Jerry and Joe have both suffered heart attacks. Jerry, upon advice from his physician, started exercising, changed his dietary intake, entered stress reduction classes, and returned to work 6 weeks after his heart attack. He has a positive outlook, is doing well, and talks about being “well.” Joe also changed his dietary habits and started exercising. However, Joe has been unable to quit smoking even though he wants to and has been advised to do so. Joe is frequently despondent, is very fearful of having another heart attack, has not yet returned to work, and frequently talks about being “ill.”

1. How does Jerry’s psychologic dimension of health status differ from Joe’s?

2. Both Jerry and Joe have heart disease. Jerry considers himself “well” whereas Joe considers himself “ill.” Explain this phenomenon based on the health locus of control model.

3. What external factors may have influenced Jerry’s decision to implement positive health behaviors?

4. What factors may have prevented Joe from developing the same positive outlook and actions that Jerry was able to take in regard to his illness?

5. What nursing interventions would be most beneficial to Joe concerning his smoking problem?

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