health outcomes) are age, social class, social support, and availability of medical treatments. The important message from these studies is that variance in health status is poorly explained by direct (main) effects of perceived control. The action is in the interaction, and the challenge is to find the right moderators for each situation.
Other than predicting that perceived control will remain a central and important construct in health psychology well into the 21st century, it is not easy to speculate about the way the construct will be operationalized and utilized in the future. One thing is for certain: New and improved methods of measurement will be developed. These will probably occur in two diametrically opposite directions: a focus on perceived control of health as a unitary dimension; and an attempt to discover other important dimensions or loci of control, such as the influence of the environment and/or a “higher power” on one's health status.5 As health psychologists become more aware of and comfortable with alternative ways of assessment -such as using computers or qualitative methods-less and less reliance will be placed on traditional paper-and-pencil measures. Method triangulation, such as combining quantitative and qualitative assessments, will become the norm rather than the exception.
K. A. Wallston (1992) pointed out that “the focus isn't strictly on locus, “ which did not stem the tide of research using the MHLC scale, but slowed it down some. The challenge for health psychologists is to select the most appropriate ways of measuring perceived control and to develop analytic strategies that examine interactions amoung these methods as well as with other constructs.
This chapter described the development of measures of perceived control of health as well as the ways in which the construct of perceived personal control has been conceptualized and operationalized by health psychologists. The complexity and the multidimensionality of the construct has been emphasized. Different levels of specificity in operationalizing the construct were presented, concentrating on the mid- and situationally specific levels. It was stressed that although measures of health locus of control may play a role in explaining variance in health behaviors and health status, these measures should optimally be used in conjunction with other indicators of perceived control of health (e.g., perceived health competence or other efficacy measures). Also stressed was the notion that the action is in the interaction. Perceptions of control moderate, or are moderated by, many other constructs, among them individual differences in demographic characteristics, background experiences, situational factors, and value orientations. Without adopting an interactionist perspective, health psychologists and other investigators in behavioral medicine will fail to discover the full explanatory power of perceived control.
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