THE ROLE OF HEALTH BELIEFS
Attribution theory
The origins of attribution theory lie in the work of Heider (1944, 1958), who argued that individuals are motivated to understand the causes of events as a means to make the world seem more predictable and .Attribution theory has been applied to the study of health and health behaviour. For example, Bradley (1985) examined patients’ attributions of responsibility for their diabetes and found that perceived control over their illness (is the diabetes controllable by me or a powerful other?) influenced their choice of treatment. Patients could either choose an insulin pump (a small mechanical device attached to the skin that provides a continuous flow of insulin), intense conventional treatment or a continuation of daily injections. The results indicated that the patients who chose an insulin pump showed decreased control over their diabetes and increased control attributed to doctors. In other words, an individual who attributed their illness externally and felt that they personally were not responsible for it was more likely to choose the insulin pump and to hand over responsibility to doctors. A further study by King (1982) examined the relationship between attributions for an illness and attendance at a screening clinic for hypertension. The results demonstrated that if the hypertension was seen as external but controllable, the individual was more likely to attend the screening clinic (‘I am not responsible for my hypertension but I can control it’).Health locus of control The issue of controllability emphasized in attribution theory has been specifically applied to health in terms of the health locus of control. Individuals differ in their tendency to regard events as controllable by them (an internal locus of control) or uncontrollable by them (an external locus of control). Wallston and Wallston (1982) developed a measure to evaluate whether an individual regards their health as:
1. controllable by them (e.g. ‘I am directly responsible for my health’);
2. not controllable by them and in the hands of fate (e.g. ‘Whether I am well or not is a matter of luck’); or
3. under the control of powerful others (e.g. ‘I can only do what my doctor tells me to do’).
It has been suggested that health locus of control relates to whether we change our behaviour (by giving up smoking or changing our diet, for instance), and also to our adherence to recommendations by a health professional. For example, if a doctor encourages someone who generally has an external locus of control to change his or her lifestyle, that person is unlikely to comply if she does not deem herself to be responsible for her health. However, although some studies support the link between health locus of control and behaviour (e.g. Rosen & Shipley, 1983), several other studies either show no relationship or indicate the reverse of what is expected (e.g. Norman, 1990; 1995).
Attribution theory
The origins of attribution theory lie in the work of Heider (1944, 1958), who argued that individuals are motivated to understand the causes of events as a means to make the world seem more predictable and .Attribution theory has been applied to the study of health and health behaviour. For example, Bradley (1985) examined patients’ attributions of responsibility for their diabetes and found that perceived control over their illness (is the diabetes controllable by me or a powerful other?) influenced their choice of treatment. Patients could either choose an insulin pump (a small mechanical device attached to the skin that provides a continuous flow of insulin), intense conventional treatment or a continuation of daily injections. The results indicated that the patients who chose an insulin pump showed decreased control over their diabetes and increased control attributed to doctors. In other words, an individual who attributed their illness externally and felt that they personally were not responsible for it was more likely to choose the insulin pump and to hand over responsibility to doctors. A further study by King (1982) examined the relationship between attributions for an illness and attendance at a screening clinic for hypertension. The results demonstrated that if the hypertension was seen as external but controllable, the individual was more likely to attend the screening clinic (‘I am not responsible for my hypertension but I can control it’).Health locus of control The issue of controllability emphasized in attribution theory has been specifically applied to health in terms of the health locus of control. Individuals differ in their tendency to regard events as controllable by them (an internal locus of control) or uncontrollable by them (an external locus of control). Wallston and Wallston (1982) developed a measure to evaluate whether an individual regards their health as:
1. controllable by them (e.g. ‘I am directly responsible for my health’);
2. not controllable by them and in the hands of fate (e.g. ‘Whether I am well or not is a matter of luck’); or
3. under the control of powerful others (e.g. ‘I can only do what my doctor tells me to do’).
It has been suggested that health locus of control relates to whether we change our behaviour (by giving up smoking or changing our diet, for instance), and also to our adherence to recommendations by a health professional. For example, if a doctor encourages someone who generally has an external locus of control to change his or her lifestyle, that person is unlikely to comply if she does not deem herself to be responsible for her health. However, although some studies support the link between health locus of control and behaviour (e.g. Rosen & Shipley, 1983), several other studies either show no relationship or indicate the reverse of what is expected (e.g. Norman, 1990; 1995).
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