An Invitation To Health, Third Canadian Edition Lecture Notes

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AN INVITATION TO HEALTH AND WELLNESS
CHAPTER 1
LEARNING OBJECTIVES
After studying the material in this chapter, students should be able to
 define health and wellness [Bloom’s Taxonomy: Remember]
 describe and discuss health promotion and wellness models [Bloom’s Taxonomy: Understand]
 name the six dimensions of wellness and describe how they relate to total wellness [Bloom’s
Taxonomy: Remember]
 list and describe the social determinants of health [Bloom’s Taxonomy: Remember]
 list the factors that shape the development of positive health behaviours [Bloom’s Taxonomy:
Remember]
 describe how beliefs and attitudes influence behaviour [Bloom’s Taxonomy: Understand]
 apply a behaviour-change theory to a personal health and wellness action plan [Bloom’s
Taxonomy: Apply]
KEY TERMS
 Action—Amodification of behaviour according to a plan. A commitment of time and energy is
required.
 Attitude—A somewhat stable set of beliefs, manner, disposition, feeling, or position with regard
to a person or thing.
 Belief—An opinion; a conviction; a confidence in truth.
 Contemplation—Awareness that there is a problem behaviour and consideration of changing it
within the next six months.
 Enabling Factors—Factors that make it possible or easier for people or populations to change
their behaviours; include individual physical capabilities and mental capacities, resources, living
conditions, societal support, and accessible facilities, programs, and services as well as
developing skills in addition to predisposing existing skills.
 Epidemiology—The study of how often diseases occur in different groups of people and why.
 Globalization—The increased transnational movement of capital, goods, people, and political
systems, and a rapid turnover of ideas and images through new communication technologies.
 Health—A state of complete physical, mental, and social well-being.

 Health Belief Model—Developed in the 1950s by social psychologists Hochbaum, Rosenstock,
and Kegels, and updated in the 1980s, the model helps to explain and predict health behaviours.
 Health Promotion—The process of enabling people to increase control over and to improve their
health.
 Healthy Environments—The creation of conditions and surroundings conducive to health.
 Holism—An emphasis on the interconnectedness between the individual and his or her mind,
body, and spirit.
 Hygiene—Healthy; akin to well and to living; a science of the establishment and maintenance of
health; conditions or practices conducive to health.
 Locus of Control—An individual’s belief about the source of power and influence over his or her
life.
 Maintenance—Continued work at changing behaviour. The change may take up to six months to
a lifetime. Some lapses may be temporary.
 Modelling—Observing other people and emulating their behaviours, successes, or positive
lifestyle choices.
 Morbidity—The number of disease rates in one period of time or in one place.
 Mortality—The number of deaths in one period of time or in one place.
 Mutual Aid—The actions people take to help each other cope.
 Norms—The unwritten rules regarding behaviour and conduct expected or accepted by a group.
 Panacea—A remedy for all difficulties; a cure-all.
 Population Health—A way of thinking about the social and economic forces that shape health. It
builds upon public health and health promotion, but goes beyond our more traditional
understanding of the causes of health and illness.
 Positive Visualization—Creating a mental picture of a goal or a behaviour change and
visualizing yourself making that change.
 Precontemplation—Not even aware that you have a problem, whereas others around you might
be. No intention of making a change.
 Predisposing Factors—Factors that encourage or inhibit us from changing such as knowledge,
attitudes, beliefs, values, self-efficacy, behavioural intentions, and existing skills.
 Preparation—Intention to change a problem behaviour within the next month.

