕症治疗的以色列女性，70%在医院招募，其余在生育咨询中心和网站招募。所有参与者均为已婚犹太教女性，这增加了不孕症固有的压力。研究测量包括为适应不孕症而修订的疾病认知问卷（IPQ-R），以及一个额外的子量表，用于评估对程序的控制，还有不孕症特异性痛苦和幸福感量表。探索性和验证性因素分析支持了因素结构，包括独特的新子量表。结构方程模型表明，感知到的后果与痛苦和幸福感的相关性最强。三种控制类型呈正相关，但在与痛苦和幸福感的关联方面有所不同：对问题的自我控制和治疗控制与这两种测量均无关，而对程序的自我控制与更高的幸福感相关。这些发现表明，当无法控制病情或治疗结果时，个体仍可能从对外部因素（如医疗保健）的控制中受益。医疗保健提供者可以通过寻求增加患者对治疗程序控制的方法来支持他们，这可能有助于更好的心理调适。未来的研究应探讨在其他低控制情况下（如新诊断的癌症；与衰老相关的衰退）对程序的感知控制的作用。
