Schmitt G M, Lohaus A, Salewski C
Psychother Psychosom Med Psychol. 1989 Jan;39(1):33-40.
The present paper focuses on the relation between control beliefs and the compliance of adolescents suffering from chronical diseases. It is assumed that the compliance will be high when the own behavior is regarded as most important for the improvement during illness (internal locus of control). A high compliance is also expected when the own state of health is seen as dependent from other persons, who are engaged in the therapeutic process (powerful others locus of control). Little compliance is expected when the state of health is regarded as dependent from fate or chance influences (chance locus of control). Thereover, it is assumed that the control beliefs are influenced by the specific disease of a patient, since diseases are controllable by the patients in different degrees and therefore should result in specific control beliefs. The theoretical assumptions were proved in an empirical study with 80 patients suffering from different diseases (Diabetes mellitus, Asthma bronchiale, Alopecia areata) and 366 healthy adolescents and adults. The results show a clear dependency of the control beliefs from the kind of disease of the patients. However, the relations between control beliefs and compliance are discrepant to the expectations which is shown mainly by null or negative correlations between internality and compliance. The empirical relations are explained by the self-reliant behavior of the internal patients which perhaps shows little compatibility to traditional concepts of compliance. The implications of the present results for the enhancement of compliance and for the definition of the compliance-concept are elaborated and discussed.
本文聚焦于控制信念与慢性病青少年患者依从性之间的关系。假定当个体行为被视为对疾病康复最为重要时（内控点），依从性会很高。当个体健康状况被认为取决于参与治疗过程的其他人时（强大他人控制点），也预计会有较高的依从性。当健康状况被认为取决于命运或机遇影响时（机遇控制点），预计依从性较低。此外，假定控制信念受患者特定疾病的影响，因为不同疾病患者对疾病的可控程度不同，进而应产生特定的控制信念。在一项针对80名患有不同疾病（糖尿病、支气管哮喘、斑秃）的患者以及366名健康青少年和成年人的实证研究中，验证了这些理论假设。结果表明，控制信念明显依赖于患者的疾病类型。然而，控制信念与依从性之间的关系与预期不符，主要表现为内控性与依从性之间呈零相关或负相关。实证关系可通过内控型患者的自力更生行为来解释，这或许表明其与传统依从性概念不太相符。本文阐述并讨论了当前研究结果对提高依从性以及依从性概念定义的启示。
