12.07.2015 Views

Baseline Questionnaire - GeroNet

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May be eliminatedID#__________GLOBAL SELF MASTERYHow strongly do you agree or disagree with the followingstatements?1. I am generally able to take care of a health problemthrough my own efforts.___ Strongly disagree___ Disagree___ Somewhat disagree___ Somewhat agree___ Agree___ Strongly agree2. If I become sick, I have the power to make myself wellagain.___ Strongly disagree___ Disagree___ Somewhat disagree___ Somewhat agree___ Agree___ Strongly agree3. I have a lot of confidence in my ability to cure myselfonce I get sick.___ Strongly disagree___ Disagree___ Somewhat disagree___ Somewhat agree___ Agree___ Strongly agree4. When I have a health problem, I am usually able to copewith it on my own.___ Strongly disagree___ Disagree___ Somewhat disagree___ Somewhat agree___ Agree___ Strongly agree

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