 Prevention—Information and support offered to help healthy people identify their health risks,
reduce stressors, prevent potential medical problems, and enhance their well-being.
 Protection—Measures that an individual can take when participating in risky behaviour to
prevent injury or unwanted risks.
 Rational-Emotive Therapy (RET)—Form of therapy developed by Ellis that focuses on
changing irrational beliefs and faulty interpretations, which result in negative emotions and
severe anxiety.
 Reinforcements—Reward or punishment for a behaviour that will increase or decrease one’s
likelihood of repeating the behaviour.
 Reinforcing Factors—Factors that reinforce behaviour change. They include praise from family
and friends, rewards from others, or encouragement and recognition for meeting goals. They
also include healthy community policies such as smoke-free facilities and on-site workplace
health and wellness programs.
 Self-Care—The decisions and actions individuals take in the interest of their own health.
 Self-Efficacy—Belief in one’s ability to accomplish a goal or change a behaviour.
 Self-Instructional Methods—The practice of positive self-talk to help an individual cope better
with stressful situations.
 Self-Talk—Repetition of positive messages about one’s self-worth to learn optimistic patterns of
thought, feeling, and behaviour.
 Social Determinants of Health (SDOH)—Income inequity, job security, working conditions,
housing and food security, education and care in early life, and social exclusion of individuals
and groups—all aspects that are very important to health and wellness status.
 Termination—Can take two to five years for a behaviour to become so deeply ingrained that a
person can’t imagine abandoning it.
 Wellness—A state of optimal health.
CHAPTER OUTLINE
I. Health and Wellness
1. Many health and wellness programs are based on very similar health risk–reduction
strategies.
2. The earliest and most enduring icons of medicine and health date back to ancient
Greece and Asklepios, the Greek god of health and father of medicine.
3. His daughter Panacea believed the best way to help people was to treat illness.

4. Her sister Hygeia (hygiene) believed that it was important to teach people how to
live so that they did not become ill.
A. First Nations Health and Wellness
1. Aboriginal health emphasizes the interconnectedness between the physical and
spiritual world, between individuals and their environment, and between the mind,
body, and spirit, which guides the concept of holism.
2. Elders’ stories teach that it is important for an individual to attempt to live
Bimaadiziwin, “the good life.”
3. First Nations Medicine Wheels encourage a balance through the four aspects of self:
physical, mental, emotional, and spiritual.
4. We are asked to live the four fundamental values of kindness, honesty, sharing, and
strength. We are asked to respect nature.
5. The control of decisions regarding health and wellness rest with the individual.
II. Health and Health Promotion
A. What Is Health?
1. The World Health Organization defines health as “not merely the absence of disease
or infirmity but a state of complete physical, mental and social well-being.”
2. In 1974 the Lalonde Report presented a conceptual framework called the Health
Field Concept, which included four main elements: human biology, environment,
lifestyle, and health-care organizations.
3. This report acknowledged that vast sums of money were being spent to treat illnesses
that could have been prevented.
4. The definition of health moved from measuring morbidity (disease) and mortality
(death) rates to viewing health as part of everyday living.
5. In 1986 the Ottawa Charter expanded health toward building healthy public policy
through health promotion.
6. A follow-up report identified three national health challenges: reducing inequities,
increasing prevention effort, and enhancing people’s capacity to cope.
7. The three mechanisms to health promotion were identified as self-care, mutual aid,
and healthy environments.
8. The Health Belief Model was developed to help explain and predict health
behaviour.
9. Other health models include the Precede-Proceed Model for Health Promotion
Planning and Evaluation and the Quality of Life Model.
10. Canadian health agencies, programs, and initiatives include the Canadian Institute
for Health Information (CIHI); Canadian Population Health Initiative (CPHI); Public
Health Agency of Canada;Canadian Institute of Health Research (CIHR);First
Nations, Inuit & Aboriginal Health Branch of Health Canada; a special commission
headed by Roy Romanow, which delivered its report recommending sweeping
changes to Canada’s health-care system; ParticipACTION;a new website called
Healthy Canadians; Physical and Health Education Canada (PHE Canada, formerly
called CAHPERD); and the Canada Research Chairs Program.
B. What Is Epidemiology?
1. Epidemiology is the study of how often diseases occur in different groups of people
and why.

