Daily questionnaire | ||
---|---|---|
Concept | Item | Rating scale |
Positive affect | 1. I feel cheerful | 7-point scale (1 ‘not at all’ to 7 ‘very much’) |
2. I feel relaxed | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
3. I feel enthusiastic | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
4. I feel satisfied | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
Negative affect | 5. I feel insecure | 7-point scale (1 ‘not at all’ to 7 ‘very much’) |
6. I feel lonely | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
7. I feel anxious | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
8. I feel irritated | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
9. I feel down | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
10. I feel desperate | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
11. I feel confident | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
12. I feel tensed | -point scale (1 ‘not at all’ to 7 ‘very much’) | |
Self-esteem | 13. I like myself | 7-point scale (1 ‘not at all’ to 7 ‘very much’) |
14. I am ashamed of myself | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
15. I doubt myself | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
16. I am satisfied with myself | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
Physical well-being | 17. I am tired | 7-point scale (1 ‘not at all’ to 7 ‘very much’) |
18. I feel well | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
19. I am in pain | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
20. I have problems in walking | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
Activity | 21. What am I doing? (just before the alert) | Doing nothing; resting; work; household; self care; caring for partner; active relaxation; passive relaxation; something else |
22. And also? | Doing nothing; resting; work; household; self care; caring for partner; active relaxation; passive relaxation; something else | |
23. And…? | Doing nothing; resting; work; household; self care; caring for partner; active relaxation; passive relaxation; something else | |
24. I like doing this | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
25. I would rather be doing something else | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
26. This is difficult for me | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
27. I feel I am being active | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
28. I can do this well | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
29. I am doing this activity together with my partner | Yes; no | |
Location | 30. Where am I? | At home; at family’s/friend’s place; at work; health care setting; public place; transport; somewhere else |
Social company | 31. Who am I with? | Partner; family; friends; colleagues; health care professional; acquaintances; strangers/others; nobody |
32. With whom else? | Partner; family; friends; colleagues; health care professional; acquaintances; strangers/others; nobody | |
33. And…? | Partner; family; friends; colleagues; health care professional; acquaintances; strangers/others; nobody | |
Branching questions in case of being in company: | ||
34. I would prefer to be alone | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
35. I think my company is pleasant | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
36. I feel at ease in this company | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
Branching questions in case of being alone: | ||
34. I would prefer to be in company of others | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
35. I enjoy being alone | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
36. I feel at ease being alone | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
Events | 37. Since the last alert the most important thing that happened is… | (take an event in mind before you continue) |
38. How pleasant was this event? | bipolar scale (−3 ‘very unpleasant’ to +3 ‘very pleasant’) | |
39. I had this situation under control | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
40. Was this situation unexpected? | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
41. The event was important to me | bipolar scale (−3 ‘very unimportant’ to +3 ‘very important’) | |
42. With whom was I? | Partner; nobody; someone else | |
General | 43. This alert disturbed me | 7-point scale (1 ‘not at all’ to 7 ‘very much’) |
Morning questionnaire | ||
1. I slept well | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
2. How long did it take before I fell asleep | 0–5 min; 5–15 min; 30–45 min; 45–60 min; 1-2 h; 2 4 h; >4 h | |
3. How often did I wake up last night | 1 time; 2 times; 3 times; 4 times; 5 times; more than 5 times | |
4. My partner disturbed my sleep | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
5. I feel rested | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
6. I feel apprehensive about today | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
Evening questionnaire | ||
1. This was an ordinary day | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
2. If I had not had the device, I would have done different things today | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
3. I generally felt well today | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
4. I generally felt tired today | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
5. I generally felt tensed today | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
6. I generally worried a lot today | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
7. I generally felt able to manage today | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
8. My health state was good today | Visual Analogue Scale (0 ‘worst imaginable health’ to 100 ‘best imaginable health’) | |
9. How many hours did you spend on caring for your partner today (incl. supervision) | 0 h; 1 h; 2 h; 3 h; 4 h; 5 h; >5 h | |
10. Today I felt strained in the interactions with my partner | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
11. Today I felt stressed due to my care responsibilities | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
12. Today I felt that the situation with my partner did not allow me as much privacy as I would have liked | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
13. Today I had enough time for myself | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
14. Today I was in need of support | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
15. Today I received enough support | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
Today, to what extent did your partner suffer from: | ||
16. Being sad or depressed | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
17. Being anxious our nervous | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
18. Acting impulsively or embarrassing | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
19. A loss of interest in activities/other people | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
20. Being irritated or impatient | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
21. Being too cheerful for no reason | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
22. Being restless | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
23. Agitation/aggression | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
24. Beliefs that you know are not true | 7-point scale (1 ‘not at all’ to 7 ‘very much’) | |
25. Seeing false visions or hearing false voices | 7-point scale (1 ‘not at all’ to 7 ‘very much’) |