The relationship of internal locus of control, value placed on health, perceived importance of exercise, and participation in physical activity during leisure

Nursing as a discipline deals with a broad range of complex phenomena. Because of this concepts and knowledge from other disciplines are often used to inform nursing science and practice. Biological science is an obvious and important example but the scope of nursing is far wider drawing on diverse disciplines such as anthropology, psychology and sociology to name but three. Laffrey and Isenberg’s (1983) study on the role of the psychological construct ‘‘locus of control’’ in determining health promoting behaviours is an example of nursing science adopting a concept from another discipline in order to explore phenomena of crucial interest to nursing, namely what determines people’s health related behaviours? If nursing is to fulfil what Laffrey and Isenberg describe as the ‘‘basic function’’ of health promotion then an understanding of this area is crucial. Perhaps this, in itself, explains why this study has been so widely cited in the 20 years since it was first published in this journal. Rotter’s Social Learning Theory (Rotter, 1954; Rotter, 1966) postulated that individuals differ in the extent to which they expect their behaviours to lead to particular reinforcements. On a general level, locus of control refers to whether an individual sees themselves in control of reinforcement or not. For the specific concept of health locus of control (Wallston et al., 1978) the reinforcement is ‘‘health’’. It is hypothesised that those who see health as a result of their own behaviours (‘‘internals’’) are more likely to engage in ‘‘healthy’’ behaviours than those who see health resulting from chance or other external factors such as the influence of powerful others. This then is the hypothesis tested by Laffrey and Isenberg. Of course other variables may intervene and Laffrey and Isenberg considered two crucial intervening variables: the extent to which health itself is valued and the extent to which a given behaviour (in this case exercise) is viewed as making an important contribution to health. Surprisingly the findings failed to confirm a relationship between health locus of control and exercise when these intervening variables were taken into account. Curiously it is this negative finding (and this should surely serve to remind us that no finding is truly ‘‘negative’’) that ensures the currency of this paper. The controversy over the extent to which health locus of control is in fact related to health behaviour has continued. Laffrey and Isenberg ‘‘borrowed’’ from the discipline of psychology and published in a nursing journal. However, the impact of their findings has gone beyond the discipline of nursing and their study is cited as often in the psychological literature as it is in nursing literature. Two recent papers that cite Laffrey and Isenberg show the emerging understanding of this complex area but also the continued relevance of their findings. Norman (1995) generally supported Laffrey and Isenberg’s findings showing that while the belief that a specific behaviour would indeed promote health was related to performing that behaviour locus of control was generally not, even for those who valued health. Thus the conclusion that there is a general personality trait that renders some more resistant to health promotion measures is rejected. Instead it is beliefs about the efficacy of particular behaviours that are important. More recently however Steptoe and Wardle (2001) highlighted a number of limitations in previous research and also noted that some health behaviours (e.g. smoking) have very different characteristics than others (e.g. taking exercise as studied by Laffrey and Isenberg). In a far larger study than any so far reported they found a small but statistically significant correlation between ARTICLE IN PRESS