Vous êtes sur la page 1sur 7

Appendix: WHOQOL-BREF [Questionnaire] The following questions ask how you feel a out your quality of life!

" will rea# out ea$h question to you% along with the res&onse o&tions! 'lease $hoose the answer that a&&ears (ost a&&ro&riate! "f you are unsure a out whi$h res&onse to gi)e to a question% the first res&onse you think of is often the est one *The nu( ers after res&onses in#i$ates the s$ores of the res&onses+! 'lease kee& in (in# your stan#ar#s% ho&es% &leasures an# $on$erns! We ask that you think a out your life in the last four weeks *The o)erall quality of life an# general health fa$et+! ,! How woul# you rate your quality of life.ery &oor/ , 'oor/ 0 1either &oor nor goo#/ 2 3oo#/ 4 .ery goo#/ 5 0! How satisfie# are you with your health.ery #issatisfie#/ , 6issatisfie#/ 0 1either satisfie# nor #issatisfie#/ 2 7atisfie#/ 4 .ery satisfie#/ 5 The following questions ask a out how (u$h you ha)e e8&erien$e# $ertain things in the last four weeks! 2! To what e8tent #o you feel that &hysi$al &ain &re)ents you fro( #oing what you nee# to #o1ot at all/ 5 9 little/ 4 9 (o#erate a(ount/ 2 .ery (u$h/ 0 9n e8tre(e a(ount/ , ,

4! How (u$h #o you nee# any (e#i$al treat(ent to fun$tion in your #aily life1ot at all/ 5 9 little/ 4 9 (o#erate a(ount/ 2 .ery (u$h/ 0 9n e8tre(e a(ount/ , 5! How (u$h #o you en:oy life1ot at all/ 5 9 little/ 4 9 (o#erate a(ount/ 2 .ery (u$h/ 0 9n e8tre(e a(ount/ , ;! To what e8tent #o you feel your life to e (eaningful1ot at all/ 5 9 little/ 4 9 (o#erate a(ount/ 2 .ery (u$h/ 0 9n e8tre(e a(ount/ , <! How well are you a le to $on$entrate1ot at all/ , 9 little/ 0 9 (o#erate a(ount/ 2 .ery (u$h/ 4 E8tre(ely/ 5 =! How safe #o you feel in your #aily life1ot at all/ , 9 little/ 0 9 (o#erate a(ount/ 2 .ery (u$h/ 4 E8tre(ely/ 5 >! How healthy is your &hysi$al en)iron(ent1ot at all/ , 0

9 little/ 0 9 (o#erate a(ount/ 2 .ery (u$h/ 4 E8tre(ely/ 5 The following questions ask a out how $o(&letely you e8&erien$e or were a le to #o $ertain things in the last four weeks! ,?! 6o you ha)e enough energy for e)ery#ay life1ot at all/ , 9 little/ 0 @o#erately/ 2 @ostly/ 4 Ao(&letely/ 5 ,,! 9re you a le to a$$e&t your o#ily a&&earan$e1ot at all/ , 9 little/ 0 @o#erately/ 2 @ostly/ 4 Ao(&letely/ 5 ,0! Ha)e you enough (oney to (eet your nee#s1ot at all/ , 9 little/ 0 @o#erately/ 2 @ostly/ 4 Ao(&letely/ 5 ,2! How a)aila le to you is the infor(ation that you nee# in your #ay-to-#ay life1ot at all/ , 9 little/ 0 @o#erately/ 2 @ostly/ 4 Ao(&letely/ 5 ,4! To what e8tent #o you ha)e the o&&ortunity for leisure a$ti)ities1ot at all/ , 2

9 little/ 0 @o#erately/ 2 @ostly/ 4 Ao(&letely/ 5 ,5! How well are you a le to get aroun#.ery &oor/ , 'oor/ 0 1either &oor nor goo#/ 2 3oo#/ 4 .ery goo#/ 5 ,;! How satisfie# are you with your slee&.ery #issatisfie#/ , 6issatisfie#/ 0 1either satisfie# nor #issatisfie#/ 2 7atisfie#/ 4 .ery satisfie#/ 5 ,<! How satisfie# are you with your a ility to &erfor( your #aily li)ing a$ti)ities.ery #issatisfie#/ , 6issatisfie#/ 0 1either satisfie# nor #issatisfie#/ 2 7atisfie#/ 4 .ery satisfie#/ 5 ,=! How satisfie# are you with your $a&a$ity for work.ery #issatisfie#/ , 6issatisfie#/ 0 1either satisfie# nor #issatisfie#/ 2 7atisfie#/ 4 .ery satisfie#/ 5 ,>! How satisfie# are you with yourself.ery #issatisfie#/ , 6issatisfie#/ 0 1either satisfie# nor #issatisfie#/ 2 7atisfie#/ 4 4