2. Epidemiology can be used to evaluate health strategies, prevent certain illnesses, and
guide health-care providers.
3. Epidemiological research uses a variety of methodological approaches.
4. Researchers can examine the distribution of disease in a specific population, called
descriptive epidemiology, or investigate hypothesized causal factors, called
analytical epidemiology.
III. Wellness and the Wellness Movement
A. What Is Wellness?
1. Wellness has been defined as purposeful, enjoyable living or, more specifically, a
deliberate lifestyle choice characterized by personal responsibility and optimal
enhancement of physical, mental, and spiritual health.
2. Halburt Dunn, a pioneer in the wellness movement, believed wellness was a dynamic
process of continually moving toward one’s potential for optimal functioning.
3. Dr. John Travis founded the first Wellness Resource Center in the U.S.
4. Dr. Bill Hetler cofounded the National Wellness Institute and developed the
Lifestyle Assessment Questionnaire (redesigned as TestWell) and the Six
Dimensions of Wellness Model.
B. Social Dimension
1. This dimension encourages a collectivist view of the world—that of contributing to
society, helping others, and valuing the concept of interdependence between
ourselves and our environment.
2. Current research shows that people with spouses, friends, and a rich social network
may outlive isolated loners by as much as 30 years.
C. Occupational Dimension
1. A “well” occupation is consistent with personal values, interests, and beliefs.
2. In a well work environment, you share your unique gifts, skills, and talents, and
enjoy work that is meaningful and rewarding.
D. Spiritual Dimension
1. Identifying your basic purpose in life; learning how to experience love, joy, peace,
and fulfillment; and helping ourselves and others achieve our potential are all aspects
of the spiritual dimension.
2. Spirituality has been described as transcendence, connectedness, a power, a force, an
energy, and a connection to a formal religion.
E. Physical Dimension
1. Physical wellness is met through participating in regular physical activity,
maintaining a healthy body weight, and avoiding harmful behaviours such as tobacco
use, drug misuse, and excessive alcohol consumption.
F. Intellectual Dimension
1. Intellectual health refers to your ability to think and learn from life experience, your
openness to new ideas, and your capacity to question and evaluate information.
G. Emotional Dimension

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1. Emotional wellness includes the degree to which one feels positive and enthusiastic
about oneself and life.
2. When you are emotionally well you have the capacity to express and manage your
own feelings, to work independently, but to also recognize the importance of being
able to ask for help or support when needed.
IV. Health Challenges
A. What Is the Average Life Expectancy?
1. In 2007 the average age at death for the overall population was 80.7 years (78.3 for
men, 83.0 for women).
2. Cancer and heart disease are the two leading causes of death for Canadians followed
by chronic lower respiratory diseases and Type 2 diabetes (which is strongly linked
to being overweight).
3. Hypertension (high blood pressure) is a major contributor to poor health, affecting
one in five Canadians.
4. Mental health issues are also concerning.
B. Do Sex and Gender Matter?
1. Sex is a classification, generally as male or female, according to the reproductive
organs and functions that derive from the chromosomal complement.
2. Gender refers to a person’s self-representation as male or female, or how that person
is responded to by social institutions on the basis of the individual’s gender
presentation.
3. The experience of being male or female in a particular culture and society can and
does have an effect on physical and psychological well-being. This realization is
both new and revolutionary.
4. Gender differences persist in sickness as well as in health.
5. Gender-specific medicine is replacing one-size-fits-all health care with new
definitions of what is normal for men and women.
C. Social Determinants
1. New research in the area of the social determinants of health (SDOH) supports the
notion that income and income distribution, education, unemployment and job
security, employment and working conditions, early childhood development, food
insecurity, housing, social exclusion, social safety net, health services, Aboriginal
status, gender, race, and disability are also very important to health and wellness
status.
D. Diversity and Social Exclusion
1. We live in the most diverse nation on earth, and increased disparities are evident as
many different groups of Canadians do not have equal access to health care and
health and wellness opportunities.
2. There is evidence that there is a growing inequality in social and economic status
between groups of Canadians, and that a larger gap lowers the health status of the
overall population.
3. Members of minority groups often encounter much difficulty accessing health-care
services in Canada due to poverty and social exclusion.
4. Social exclusion is based on gender, age, ability, sexual orientation, race, ethnicity,

