Perceived Control

Because strong control beliefs have been related to so many positive outcomes, there have been many attempts to enhance such feelings through interventions. Researchers have attempted to modify or enhance control beliefs in regard to memory, rehabilitation from physical impairments, cancer treatment, dealing with chronic diseases such as osteoarthritis or rheumatoid arthritis, as well as to facilitate control beliefs in the face of losses associated with aging. These studies indicate that control beliefs can be influenced well into late life. Such findings grow in importance as models of health behavior move from the treating of acute illnesses in a physician-directed environment to long-term symptom management associated with chronic diseases in a patient-directed environment.

For example, a number of nursing home studies have reported that when people are given opportunities to exercise control, they show significant improvements on a number of measures, ranging from memory tasks and activity to overall health and psychological adjustment. In an often cited study by Drs. Ellen Langer and Judith Rodin, conducted in 1996, nursing home residents who were given more control over their environment (e.g., when to watch a movie, taking care of a house plant) were happier, more active, and more alert at a follow-up conducted months later. Also, only 15 percent of the group with enhanced control had died, compared with 30 percent in the group of residents who were told the hospital staff was responsible for their care (see also Banziger and Roush; Schulz and Hanusa for other interventions in institutional settings). The research in this area indicates that strong beliefs in perceived control may reverse, delay, or protect against functional declines associated with aging.

The success of interventions seeking to increase control beliefs (especially in later life) presumably will hinge on the assessment of relevant components of control: desire, ability/perception, and actual control available. Efficacious interventions will likely be those that first determine which aspects should be changed and then successfully produce the desired changes. For example, if nursing homes are designed to discourage control, attempting to enhance control in such a setting could lead to frustration for the individual as well as for the staff. Accordingly, interventions designed with a multilevel focus that balance an individual's needs and abilities with the adaptability of the environment may be the most effective.