Appraisals of control and predictability in adapting to a chronic disease

In a sample of 92 patients with rheumatoid arthritis, we examined interrelations among various control appraisals, illness predictability, psychosocial adjustment, mood, and illness status. Perceiving greater personal control over the disease and symptoms and perceiving greater health-care-provider control over symptoms were associated with greater illness predictability. Patients reported more personal control over their symptoms than over the course of the disease and thought that their health care providers had more control over disease course than they did themselves. Multiple regression analyses showed that perceiving greater personal control over one's medical care and treatment was associated with positive mood and psychosocial adjustment. Negative mood was also associated with the belief that providers have greater control over the patient's daily symptoms. Patients who had a more severe disease and expressed greater personal control over its course reported greater mood disturbance and were rated as exhibiting less positive adjustment, but those who had more severe daily symptoms and expressed greater personal control over their symptoms reported less mood disturbance. These findings are discussed in terms of the possible benefits of patients' active participation in their care and the implications of perceiving personal and others' control over more or less controllable aspects of the illness, especially when the illness is more severe.