Lois Daniel


The literature indicates that many diabetic patients do not adhere to their prescribed medical regimen and that there is a need to discover factors that stimulate compliant behavior. It has been proposed that the patient's decision to accept or reject treatment has many determinants. This study explored the effect of one such determinant, the locus of control (the source of the stimulus for a person's behavior). It was hypothesized that a person with an internal locus (one who believes his actions influence his future) would be more likely to comply with a medical regimen than one with an external locus (one who perceives a powerlessness or lack of control of his future).

This descriptive study included a convenience sample of seventeen patients, ten females and seven males, who had had diabetes mellitus for a period of two years. The age range was from twenty-one to seventy years, with average age of fifty.

Rotter's External versus Internal Scale of Reinforcement was used to determine the locus of control of each patient and a Compliance Scale was constructed to measure the percent compliance to the medical regimen.

Other data collection instruments were a home visit interview guide aimed at obtaining information regarding diet, medication, and urine testing practices; and a scale for rating each patient’s compliance to his prescribed medial regimen.

The I. E. scores were found to range from three to seventeen with fifteen patients rated as Externals (score of seven or above) and two patients rated as Internals.

Twelve of the seventeen diabetics stated that they were following the diet plan; the average percent diet compliance score for the seventeen patients was fifty-three percent. Ten complied with the medication regimen; the average percent medication compliance score was eighty-three percent. And the average percent compliance score was fifty-two percent for urine testing. The average compliance to the total diabetic medical regimen for diet, medications, and urine testing was sixty-three percent.

When the compliance results were compared with locus of control scores, it was found that the Internals complied with their regimen better than the Externals. There was a low negative correlation (0.41) between the diabetic medical regimen compliance score and the locus of control score, significant at the 5 percent level. This means that the patients with internal locus of control (low I. E. score) did better in terms of compliance with the medical regimen. There was also a low negative correlation (0.44) between diet compliance and locus of control, and between urine testing compliance and locus of control (0.42), significant at the 5 percent level. This means that Internals comply to the diet and urine testing better than Externals. There was a positive correlation (0.13) between medication compliance score and locus of control score which is not significant at the 5 percent level. This means that there is no relationship between medication compliance and locus of control.

Important considerations which would prevent generalization of the results of this study to a broad diabetic population are: 1) there was a small sample, 2) there were not equal numbers of Externals and Internals for comparison, 3) all variables known to exist within the diabetic population were not adequately represented.

It was concluded that a relationship was shown between low compliance to the diabetic regimen and external locus of control. In general, patients complied better to the medication regimen than to diet and to urine testing.

LLU Discipline





Graduate School

First Advisor

Dorothy M. Martin

Second Advisor

Ruth M. White

Third Advisor

Alberta Mazat

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Diabetes Mellitus



Page Count

vii; 82

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives