Compliance level Test - the question form
Questions: 66 · 13 minutes
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Male form
Female form
1. I feel upset if I miss a dose of my medication.
1 – Always
2 – Sometimes
3 – Never
2. If I feel I could manage without my medication today, I still follow the doctor’s instructions because I think the doctor would not approve of a break in treatment.
1 – Always
2 – Sometimes
3 – Never
3. I do not follow treatment against my doctor’s instructions.
1 – Always
2 – Sometimes
3 – Never
4. If, for any reason, I do not follow my doctor's instructions, I inform them immediately.
Always
Sometimes
Never
5. I feel very anxious before seeing my treating physician.
1 – Always
2 – Sometimes
3 – Never
6. I consider illness to be simply an obstacle that needs to be overcome.
1 - Always
2 - Sometimes
3 - Never
7. I prefer to take well-known, tried-and-tested, widely advertised medications.
1 – Always
2 – Sometimes
3 – Never
8. I often forget to take my medication if it needs to be taken some time before meals.
Always
Sometimes
Never
9. I would like my doctor to think that I am able to manage my medication schedule on my own.
Always
Sometimes
Never
10. I feel that my doctor judges me for how well I follow my medication schedule, and I try to avoid this.
Always
Sometimes
Never
11. I seek help only from a doctor who has been recommended to me as the most competent in that area.
Always
Sometimes
Never
12. I fully agree with all of my doctor's recommendations.
1 – Always
2 – Sometimes
3 – Never
13. I follow my doctor's instructions exactly.
Always
Sometimes
Never
14. I see a doctor at the first signs of illness because I am very concerned about my health.
Always
Sometimes
Never
15. I remember when and which medications I need to take.
Always
Sometimes
Never
16. Even if my symptoms improve almost immediately, I still continue the prescribed treatment.
Always
Sometimes
Never
17. I know exactly what to do if my condition suddenly flares up.
Always
Sometimes
Never
18. When I think about possible complications, I feel very afraid.
Always
Sometimes
Never
19. I have a panic attack when my illness is discussed.
Always
Sometimes
Never
20. If people say that a doctor is "good," I am willing to trust them with my health.
Always
Sometimes
Never
21. When I start treatment, I set a goal to get well.
Always
Sometimes
Never
22. I am a responsible person, and I approach my treatment accordingly.
1 - Always
2 - Sometimes
3 - Never
23. I tell my treating doctor about any concerns I have about possible complications of my condition.
Always
Sometimes
Never
24. I am confident that I can cope with my illness.
Always
Sometimes
Never
25. If difficulties arise during treatment, I try to do everything I can to overcome them.
1 – Always
2 – Sometimes
3 – Never
26. I follow my doctor’s instructions and recommendations exactly, despite worries about possible side effects.
1 – Always
2 – Sometimes
3 – Never
27. I feel calm if I know that I am not causing unnecessary trouble for my treating physician.
Always
Sometimes
Never
28. I follow all of my doctor’s instructions responsibly.
1 – Always
2 – Sometimes
3 – Never
29. Many people say that following medical advice is the basis of overcoming illness, and I share this view.
Always
Sometimes
Never
30. Taking medication makes me feel anxious about taking the medications.
1 – Always
2 – Sometimes
3 – Never
31. I have mood swings after taking my medication.
Always
Sometimes
Never
32. When leaving home, I check whether I have my required medication with me.
Always
Sometimes
Never
33. When dealing with my health problems, I generally cannot manage without help from others.
1 – Always
2 – Sometimes
3 – Never
34. I feel that I am too concerned about my health.
Always
