A MULTI-METHODOLOGICAL APPROACH TO THE MEASUREMENT OF CLIENT CONTROL (Q-METHODOLOGY).
Contributors: University of Maryland at Baltimore.
Published: 1985
Number of pages: 237
Subjects: Health Sciences, Nursing.
Description: Hospitalization is a stressful experience for clients, one which traditionally involves forfeiture of control over customary activities and the means of directing one's life. The purposes of this study were to identify events that confer a sense of control to clients during hospitalization, and to ascertain the kinds of people who find control through various means. Q methodology was central to the descriptive, replicated research design.

Thirty adult, medical-surgical inpatients of both genders, representing a dispersion of ages and educational levels, constituted the purposive samples for the original and replication phases. Data were collected via two Q sorts using the Client Control Q Set, a post-Q sort interview, and the Health Opinion Survey.

Factor analysis and the construction of factor arrays pointed to three dimensions of client control which were similar for the two Q sorts in both the major and replication data sets. A central theme common to all three dimensions was the importance of cognitive control related to diagnostic tests, surgery, treatment, and lifestyle implications. In addition to the cognitive control theme, some patients wanted to be included in making decisions about their care and treatment. Other patients preferred not to be involved in decision making, but instead found control through execution of the patient role. A third group of patients focused on activities which regulated their physical environment and enhanced their personal integrity and behavioral independence. Scores on the Health Opinion Survey were congruent with the control dimensions derived from Q sort data. Patients hospitalized for diagnosis and/or treatment of cancer were predominant among those who wanted to be involved in making decisions related to the care and treatment of their illness.

This study revealed that patients do want control over the people and events which impact on their well-being, but differ in manifestation. It is important not to deprive clients of desired controlling mechanisms nor to advocate the assumption of control which they are not equipped to handle. Facilitating a flow of information is essential; fostering decisional involvement for those who want it and preserving behavioral independence for others are high priorities of care.
Notes: Source: Dissertation Abstracts International, Volume: 46-09, Section: B, page: 3005.

Thesis (PH.D.)--UNIVERSITY OF MARYLAND AT BALTIMORE, 1985.

School code: 0373.