A sense of being control was part of the active participatory process for the participants of this study. According to Bandura, et. al. (1995), feeling out of control increased stress responses, including physiological changes, that potentially could affect healing. Feeling out control also affects psychological well-being which these participants describe as part of healing. Seeman and Seeman (1993) found that people who felt a low sense of control had less optimism about their health, more illness episodes, longer bed confinements when ill, and more dependence on their physicians.
Control was a struggle for many participants. During the surgery and very early recovery they could usually relinquish this control. Moch (1998) described a control/uncontrol balance. In another study by Taylor (1993), two-thirds of the 78 subjects believed they had at least some control over course and recurrence of their cancer, and 37% saw themselves having “a lot of control. ” They, like the participants in this study, believed they actively participated in the healing process.
Smith (1999) found that 89% of 44 medical-surgical patients seemed surprised when the researcher asked them what they did to help themselves recover. This was during their hospital stay and perhaps too early for them to be feeling a need to regain control or take charge of their healing. Another aspect of Active Participation that can examine in light of the literature is the desire for privacy.
Before the data were reexamined in light of the follow-up interviews, the privacy of the healing experience was a puzzle as it seemed to contradict the notion that social support has an important affect on health outcomes and also acts as a buffer to stress, thus improving mental and physical health (Broadhead, et al. , 1993). Although these participants tried to gain privacy, sometimes rejecting social contacts, all but one of them had strong social networks on which to rely, so they did not feel a deficit in this area.
Had they not had strong social ties, ties, their desire for privacy may have been different. The desire for privacy could also be a reflection of the desire to restore the privacy of those things that were private before surgery during illness, especially when hospitalization is involved, privacy is often relinquished in such areas as eating, bowel habits, and exposure of parts of the body not usually exposed. These losses of privacy could be uncomfortable enough that people may temporarily revert to the opposite extreme, insisting on privacy beyond their typical level.
This insistence on privacy may be a transitional state related to achieving balance. The desire for privacy seemed to represent a phase related to regaining independence and control. Later, when participants were recontacted, it was discovered that they again allowed close contact, at times even closer contact, than they had had prior to surgical experience, and not wanting to hear their stories about theses experiences, to enjoying the comradeship between herself and others who had been through similar experiences and enjoying people in general and her relationship to them more than she ever had.