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Symptoms
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| |
Did the child show any worrying symptoms?
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| | |
All the time
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Most of the time
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Often
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Sometime
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Seldom
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Very seldom
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Never
|
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Emotions
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Have you experienced anxiety because of your child's health problems?
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| | |
All the time
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Most of the time
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Often
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Sometimes
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Seldom
|
Very seldom
|
Never
|
|
Role functioning
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Social
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Please indicate how much you have been limited by your child's disease in listed activities in past two weeks - Social activities (going to church, cinema, visiting friends)
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| | |
Extremely limited
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Very limited
|
Quite limited
|
Moderately limited
|
Somewhat limited
|
Hardly limited
|
Not limited
|
|
Occupational
| | | | | | | | |
| |
Please indicate how much you have been limited by your child's disease in work related activities in past two weeks
|
| | |
Extremely limited
|
Very limited
|
Quite limited
|
Moderately limited
|
Somewhat limited
|
Hardly limited
|
Not limited
|
|
Family
| | | | | | | | |
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Do you struggle to find time to spend with other family members (spouse, another child) because of your child' disease?
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| | |
Extremely limited
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Very limited
|
Quite limited
|
Moderately limited
|
Somewhat limited
|
Hardly limited
|
Not limited
|
|
Scaling for answers (points)
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1
|
2
|
3
|
4
|
5
|
6
|
7
|
