Table 1.
Infants and Toddlers Dermatology Quality of Life (InToDermQoL) | |||
---|---|---|---|
The aim of this questionnaire is to measure how much your child’s skin problem has affected them over the last week | |||
Child’s name: | Child’s age: | Child’s gender: | Date: |
Diagnosis: | Disease severity: | Filled in by: mother/father/another person | |
1. Your child’s itching or scratching because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
2. Your child’s bleeding (from injured skin and/or mucosa) because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
3. Your child’s pain because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
4. Your child’s sleep problems because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
5. Your child’s mood changes because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
6. Your child’s bathing problems because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
7. Your child’s problems with dressing/undressing (irritation of lesions, pain) because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
8. Your child’s feeding problems because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
9. Your child’s problems during physical activity (infant’s movements or walking, running, crawling, etc.) | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
10. Your child’s problems with treatment (e.g., home treatment, bandaging, skin care, etc.) | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
If your child is over 1 year of age | |||
11. Your child’s tiredness because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
12. Restrictions and limitations (social, nutritional, physical activity, and sports, pets, etc.) your child had because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
If your child is over 3 years of age | |||
13. Do other peoples’ questions about your child’s skin disease affect your child? | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
14. Your child’s feeling of being different from peers because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ | ||
15. Rejection by other children because of their skin disease | Very much | □ | |
Quite a lot | □ | ||
Only a little | □ | ||
Not at all | □ |
Supported by the EADV grant no. 2015–11