| RPT |
.| .| Multidimensional Health Locus of Control: Form C| | Date Given: <.Date_Given.>| Clinician: <.Staff_Ordered_By.>| Location: <.Location.>| | Veteran: <.Patient_Name_Last_First.>| SSN:
see that the right things happen.| <*Answer_5390*>| 11. Whatever improvement occurs with my condition is largely a matter of good fortune.| <*Answer_5391*>| 12. The main thing which affects
my condition is what I myself do.| <*Answer_5392*>| 13. I deserve the credit when my condition improves and the blame when it gets worse.| <*Answer_5393*>| 14. Following doctor's orders to
the letter is the best way to keep my condition from getting any worse.| <*Answer_5394*>| 15. If my condition worsens, it's a matter of fate.| <*Answer_5395*>| 16. If I am lucky, my condition
will get better.| <*Answer_5396*>| 17. If my condition takes a turn for the worse, it is because I have not been taking proper care of myself.| <*Answer_5397*>| 18. The type of help I receive
from other people determines how soon my condition improves.| <*Answer_5398*>| | | Information contained in this note is based on a self-report assessment and is not sufficient to use alone for
diagnostic purposes. Assessment results should be verified for accuracy and used in conjunction with other diagnostic activities and procedures.| $~
<.Patient_SSN.>| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)| Gender: <.Patient_Gender.>| | MHLC-C| | Internal: <-Internal->| Range: 6-36. High score indicates belief that one's behavior
controls one's health. | | Chance: <-Chance->| Range: 6-36. High score indicates belief that health is controlled by chance, luck or fate. | | Doctors: <-Doctors->| Range:
3-18. High score indicates belief that health is controlled by health professionals.| | Other People: <-Other People->| Range: 3-18. High score indicates belief that significant others
determine one's health.| | Questions and Answers| | 1. If my condition worsens, it is my own behavior which determines how soon I will feel better again.| <*Answer_5381*>| 2. As to my condition,
what will be will be.| <*Answer_5382*>| 3. If I see my doctor regularly, I am less likely to have problems with my condition.| <*Answer_5383*>| 4. Most things that affect my condition happen
to me by chance.| <*Answer_5384*>| 5. Whenever my condition worsens, I should consult a medically trained professional.| <*Answer_5385*>| 6. I am directly responsible for my condition getting
better or worse.| <*Answer_5386*>| 7. Other people play a big role in whether my condition improves, stays the same, or gets worse.| <*Answer_5387*>| 8. Whatever goes wrong with my condition
is my own fault.| <*Answer_5388*>| 9. Luck plays a big part in determining how my condition improves.| <*Answer_5389*>| 10. In order for my condition to improve, it is up to other people to
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