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. Author manuscript; available in PMC: 2014 Apr 1.
Published in final edited form as: Psychooncology. 2012 May 18;22(4):911–921. doi: 10.1002/pon.3091
A.
Did this
happen to
you?
B.
If it did happen, how upsetting was it?
No Yes Not at all
upsetting
A little
bit
upsetting
Moderately
upsetting
Very
upsetting
Extremely
upsetting
1. Fired from your job as a result of
your illness/transplant
0 1 2 3 4
2. Had to take a paid leave of
absence due to your
illness/transplant
0 1 2 3 4
3. Had to take an unpaid leave of
absence due to your
illness/transplant
0 1 2 3 4
4. Had to quit your job or retire as a
result of your illness/transplant
0 1 2 3 4
5. Experienced a pay cut or loss of
income due to your
illness/transplant
0 1 2 3 4
6. You had to go on disability due to
your illness/transplant
0 1 2 3 4
7. You were threatened with losing
your job due to your
illness/transplant
0 1 2 3 4
8. Your partner's work situation was
hurt by your illness/transplant
0 1 2 3 4
9. Your employer was unsupportive 0 1 2 3 4
10. Your partner's employer was
unsupportive
0 1 2 3 4
11. You had to go back to work too
soon after your illness/transplant
0 1 2 3 4
12. You could not go back to work as
soon as you wanted after your
illness/transplant
0 1 2 3 4

Note. Responses to Part A are first coded such that “No”=0 and “Yes”=1. Next, for each item, responses to Part A and Part B are multiplied. The resulting products are then summed. Scores range from 0–48 with higher scores indicating greater perceived employment stress.