LOCUS OF CONTROL AND EDUCATIONALLY BASED PATIENT CARE OUTCOMES IN A CHRONIC PAIN CENTER

The study was conducted to investigate the relationship of locus of control and educationally based patient care outcomes in a center for the holistic treatment of chronic pain. Both formative and summative outcome measures were investigated before, during, and following treatment.;Descriptive statistical analysis of demographic/biographic data revealed no substantial differences between internal and external subjects classified according to admission LC scores. The Pearson product-moment test of correlation and Student's t ratio test of the significance of the difference between means were applied to test the hypotheses. Using the .05 level of significance it was found that both treatment outcome measures and follow-up measures related to locus of control.;The LC scores of those subjects designated external on admission moved in the internal direction at a significant level of change. Physical therapy outcome measures indicated that internal subjects were more dysfunctional on admission than externals. Thermal biofeedback gains correlated significantly with LC scores in the direction of internality. Internal subjects made significant gains with electromyogram biofeedback measures which was not true of externals. Wellness education outcome measures using the Gottlieb Clinical Assessment Scale correlated significantly with LC in the direction of internality. No pain level measures correlated significantly with LC. Internals made significant gains in 18 of 25 admission to discharge gains measured. Externals made significant gains in only 6 of the same measures.;On follow-up, 18 of 21 subjects indicated that their pain was the same or worse than at discharge. Eleven of those 18 considered themselves to be improved in overall functioning. Twelve of 13 who added additional comments to the follow-up questionnaire indicated that their level of pain was less troublesome due to increased knowledge about pain, increased feelings of self control, and decreased fear of the pain experienced. Of 11 specific variables tested on follow-up (excluding medication), only overall functioning related significantly to LC. Medication behavior changes from pre-admission to follow-up related to LC. Internals took less non-narcotic analgesics with less frequency than externals. Internals also significantly reduced the use of non-narcotic analgesics and tranquilizers from pre-admission to follow-up.;Record review, interview, questionnaire, direct assessment, and Rotter's Locus of Control Scale were used to collect data for 22 subjects selected by convenience sampling. Subjects were tested on admission, at mid-treatment, at discharge and one month after discharge. Outcome measures included locus of control scores (LC), physical therapy gains, relaxation training gains, wellness education gains, medication behavior changes, and selected follow-up measures.;Discriminant analysis was applied to sample data dichotomized according to LC testing on admission to determine whether discriminating variables existed that could clearly distinguish between internals and externals in this sample. Three specific outcome measures emerged as discriminators: follow-up social activity, admission self pain rating, and the last recorded thermal biofeedback reading. Externals were involved in more social activities on follow-up, in less pain on admission, and less able to achieve relaxation using thermal biofeedback measures of relaxation.;It was concluded that educationally based treatment modality outcomes in this controlled pain center significantly related to locus of control. Nineteen of 21 subjects achieved internality by the time of discharge. This plus the findings noted above resulted in the nonacceptance of both hypotheses.