ILD CARE

WHOQOL-Bref
The WHOQOL (World Health Organisation Quality of Life) Bref is questionnaire asks how you feel about your quality of life, health and other areas of your life. Please answer all the questions. If you are unsure about which response to give to a question, please choose the best one you can. There are no right or wrong answers. Your answer will be kept strictly confidential. Please keep in mind your standards, hopes, pleasures and concerns. We ask that you think about your life in the last two weeks. For example, thinking about the last two weeks, a question might ask: How much do you worry about your health? Not at all Not much A moderate amount Very much An extreme amount You should choose the number that best fits how much you have worries about your health over the last two weeks. So you would choose the number 4 if you worried about your health “very much”, or circle number 1 if you have worried “not at all” about your health. Please read each question, assess your feelings, and choose the number on the scale for each question that gives the best answer for you.
The following questions ask about how much you have experienced certain things in the last two weeks, for example, positive feelings such as happiness or contentment. If you have experienced these things an extreme amount, choose the number next to "An extreme amount". If you have not experienced these things at all, choose the number next to "Not at all". You should choose one of the numbers in between if you wish to show that your answer lies somewhere between "Not at all" and "Extremely". Questions refer to the last two weeks.
1.	How much do you feel that pain prevents you from doing what you need to do?
	Not at all Not much A moderate amount Very much An extreme amount
2.	How much do you enjoy life?
	Not at all Not much A moderate amount Very much An extreme amount
3.	How well are you able to concentrate?
	Not at all Not much Moderately Very well Extremely
4.	How much do you need medical treatment to function in your daily life?
	Not at all Not much A moderate amount Very much An extreme amount
5.	How safe do you feel in your daily life?
	Not at all Not much Moderately Very much Extremely
6.	How healthy is your physical environment?
	Not at all Not much Moderately Very much Extremely
The following questions ask about how completely you experienced, or were able to do certain things in the last two weeks, for example activities of daily living like washing, dressing or eating. If you have been able to do these things completely, circle the number next to "Completely". If you have not been able to do these things at all, circle the number next to "Not at all". You should circle one of the numbers in between if you wish to show that your answer lies somewhere between "Not at all" and "Completely". Questions refer to the last two weeks.
7.	Do you have enough energy for everyday life?
	Not at all Not much Moderately A great deal Completely
8.	How much are you able to accept your bodily appearance?
	Not at all Not much Moderately A great deal Completely
9.	To what extent do you have enough money to meet your needs?
	Not at all Not much Moderately A great deal Completely
10.	How available to you is the information that you need in your day-to-day life?
	Not at all Not much Moderately A great deal Completely
11.	To what extent do you have the opportunity for leisure activities?
	Not at all Not much Moderately A great deal Completely
The following questions ask you to say how satisfied, happy or good you have felt about various aspects of your life over the last two weeks, for example, about your family life or you energy level. Decide how satisfied or dissatisfied you are with each aspect of your life and then circle the number that best fits how you feel about this. Questions refer to the last two weeks.
12.	How satisfied are you with your health?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
13.	How satisfied are you with your sleep?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
14.	How satisfied are you with yourself?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
15.	How satisfied are you with your ability to perform daily living activities?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
16.	How satisfied are you with your personal relationships?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
17.	How satisfied are you with your sex life?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
18.	How satisfied are you with the support you get from your friends?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
19.	How satisfied are you with the conditions of your living place?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
20.	How satisfied are you with your access to health services?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
21.	How satisfied are you with your transport?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
22.	How would you rate your quality of life?
	Very poor Poor Neither poor nor good Good Very good
The following questions refer to how often you have felt or experienced certain things, for example the support of your family or friends, or negative experiences such as feeling unsafe. If you have not experienced these things at all in the last two weeks, circle the response "never". If you have experienced these things, decide how often and circle the appropriate number. So for example if you have experienced pain all the time in the last two weeks, circle the number next to "Always". Questions refer to the last two weeks.
23.	How often do you have negative feelings, such as blue mood, despair, anxiety, depression?
	Never Seldom Quite often Very often Always
24.	How satisfied are you with your capacity for work?
	Very dissatisfied Dissatisfied Neither satisfied nor dissatisfied Satisfied Very satisfied
25.	How well are you able to get around?
	Very poor Poor Neither poor nor good Good Very good
26.	To what extent do you feel life to be meaningful?
	Not at all Not much A moderate amount Very much An extreme amount

When all questions are answered, please press the button >>

WHOQOL-Bref