The development of the rational medicine, based on scientific evidence (evidence based medicine, EBM) in the late 21 century lead to the opening of the Pandora box of doubt in the evidence base of medicine. Paradoxically part of the specialists and the public, who are inconvenient with the critical assessment of the evidence, start to criticize the EBM for the corrupted evidence base. In the real world the only way out from the situation with the weak evidence base is the work to support the free access to the research evidence and hard work to improve the quality of evidence
This paper analyzes opportunities of application of the self-determination theory to the compliant behavior and describes the process of development and validation scale for measuring compliance-related causality orientations in the normative sample. Experts’ appraisals demonstrated that in clinical settings controlled causality orientation could be divided into two subscales: controlled by doctors and controlled by others subscales. Empirical data (N=246 students) supports internal consistency (Cronbach's alpha .76-.79), test-retest reliability and factor validity of the scale. All the subscales correlate with general controlled orientation subscale as well as relevant subscales of General Causality Orientation Scale. Controlled by doctors and impersonal causality orientations were negatively related to health-related quality of life. Compliance-Related Causality Orientations Scale correlated with retrospective appraisals of last episode of somatic illness (subjective interference with other domains, fear of future complications, fear of more severe illness, subjective ability to follow chosen treatment. Although testing prospective validity of the scale is a challenge for future research, the scale could be useful to study motivational factors of compliant behavior both in the normative and clinical samples.