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and religious beliefs.
5. Publichealth experts are replacing the word“minority”with“underserved.”
E. Job Security and Working Conditions
1. Globalization has led to changes in the workforce that include layoffs and the
increase in temporary, part-time, casual, contract, and self-employment situations,
leading to job insecurity for half of working Canadians.
F. Housing and Food Security
1. Low-income families, especially Aboriginal ones; new immigrants; and single-parent
families struggle with housing issues in Canada.
2. Low-income families are 13 times more likely to report that their children go hungry
than higher income families; this is especially true for single mothers.
G. Education and Care in Early Life
1. We do not have enough regulated childcare spaces in Canada for children of working
parents.
2. Budget cutbacks to public school education endanger the health of Canadians and the
well-being of the social structure of our society.
3. Aboriginal students have lower rates of high-school graduation, and their attendance
is well below the national average.
H. Taking Action
1. Six key strategies to enhance the social determinants of health have been adopted by
health agencies and provincial governments:
a. adopting a framework for social inclusion
b. promoting full employment, job security, and healthy working conditions
c. protecting universal access to our high-quality health system
d. protecting Canada’s high-quality publiceducation system
e. ensuring the right of all Canadians to adequate housing and food
f. reducing income disparities by ensuring minimum wages and levels of social
assistance
V. The Health of College and University Students
1. College-aged men are more likely than college-aged women to engage in risk-taking
behaviours, to use drugs and alcohol, to engage in risky sexual behaviours such as
having multiple partners and having sex while under the influence of alcohol, and to
drive dangerously.
2. Dormitories have proven to be breeding grounds for serious infectious diseases such
as meningitis; second-hand smoke can pose a long-term threat to smokers’
roommates; and binge drinking imperils drinkers and those surrounding them.
3. Undergraduates face risks to their psychological health. College students reported
more distress than the general population or their peers not enrolled in college.
4. First-year students suffer the most in terms of physical and emotional well-being.
5. Increased education has long-term health benefits.
VI. Making Healthy Changes
A. Understanding Health Behaviour
1. To make lasting beneficial changes, it helps to understand the three types of

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influences that shape behaviour: predisposing, enabling, and reinforcing factors.
2. Predisposing Factors
a. Predisposing factors include knowledge, attitudes, beliefs, values, and
perceptions.
b. People are most likely to change health behaviour if they hold three beliefs:
Susceptibility—They acknowledge they are at risk for the negative
consequences of their behaviour.
Severity—They believe they may pay a high price if they don’t make a
change.
Benefits—They believe the proposed change will be an advantage to
their health.
c. The value or importance we give to health also plays a major role in changing
behaviour.
3. Enabling Factors
a. Enabling factors include skills, resources, accessible facilities, and physical
and mental capacities.
4. Reinforcing Factors
a. Reinforcing factors may include praise from family and friends, rewards from
teachers or parents, or encouragement and recognition for meeting a goal, but
lasting change depends on an internal commitment and sense of achievement.
B. Decision-Making
1. The entire process of maintaining or restoring health depends on your decisions; it
cannot start or continue without them.
2. If you think of decision-making as a process, you can break down even the most
difficult choices into manageable steps, which include setting priorities, informing
yourself, considering all your options, tuning into your intuitive feelings, and
considering a “worst-case” scenario.
C. The Health Belief Model
1. Use this model to explain and predict health behaviours by focusing on attitudes and
beliefs.
2. According to this model, people will take a health-related action based on the
following factors:
perceived susceptibility, perceived severity, perceived benefits, cues to action, and
self-efficacy.
3. This model has been used over the years to help people change unhealthy behaviours
such as smoking, overeating, and inactivity.
D. How Can I Begin to Make Lifestyle Changes?
1. Change is never easy; when you decide to change a behaviour, you have to give up
something familiar and easy for something new and challenging.
2. Change always involves risk—and the prospect of rewards.
3. Researchers have identified various approaches that people use in making beneficial
changes,
including the moral model, the enlightenment model, the behavioural model, the
medical model, and
the compensatory model.

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College/University Students and Health: Ask students how they handle the possible newfound
freedom they have achieved since attending college/university. How do their parents handle and
react to it? How does this sense of independence affect their health? What health challenges do they
face?
Wellness-Illness Continuum: Have students identify where they are on the Wellness-Illness
Continuum (Figure 1-4). Be sure they include all six domains of health. What does the Wellness-
Illness Continuum represent? Can you fluctuate on this continuum?
Changing Health Behaviour: Ask students to reflect on a personal change attempt. Discuss
positive strategies they used. Discuss unsuccessful attempts. Why were they unsuccessful? What
could they have done differently? Point out the Stages of Change (Figure 1-10) and compare
successful and unsuccessful changes.
GUEST SPEAKERS AND PANEL PRESENTATIONS
Compose a panel of class members or community representatives from diverse ethnic, religious, and
racial groups to discuss their cultures’ views about health and illness. In particular, you might
invitemembers of the First Nations community to your classroom to discuss their spiritual beliefs
and culture so that others might have a better understanding of their perspective on health and
wellness.
Form a panel,possibly comprising a psychologist, sociologist, environmentalist, and physician,and
have the members share their definitions of health and how they work to protect it.
Invite someone who has recently overcome a major health obstacle or problem to discuss what
helped them to adjust to or overcome the problem.
Invite a member of a community support group (e.g., Alcoholics Anonymous, Weight Watchers) to
share their methods/steps to creating behavioural change.

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Method:
1. Go to an area where students can easily move around.
2. Divide the group into two or three teams.
3. Have them stand in a straight line.
4. Give them a topic regarding health (e.g., times a week you exercise, number of fruits and
vegetables eaten daily, number of sports teams played on in high school)
5. Have them line up accordingly (e.g., most to least, least to most).
6. Keep track of time to see which group lines up first (and then compare times afterwards).
7. To add a twist, don’t let them talk while trying to line up.
8. Repeat many times so that the students get a chance to be in different location each
time.
Discussion:
1. Elaborate on the following communication facts:
a. Verbal messages(words) account for 7 percent of communication.
b. Nonverbal cues (e.g., expression, gesture, or dress) account for 93 percent of
communication.
2. Discuss with the students how they felt when they couldn’t talk.What did they rely on
to communicate?
a. How did each of them communicate? Were there different styles?
b. Is nonverbal communication as effective as verbal communication? Explain.
3. Discuss whether anyone was always in the same place in line or not. Discuss
differences amongst each other.
4. How might these differences reflect how we treat ourselves? Our lifestyle behavio

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Activity #3
Presentation on Various Cultures
Purpose:
To better understand the health needs and practices of various cultures
Time:
Two to three class periods
Method:
1. Have students select (or assign) various cultures to research the health needsand practices of
each culture. You may want to put them in groups.
a. Ask students to research the various dimensions of health regarding their selected (or
assigned) culture.
2. Give the students ample time to research their given culture.
3. Have students present to either small groups or to the entire class; whatevertime allows.
Discussion:
1. Discuss the various ways that people perceived the dimensions and how others fromdifferent
cultures might interpret these dimensions.
2. Ask the students how they feel about these various cultures after having a chance tolook at them
more closely.
Activity #4
How Do We Compare?
Purpose:
To introduce and investigate the various health concerns and illnesses around the world and
compare them to those in Canada
Time:
One class period
Method:
1. Reserve a classroom that has access to enough computers for your class.
2. Have students investigate the World Health Organization website and the Health Canada
website, and make a list of the top illnesses around the world.
3. To add another dimension, give the students a particular case study and ask them

