Document Type

Thesis - University Access Only

Award Date


Degree Name

Master of Science (MS)

Department / School

Graduate Nursing


The purpose of this study was to identify the relationship between individual health locus of control style (i.e. chance, internal, or powerful other) and the utilization of the emergency room, office-based health care visits, and hospital admissions in a rural South Dakota population. The multidimensional health locus of control scale developed by Wallston, Wallston, and DeVillis (1978) and healthcare utilization questions developed by Aday and Andersen (1974) are combined in a questionnaire that was randomly distributed to 500 members of the SD Farmer's Union. Two hundred and thirty-two (232) surveys were completed and analyzed descriptively and statistically using a heirarchical poisson regression. Statistical significance was defined by a g-value less than 0.05. Rural people who were more likely to utilize the emergency department included those who lived a farther distance from the emergency room, those with a higher educational level, and individuals who have lived at their residence for more than five years. No specific health locus of control (HLOC) style was found to be statistically significant for predicting emergency department utilization. Rural persons more likely to be admitted to the hospital were male, unmarried individuals who perceived their health care provider to be accessible and available, and did not participate in the Medicare program. Individuals reporting a powerful others BLOC were more likely to be hospitalized in the past six months whereas individuals least likely to be hospitalized reported a chance BLOC. Rural persons more likely to utilize office-based health care provider visits tended to be older adult females who have lived at their residence for more than five years and who were employed outside of their home. Powerful others health locus of control was also found to be a strong predictor of office-based care visits with a R-value of 0.0002.

Library of Congress Subject Headings

Medical care -- Utilization
Health behavior
Locus of control



Number of Pages



South Dakota State University