Therapy Commitment Factors Scale Test - the question form
Questions: 12 · 3 minutes
1. Not understanding the purpose of taking the medication.
1 – Does not affect at all
2 – Affects slightly
3 – Sometimes affects
4 – Often affects
5 – Very often affects
2. Having to take medication continuously.
1 - This factor does not affect me at all
2 - This factor affects me slightly
3 - This factor sometimes affects me
4 - This factor often affects me
5 - This factor very often affects me
3. Not seeing a noticeable effect from the treatment.
1 – Does not influence at all
2 – Influences slightly
3 – Sometimes influences
4 – Often influences
5 – Very often influences
4. An inconvenient medication dosing schedule.
1 – Does not affect at all
2 – Affects slightly
3 – Sometimes affects
4 – Often affects
5 – Very often affects
5. Concern about developing side effects from taking the medication.
1 – The factor does not influence at all
2 – The factor has a slight influence
3 – The factor sometimes influences
4 – The factor often influences
5 – The factor very often influences
6. Having to take a large number of medications overall.
1 - The factor does not influence at all
2 - The factor has a minor influence
3 - The factor sometimes influences
4 - The factor often influences
5 - The factor very often influences
7. Frequent changes in medications.
1 – The factor does not influence at all
2 – The factor has a minor influence
3 – The factor sometimes influences
4 – The factor often influences
5 – The factor very often influences
8. Concern about becoming dependent on the medication.
1 – Does not affect at all
2 – Slightly affects
3 – Sometimes affects
4 – Often affects
5 – Very often affects
9. High cost of the medication.
1 – The factor does not influence at all
2 – The factor has a slight influence
3 – The factor sometimes influences
4 – The factor often influences
5 – The factor influences very often
10. Difficulty obtaining a medical consultation.
1 – Does not affect at all
2 – Affects slightly
3 – Sometimes affects
4 – Often affects
5 – Very often affects
11. Forgetfulness.
1 – Does not affect at all
2 – Slightly affects
3 – Sometimes affects
4 – Often affects
5 – Very often affects
12. Feeling well.
1 – This factor does not influence at all
2 – This factor has a minor influence
3 – This factor sometimes influences
4 – This factor often influences
5 – This factor very often influences