Sometimes
Never
35. I consult my doctor when I decide to stop taking my medication.
1 – Always
2 – Sometimes
3 – Never
36. I look forward to my next dose because I am afraid I might miss it.
1 – Always
2 – Sometimes
3 – Never
37. I believe that people who are careless about following a doctor's instructions put their health at risk.
1 – Always
2 – Sometimes
3 – Never
38. If I feel unwell, I try to push through it.
1 – Always
2 – Sometimes
3 – Never
39. When I am ill, what upsets me most is that people begin to avoid me.
Always
Sometimes
Never
40. I try to overcome my illness and work (study) as before.
1 – Always
2 – Sometimes
3 – Never
41. I try my best not to give in to the illness.
1 – Always
2 – Sometimes
3 – Never
42. I am frightened by the difficulties and risks associated with the upcoming treatment.
Always
Sometimes
Never
43. I would be willing to undergo even very painful or dangerous treatment if it would help me get rid of my illness.
1 – Always
2 – Sometimes
3 – Never
44. I would like to be treated by a doctor who is well known.
Always
Sometimes
Never
45. I often worry that I did not tell my doctor something important that could affect the success of my treatment.
Always
Sometimes
Never
46. I feel uncomfortable if I do not take my medication on time.
1 – Always
2 – Sometimes
3 – Never
47. When I am ill, I feel ashamed to admit it even to the people closest to me.
Always
Sometimes
Never
48. I would not want to burden people close to me with my illness.
Always
Sometimes
Never
49. I do not think that illness can interfere with my work or studies.
1 – Always
2 – Sometimes
3 – Never
50. I hope that careful treatment and following my regimen will lead to better health in the future.
Always
Sometimes
Never
51. I believe that taking my medications helps my recovery.
Always
Sometimes
Never
52. I worry that my illness may significantly affect my future.
Always
Sometimes
Never
53. I do everything I can to overcome my illness.
Always
Sometimes
Never
54. I try not to disappoint my treating clinician, so I follow all of their recommendations.
Always
Sometimes
Never
55. When following my doctor’s instructions, I worry for a long time that I might do something incorrectly.
Always
Sometimes
Never
56. I willingly listen to advice about my health.
Always
Sometimes
Never
57. I try to follow a healthy lifestyle to maintain my health as well as possible.
Always
Sometimes
Never
58. If a doctor says I am ill, then I need to be treated.
1 – Always
2 – Sometimes
3 – Never
59. To start treatment, I need to know the sequence of steps.
1 – Always
2 – Sometimes
3 – Never
60. If I feel emotional support and care from my doctor, I follow their recommendations willingly.
1 – Always
2 – Sometimes
3 – Never
61. If the prescribed procedures/medications cause me discomfort, I still continue treatment because I do not want to disappoint my doctor.
1 – Always
2 – Sometimes
3 – Never
62. I feel worried if my treating physician advises switching from my current medication to a newer one.
1 – Always
2 – Sometimes
3 – Never
63. I believe that effective treatment is based on a close, trusting relationship with the doctor.
Always
Sometimes
Never
64. I feel reassured about my health condition when my doctor is in a good mood.
Always
Sometimes
Never
65. When my health is at risk and I cannot cope with it, I feel that only my doctor can help me.
Always
Sometimes
Never
66. Because I am very concerned about my health, I am willing to take any medication prescribed by a doctor.
1 – Always
2 – Sometimes
3 – Never
1. I feel upset if I miss a dose of my medication.
Always
Sometimes
Never
2. If I feel I could do without my medication today, I still follow my doctor's instructions because I think my doctor would not approve of a break in treatment.
