A. Self-Consciousness
Questionnaire |
8. Do you feel rather happy or unhappy?
Why? |
1. What is your name (surname and first name)? |
9. Would you say that you are rather
fair or dark-haired? |
2. Why have you come to see me? |
10. Are you now sitting, standing or
lying down? |
3. Do you have any health problems that prevent you
from |
11. What are you planning to do shortly
or tomorrow? |
leading a normal life? |
12. If you had to live your life over
again, is there anything you |
4. Have you got any problem with your memory? |
would like to change? What? |
5. Have you had a job? What was it? |
13. Is it a good thing or a bad thing
to tell a lie? Why? |
6. What is the first name of your spouse (or
partner)? |
14. Is it a good thing or a bad thing
to give some money or |
7. What is your mother´s first name? |
some food to someone who is starving?
Why? |
|
B. Denial of Illness
Scale |
Questions |
Scoring |
|
|
1. Patient minimizes present symptoms (at
interview). |
0 (no) |
1 (once or twice) |
2 (more than twice) |
2. Patient alludes to there being nothing really
wrong with her or |
0 (no) |
1 (once or twice) |
2 (more than twice) |
him and that she or he is ready to go home. |
|
|
|
3. Patient (past or present) displaces source of
symptoms to organs |
(no) |
1 (once or twice) |
2 (more than twice) |
other than brain or complains of symptoms unrelated
to the |
|
|
|
central nervous system. |
|
|
|
4. Did the patient at any time admit to fear of
death? |
0 (yes) |
1 (no) |
|
5. Did the patient at any time admit to fear of
invalidism? |
0 (yes) |
1 (no) |
|
6. Patient verbally denies being in the
hospital. |
0 (not at all) |
1 (sometimes) |
2 (every time) |
7. Patient displays, at least on the surface, a
carefree, cheerful, |
0 (no) |
1 (once or twice) |
2 (more than twice) |
jovial approach to life. |
|
|
|
8. Patient´s behavior during interview is
characterized by |
0 (no) |
1 (once or twice) |
2 (more than twice) |
nonchalance, coolness, imperturbablity. |
|
|
|
9. Patient displaces fear for his or her own
illness to family, older |
0 (no) |
1 (at least 1 time during |
|
patients, weaker patients, and so on. |
|
the interview) |
|
10.Patient projects illness or weakness to family,
spouse, and so on |
0 (no) |
1 (at least 1 time during the interview) |
|