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Scott, K. (2002, November). A lost decade: Income equality and the health of Canadians. Paper
presented at the Social Determinants of Health Across the Life-Span Conference, Toronto.
FILMS (DVDS/VIDEOCASSETTES)
The Concept of Holistic Health
(improving overall health; shows all dimensions)
Hogg Foundation Library
P.O. Box 7998
University of Texas
Austin, TX 78712
Doctors Ought To Care
(Dr. Alan Blum discusses good and bad health habits and self-prevention strategies.)
Hogg Foundation for Mental Health
Hogg Foundation Library
P.O. Box 7998
University of Texas
Austin, TX 78712
Health and Lifestyles
(Lifestyles have an effect upon health; it’s never too late to begin the change process.)
Spectrum Films
2755 Jefferson Street, Suite 108
Carlsbad, CA 92088
Healthy Lifestyles
(This two CD-Rom set multimedia program provides information to help viewers make the best
decisions for healthy living and feeling great.)
Films for Humanities and Sciences
P.O. Box 2053
Princeton, NJ 08543-2053
Homeostasis
(o

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(This program investigates the ramifications of applying the theories of prevention
medicine: modifications in diet and lifestyle.)
Films for Humanities and Sciences
P.O. Box 2053
Princeton, NJ 08543-2053
To Live or Die
(How lifestyle choices affect diseases is demonstrated. Connection between disease and behaviour
in the lives of two individuals is discussed after their deaths.)
Perennial Education, Inc.
930 Pitner Avenue
Evanston, IL 60202
The Wellness Revolution
(Take charge of your physical and mental well-being; choosing healthful lifestyles.)
Modern Talking Picture Service
Film Scheduling Center
500 Park Street
North St. Petersburg, FL 33709
What Is Your Health Hazard Risk?
(provides guidance for improving health and longevity through health quiz)
IBIS Media
175 Tompkins Avenue
Pleasantville, NY 10570
You Can’t Buy Health
(health maintenance program described by medical authorities)
Produced by Burd and Cavan Communications Company
Order from Blue Cross and Blue Shield Insurance Company.
INTERNET RESOURCES
Canadian Institute for Health Information (CIHI)
Access information about national health indicators and standards, health spending, current health
research, and the Canadian Population Health Initiative (CPHI).
www.cihi.ca

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Public Health Agency of Canada
Find credible and practical e-health information gathered from federal, provincial, and municipal
agencies; university libraries; and community groups.
www.publichealth.gc.ca
Canadian Institutes for Health Research
Learn about Canada’s lead federal funding agency and funding opportunities for health research in
four areas: biomedical, clinical, health systems and services, and population and public health.
www.cihr-irsc.gc.ca/e/193.html
The First Nations, Inuit& Aboriginal Health Branch of Health Canada
Discover public health and health-promotion services for First Nations, Inuit & Aboriginal people
in Canada.
www.hc-sc.gc.ca/fniah-spnia
Health Canada
Health information can be found at this federal government website. Check out The Daily, a special
page that keeps Canadians on top of current health issues.
www.hc-sc.gc.ca
Speakwell
Visit this award-winning e-wellness website from Speakwell, a health and wellness education
company. Check out the WELL newsletter, which is free of charge.
www.speakwell.com

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Build Your Future
Making Healthy Changes
Ultimately you have more control over your health than anyone else. Use this course as an
opportunity to zero in on at least one less-than-healthful behavior and improve it. Here are some
suggestions for small steps that can have a big payoff. Check those that you commit to making
today, this week, this month, or this term. Indicate “t,” “w,” “m,” or term, and repeat this self-
evaluation throughout the course.
___ Use seat belts. In the last decade, seat belts have saved more than 40,000 lives and prevented
millions of injuries.
___ Eat an extra fruit or vegetable every day. Adding more fruit and vegetables to your diet can
improve your digestion and lower your risk of several cancers.
___ Get enough sleep. A good night’s rest provides the energy you need to make it through the
following day.
___ Take regular stress breaks. A few quiet minutes spent stretching, looking out the window, or
simply letting yourself unwind are good for body and soul.
___ Lose a pound. If you’re overweight, you may not think a pound will make a difference, but it’s
a step in the right direction.
___ If you’re a woman, examine your breasts regularly. Get in the habit of performing a breast
self-examination every month after your period (when breasts are least swollen or tender).
___ If you’re a man, examine your testicles regularly. These simple self-exams can spot the signs
of cancer early, when it is most likely to be cured.
___ Get physical. Just a little exercise will do some good. A regular workout schedule will be good
for your heart, lungs, muscles, bones—even your mood.

