Scales and questions | |||
---|---|---|---|
How often you do them to manage your illness(es)? | Responses (number of points) | ||
Coping tasks | |||
(1) Deal with feelings of worry or sadness or fears that affect any or all of your daily life, including family and work relationships | Never (1) | Sometimes (2) | Mostly or Always (3) |
(2) Allow for extreme tiredness or limited energy when planning your day | Never (1) | Sometimes (2) | Mostly or Always (3) |
(3) Avoid/limit activities that you enjoy doing (e.g., social activities with family/friends, doing hobbies) | Never (1) | Sometimes (2) | Mostly or Always (3) |
(4) Deal with unexpected or new problems in your life and/or work due to your illness (e.g., financial issues; changes in illness or a new illness) | Never (1) | Sometimes (2) | Mostly or Always (3) |
(5) Make changes to any part of your diet (food or fluids), your activities, or your medications due to a change in your illness | Never (1) | Sometimes (2) | Mostly or Always (3) |
(6) Managing discomfort and pain | Never (1) | Sometimes (2) | Mostly or Always (3) |
Physical tasks | |||
(1) Ask for or need help with household chores (e.g., preparing meals, cleaning your home, doing laundry, grocery shopping) | Never (1) | Sometimes (2) | Mostly or Always (3) |
(2) Ask for or help with self-care (e.g. eating, dressing, bathing)* | Never (1) | Sometimes, Mostly or Always (2) | |
(3) Dealing with physical limitations | Never (1) | Sometimes (2) | Mostly or Always (3) |
Miscellaneous (all coded initially as never, sometimes, mostly, always) | |||
(1) Check things such as blood pressure or blood sugar levels | |||
(2) Take medications daily | |||
(3) (if you are working): Miss work, have to leave early, work shorter hours or struggle to complete all your work |