Your completion of this survey or questionnaire will serve as your consent to be in this research study.

SECTION A
What percentage of patients with Sickle Cell Disease:		>5%	6-20%	21-50%	51-75%	>75%
1	Over-report (exaggerate) pain?	1	2	3	4	5
2	Fail to comply with medical advice?	1	2	3	4	5
3	Abuse drugs, including alcohol?	1	2	3	4	5
4	Manipulate you or other providers?	1	2	3	4	5
5	Are drug-seeking when they come to the hospital?	1	2	3	4	5
6	Are frustrating to take care of?	1	2	3	4	5
7	Makes me feel glad that I went into medicine?	1	2	3	4	5
8	Are the kind of person I could see myself friends with?	1	2	3	4	5
9	Are satisfying to take care of?	1	2	3	4	5
10	Are easy to empathize with?	1	2	3	4	5

SECTION B
Please indicate your opinion about the degree to which each of the following is a sign that a patient with sickle cell disease is inappropriately/unnecessarily drug-seeking:		Strongly Disagree	Disagree	Not sure but probably Disagree	Not sure but probably Agree	Agree	Strongly Agree
1	Patient requests specific narcotic drug and dose	1	2	3	4	5	6
2	Patient changes his/her behavior (e.g. appears in greater distress) when provider walks in room	1	2	3	4	5	6
3	Patient appears comfortable (e.g. talking on phone or watching TV) while complaining of severe pain	1	2	3	4	5	6
4	Patient has history of disputes with staff	1	2	3	4	5	6
5	Patient rings bell for nurse and constantly asks for more pain medication before next dose is due	1	2	3	4	5	6
6	Patient has history of signing out against medical advice	1	2	3	4	5	6
7	Patient tampers with a patient-controlled analgesia (PCA) device	1	2	3	4	5	6
8	Patient complains of severe pain but has no change in hemoglobin, a normal reticulocyte count, and a normal physical exam.	1	2	3	4	5	6

SECTION C
Please indicate your level of agreement with the following statements:		Strongly Disagree	Disagree	Not sure but probably Disagree	Not sure but Probably Agree	Agree	Strongly Agree
1	The most reliable indicator of the existence and intensity of acute pain episodes in sickle cell disease is patient self-report.	1	2	3	4	5	6
2	An important focus of the health care provider in treating acute pain episodes in sickle cell disease is adequate pain relief.	1	2	3	4	5	6
3	An important focus of the health care provider in treating acute pain episodes in sickle cell disease is prevention of drug addiction.	1	2	3	4	5	6
4	A patient with sickle cell disease can present with crisis in the absence of any objective measures (e.g baseline hemoglobin, normal reticulocyte count, normal physical exam).	1	2	3	4	5	6

SECTION D
Please state how often the following things occur:		Always	Most of the time	Some of the time	Rarely	Never
1	I am bothered by the way some doctors treat patients with sickle cell disease.	1	2	3	4	5
2	I am bothered by the way some nurses treat patients with sickle cell disease.	1	2	3	4	5
3	I am bothered by the way some of my own friends and colleagues treat patients with sickle cell disease.	1	2	3	4	5
4	I try to imagine myself in the shoes of a patient with sickle cell disease when providing care for them.	1	2	3	4	5

SECTION E
In your opinion, many patients with sickle cell disease who exaggerate pain do so as a result of:		Strongly Disagree	Disagree	Not sure but probably Disagree	Not sure but probably Agree	Agree	Strongly Agree
1	Inappropriate or unnecessary drug addiction/ drug seeking	1	2	3	4	5	6
2	Inadequate pain management by doctors and nurses	1	2	3	4	5	6
3	Personality disorders	1	2	3	4	5	6
4	Previous poor pain management in the healthcare system	1	2	3	4	5	6
5	A perception among patients of the need to ‘act out’ in order to get appropriate pain medication	1	2	3	4	5	6

Thank you for taking the time to participate.