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Loss of control is a well-documented human response to hospitalization. The purpose of this study was to construct and test a theoretical model of perceived territorial control among hospitalized adults. Territorial control was defined as the freedom or choice one has in regulating or influencing the objects, activities, and social intereactions within a particular space claimed or identified as one's own. The space of concern in this study was the patient's hospital room. The study focused not on the negative aspects of a loss of control but on the positive outcomes of having a sense of control. A three-stage, multivariate, causal-modeling design was used to estimate the impact of perceived territorial control on state anxiety and satisfaction with care in a convenience sample of 80 Hispanic and Anglo-American males and females between the ages of 18 and 79 who were in the hospital for short-term orthopedic care. Attitudinal, self-report measures were used predominantly. Instruments were constructed to index centrality of territory and territorial control perceptions. Correlational and multiple regression statistical techniques were used to estimate the theoretical model. Tests for violations of the statistical and causal assumptions were performed. Centrality of territory, assistance needs, and the powerful others locus of control significantly influenced patient territorial control perceptions. Temporal duration, internal locus of control, and chance locus of control made no significant impact on perceived territorial control. Patient territorial control perceptions significantly decreased state anxiety and significantly increased satisfaction with care. Perceived territorial control explained 24 percent of the variance in patient state anxiety and 21 percent of the variance in satisfaction with care. An unstaged, empirical test of the model increased the explained variance to 32 percent for state anxiety and 40 percent for satisfaction with care. There was a positive relationship (r = .41) between age and centrality of territory and a negative relationship (r = -.31) between age and state anxiety. The implications were related primarily to continued theory-building and the development of nursing practice theories.

The purpose of this study was to identify events that give a sense of control (decisional, behavioral, and cognitive) to clients during hospitalization, and to identify commonalities among patients related to the importance attached to selected hospitalization events and a sense of control. Bandura's social learning theory provided the conceptual framework for the study.A non probability convenience sampling of 45 adult patients hospitalized for the treatment of genitourinary, gastrointestinal, thyroid disease, or cancer of any origin, completed the instruments which measure client control: The Client Control Q Set (CCQS;) and, The Health Opinion Survey (HOS.) A semi-structured interview validated the CCQS and a background data form provided demographic information. Q factor analysis was used to identify factors of client control. The emerging factors were analyzed in relationship to the results of the HOS and patient demographic information. Subjects' human rights were protected.This study was a modified replication of Dennis' (1985) investigation to determine if a sense of control was important to hospitalized patients. The investigation supported Dennis' (1985) findings that cognitive control over diagnostic tests, surgery, treatment and illness care was important to hospitalized patients. Another important dimension of control was identified through behavioral means involving the environment. Health Opinion Survey scores identified a need to be actively involved in the health care process by patients who also desired cognitive control over diagnosis, surgery, and tests. Also, commonalities of occupation, sex, age, and diagnosis emerged among patients who identified a need for cognitive control. Likenesses emerged in nonprofessional females between the age of 21-40 receiving treatment for gastrointestinal disease.The study supported the assumption that patients do desire a senseof control during hospitalization and also supported the need to recognize other patients may not desire a sense of control. It is important to recognize the difference and respond appropriately to individual patients. The study revealed the need for nurses to facilitate a flow of information to patients regarding diagnosis, surgery and impending tests. / School of Nursing

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