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Self-Survey
Are You in Control of Your Health?
To test whether you are the master of your fate, asserting control over your destiny or just hanging
on, hoping for the best, take the test below. Depending on which statement you agree with, check
either a or b for each of the following.
1.
(a) Many of the unhappy things in people’s lives are partly due to bad luck. ___
(b) People’s misfortunes result from mistakes they make. ___
2.
(a) One of the major reasons why we have wars is that people don’t take enough interest in
politics. ___
(b) There will always be wars, no matter how hard people try to prevent them. ___
3.
(a) In the long run, people get the respect they deserve in this world. ___
(b) Unfortunately, an individual’s worth often passes unrecognized no matter how hard he tries.
___
4.
(a) The idea that teachers are unfair to students is nonsense. ___
(b) Most students don’t realize the extent to which their grades are influenced by accidental
happenings. ___
5.
(a) Without the right breaks, one cannot be an effective leader. ___

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(b) Capable people who fail to become leaders have not taken advantage of their opportunities.
___
6.
(a) No matter how hard you try, some people just don’t like you. ___
(b) People who can’t get others to like them don’t understand how to get along with others. ___
7.
(a) I have often found that what is going to happen will happen. ___
(b) Trusting to fate has never turned out as well for me as making a decision to take a definite
course of action. ___
8.
(a) In the case of the well-prepared student, there is rarely, if ever, such a thing as an unfair test.
___
(b) Many times exam questions tend to be so unrelated to course work that studying is really
useless. ___
9.
(a) Becoming a success is a matter of hard work; luck has little or nothing to do with it. ___
(b) Getting a good job depends mainly on being in the right place at the right time. ___
10.
(a) The average citizen can have influence in government decisions. ___
(b) This world is run by the few people in power, and there is not much the little guy can do
about it. ___
11.
(a) When I make plans, I am almost certain that I can make them work. ___

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(b) It is not always wise to plan too far ahead because many things turn out to be a matter of
luck anyway. ___
12.
(a) In my case, getting what I want has little or nothing to do with luck. ___
(b) Many times we might just as well decide what to do by flipping a coin. ___
13.
(a) What happens to me is my own doing. ___
(b) Sometimes I feel that I don’t have enough control over the direction my life is taking. ___

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Scoring: Give yourself one point for each of the following answers:
1a, 2b, 3b, 4b, 5a, 6a, 7a, 8b, 9b, 10b, 11b, 12b, 13b
You do not get any points for other choices.
Add up the totals. Scores can range from 0 to 13. A high score indicates an external locus of
control, the belief that forces outside yourself control your destiny. A low score indicates an internal
locus of control, a belief in your ability to take charge of your life.
Source: Based on J. B. Rotter, “Generalized Expectancies for Internal versus External Control of
Reinforcement,” Psychological Monographs, Vol. 80, Whole No. 609 (1966).
If you turned out to be external on this self-assessment quiz, don’t accept your current score as a
given for life. If you want to shift your perspective, you can. People are not internal or external in
every situation. At home you may go along with your parents’ or roommates’ preferences and let
them call the shots. In class you might feel confident and participate without hesitation.
Take inventory of the situations in which you feel most and least in control. Are you bold on the
basketball court but hesitant on a date? Do you feel confident that you can resolve a dispute with
your friends but throw up your hands when a landlord refuses to refund your security deposit? Look
for ways to exert more influence in situations in which you once yielded to external influences. See
what a difference you can make.

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Subject

Nursing

An Invitation To Health, Third Canadian Edition Lecture Notes

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