Treatment Self-regulation Questionnaire

Disease Self-management
The questions below are reasons for your beginning or keeping regular disease
self-management. Different people have different reasons for doing this, and we
would like to know to what degree the following reasons are true to you. Fifteen
answers below are about this 1 question.
Please indicate how true each reason is to you using the following 7-point scale.
1 2 3 4 5 6 7
Not true at all Partly true Completely true

The reason why I engage in disease self-management is:

1. Because I feel that I want to take responsibility for my health.
2. Because I would feel guilty or ashamed if I did not manage my own disease.
3. Because I personally think it is best for my health.
4. Because other people would be angry with me if I did not do this.
5. I don’t think about that at all.
6. Because I have considered it seriously and believe that it is important to many
aspects of my life.
7. Because I would feel very terrible if I did not manage my own disease.
8. Because this is an important choice that I really want to make.
9. Because I feel stressed when other people do so.
10. Because it is easier that the others ask me to do than that I think over and do.
11. Because it is in line with my goals of life.
12. Because I want to get others’ approval.
13. Because it is very important to maintain healthy as much as possible.
14. Because I want other people to see that I can do it.
15. I really don't know why.