Always
Sometimes
Never
3. I do not follow treatment contrary to my doctor's instructions.
Always
Sometimes
Never
4. If, for any reason, I do not follow my doctor's instructions, I inform them right away.
Always
Sometimes
Never
5. I feel very anxious before seeing my treating doctor.
1 – Always
2 – Sometimes
3 – Never
6. I think that illness is simply an obstacle that needs to be overcome.
Always
Sometimes
Never
7. I prefer to take well-known, trusted, widely advertised medications.
Always
Sometimes
Never
8. I often forget to take my medication if it needs to be taken some time before a meal.
Always
Sometimes
Never
9. I would like the doctor to think that I am able to manage my medication schedule on my own.
1 – Always
2 – Sometimes
3 – Never
10. I feel that my doctor judges me for how well I follow my medication schedule, and I try to avoid this.
Always
Sometimes
Never
11. I seek help only from the doctor who has been recommended to me as the most competent in that field.
1 – Always
2 – Sometimes
3 – Never
12. I fully agree with all of my doctor’s instructions.
Always
Sometimes
Never
13. I follow my doctor's instructions exactly.
Always
Sometimes
Never
14. I see a doctor at the first signs of illness because I am very concerned about my health.
1 – Always
2 – Sometimes
3 – Never
15. I remember when to take my medications and which medications I need to take.
Always
Sometimes
Never
16. Even if my symptoms improve almost immediately, I still continue the prescribed treatment.
Always
Sometimes
Never
17. I know exactly what to do if I suddenly have an exacerbation of my condition.
Always
Sometimes
Never
18. When I think about possible complications, I feel very frightened.
Always
Sometimes
Never
19. I have a panic attack when my illness is discussed.
Always
Sometimes
Never
20. If people say that a doctor is “good,” I am willing to trust them with my health.
Always
Sometimes
Never
21. When I start treatment, I set a goal to recover.
Always
Sometimes
Never
22. I am a responsible person, and I approach my treatment accordingly.
Always
Sometimes
Never
23. I tell my treating doctor about any concerns I have about complications of my illness.
Always
Sometimes
Never
24. I am confident that I can cope with my illness.
Always
Sometimes
Never
25. If difficulties arise during treatment, I try to do everything I can to overcome them.
1 – Always
2 – Sometimes
3 – Never
26. I follow my doctor's instructions and recommendations exactly, despite anxiety about possible side effects.
Always
Sometimes
Never
27. I feel calm when I know I am not causing unnecessary inconvenience to my treating clinician.
Always
Sometimes
Never
28. I follow all of my doctor’s instructions responsibly.
1 – Always
2 – Sometimes
3 – Never
29. I believe that following medical instructions is the basis for overcoming illness.
Always
Sometimes
Never
30. Taking medication makes me feel anxious about taking the medicines.
1 – Always
2 – Sometimes
3 – Never
31. I have mood swings after taking my medication.
1 – Always
2 – Sometimes
3 – Never
32. When leaving home, I check whether I have taken the necessary medication with me.
1 – Always
2 – Sometimes
3 – Never
33. When dealing with my health problems, I generally cannot manage without help from others.
Always
Sometimes
Never
34. I feel that I am overly concerned about my health.
Always
Sometimes
Never
35. I consult my doctor when I decide to stop taking my medication.
Always
Sometimes
Never
36. I look forward to my next dose of medication because I am afraid of missing it.
Always
Sometimes
Never
37. I believe that people who are careless about following a doctor's instructions put their health at risk.
1 – Always
2 – Sometimes
3 – Never
38. If I feel unwell, I try to push through it.
Always
Sometimes
Never
39. When I am ill, what upsets me most is that people start to avoid me.
Always
Sometimes
Never
40. I try to overcome my illness and work (study) as I did before.
Always
Sometimes
Never
41. I try my best not to give in to my illness.
Always
Sometimes
Never
42. I am frightened by the difficulties and risks associated with the upcoming treatment.
1 – Always
2 – Sometimes
3 – Never
43. I would be willing to undergo the most painful and even dangerous treatment if it would get rid of my illness.
1 – Always
2 – Sometimes
3 – Never
44. I would like to be treated by a doctor who is well known.
Always
Sometimes
Never
45. I often worry that I did not tell my doctor something important that could affect the success of my treatment.
1 – Always
2 – Sometimes
3 – Never
46. I feel uncomfortable if I do not take my medication on time.
Always
Sometimes
Never
47. When I am ill, I feel ashamed to admit it even to the people closest to me.
Always
Sometimes
Never
48. I would not want to burden people close to me with my illness.
1 – Always
2 – Sometimes
3 – Never
49. I do not think that my illness can interfere with my work or studies.
Always
Sometimes
Never
50. I hope that careful treatment and following the prescribed regimen will improve my health in the future.
Always
Sometimes
Never
51. I believe that taking my medication helps my recovery.
Always
Sometimes
Never
52. I worry that my illness may significantly affect my future.
Always
Sometimes
Never
53. I do everything I can to overcome my illness.
1 – Always
2 – Sometimes
3 – Never
54. I try not to disappoint my treating clinician, so I follow all of their recommendations.
1 – Always
2 – Sometimes
3 – Never
55. When following my doctor’s instructions, I worry for a long time that I might do something incorrectly.
1 – Always
2 – Sometimes
3 – Never
56. I willingly listen to advice about my health.
Always
Sometimes
Never
57. I try to follow a healthy lifestyle to maintain my health in the best possible condition.
Always
Sometimes
Never
58. If a doctor says I am ill, then I need to get treated.
1 – Always
2 – Sometimes
3 – Never
59. To start treatment, I need to know the steps in advance.
1 – Always
2 – Sometimes
3 – Never
60. If I feel my doctor provides emotional support and care, I follow their recommendations willingly.
Always
Sometimes
Never
61. If the prescribed procedures/medications cause me discomfort, I still continue treatment because I do not want to disappoint my doctor.
1 – Always
2 – Sometimes
3 – Never
62. I feel concerned if my treating physician advises switching from an older medication to a newer one.
1 – Always
2 – Sometimes
3 – Never
63. I believe that effective treatment is based on a close, trusting relationship with the doctor.
1 – Always
2 – Sometimes
3 – Never
64. I feel reassured about my health when my doctor is in a good mood.
1 – Always
2 – Sometimes
3 – Never
65. When my health is in danger and I cannot cope with it, I believe that only my doctor can help me.
1 – Always
2 – Sometimes
3 – Never
66. Because I am very concerned about my health, I am willing to take any medication prescribed by my doctor.
1 – Always
2 – Sometimes
3 – Never