.ery satisfie#/ 5 0?! How satisfie# are you with your &ersonal relationshi&s.ery #issatisfie#/ , 6issatisfie#/ 0 1either satisfie# nor #issatisfie#/ 2 7atisfie#/ 4 .ery satisfie#/ 5 0,! How satisfie# are you with the su&&ort you get fro( your frien#s.ery #issatisfie#/ , 6issatisfie#/ 0 1either satisfie# nor #issatisfie#/ 2 7atisfie#/ 4 .ery satisfie#/ 5 00! How satisfie# are you with the $on#itions of your li)ing &la$e.ery #issatisfie#/ , 6issatisfie#/ 0 1either satisfie# nor #issatisfie#/ 2 7atisfie#/ 4 .ery satisfie#/ 5 02! How satisfie# are you with your a$$ess to health ser)i$es.ery #issatisfie#/ , 6issatisfie#/ 0 1either satisfie# nor #issatisfie#/ 2 7atisfie#/ 4 .ery satisfie#/ 5 04! How satisfie# are you with your trans&ort.ery #issatisfie#/ , 6issatisfie#/ 0 1either satisfie# nor #issatisfie#/ 2 7atisfie#/ 4 .ery satisfie#/ 5 The following question refers to how often you ha)e felt or e8&erien$e# $ertain things 5

in the last four weeks! 05! How often #o you ha)e negati)e feelings su$h as lue (oo#% #es&air% an8iety% #e&ression1e)er/ 5 7el#o(/ 4 Quite often/ 2 .ery often/ 0 9lways/ , [7$oring (etho#] Equations for $o(&uting #o(ain raw s$ores/ 6o(ain , *&hysi$al+ s$ore B Q2 C Q4 C Q,? C Q,5 C Q,; C Q,< C Q,= 6o(ain 0 *&sy$hologi$al+ s$ore B Q5 C Q; C Q< C Q,, C Q,> C Q05 6o(ain 2 *so$ial+ s$ore BQ0? C Q0, 6o(ain 4 *en)iron(ental+ s$ore B Q= C Q> C Q,0 C Q,2 C Q,4 C Q00 C Q02 C Q04 Transfor(e# s$ores were esti(ate# using the following ta les for stan#ar#iDing s$ores fro( ?-,?? with the lowest s$ore of Dero an# the highest s$ore of ,??! *7ee Referen$e 0? for a##itional infor(ation+

Ta les for $on)erting raw s$ores to transfor(e# s$ores Raw < = > ,? ,, ,0 ,2 ,4 ,5 ,; ,< ,= ,> 0? 0, 00 02 04 05 0; 0< 0= 0> 2? 2, 20 22 24 25 Transfor(e# ? ; ; ,2 ,2 ,> ,> 05 2, 2, 2= 2= 44 44 5? 5; 5; ;2 ;2 ;> ;> <5 =, =, == == >4 >4 ,?? Raw ; < = > ,? ,, ,0 ,2 ,4 ,5 ,; ,< ,= ,> 0? 0, 00 02 04 05 0; 0< 0= 0> 2? Transfor(e# ? ; ; ,2 ,> ,> 05 2, 2, 2= 44 44 5? 5; 5; ;2 ;> ;> <5 =, =, == >4 >4 ,?? Raw 0 2 2 4 5 5 ; < < = > > ,? Transfor(e# ? ; ,> 05 2, 44 5? 5; ;> <5 =, >4 ,?? Raw = > ,? ,, ,0 ,2 ,4 ,5 ,; ,< ,= ,> 0? 0, 00 02 04 05 0; 0< 0= 0> 2? 2, 20 22 24 25 2; 2< 2= 2> 4? Transfor(e# ? ; ; ,2 ,2 ,> ,> 05 05 2, 2, 2= 2= 44 44 5? 5? 5; 5; ;2 ;2 ;> ;> <5 <5 =, =, == == >4 >4 ,?? ,??

<

Vous aimerez peut-être aussi