| Physical Well-being |
GP1 |
I have a lack of energy |
|
GP2 |
I have nausea |
|
GP3 |
Because of my physical condition, I have trouble meeting the needs of my family |
|
GP4 |
I have pain |
|
GP5 |
I am bothered by side effects of treatment |
|
GP6 |
I feel ill |
|
GP7 |
I am forced to spend time in bed |
| Social/Family Well-being |
GS1 |
I feel close to my friends |
|
GS2 |
I get emotional support from my family |
|
GS3 |
I get support from my friends |
|
GS4 |
My family has accepted my illness |
|
GS5 |
I am satisfied with family communication about my illness |
|
GS6 |
I feel close to my partner (or the person who is my main support) |
|
GS7 |
I am satisfied with my sex life |
| Emotional Well-being |
GE1 |
I feel sad |
|
GE2 |
I am satisfied with how I am coping with my illness |
|
GE3 |
I am losing hope in the fight against my illness |
|
GE4 |
I feel nervous |
|
GE5 |
I worry about dying |
|
GE6 |
I worry that my condition will get worse |
| Functional Well-being |
GF1 |
I am able to work (include work at home) |
|
GF2 |
My work (include work at home) is fulfilling |
|
GF3 |
I am able to enjoy life |
|
GF4 |
I have accepted my illness |
|
GF5 |
I am sleeping well |
|
GF6 |
I am enjoying the things I usually do for fun |
|
GF7 |
I am content with the quality of my life right now |
| Additional Concerns (19-item palliative subscale) |
PAL1 |
I maintain contact with my friends |
|
PAL2 |
I have family members who will take on my responsibilities |
|
PAL3 |
I feel that my family appreciates me |
|
PAL4 |
I feel like a burden to my family |
|
B1 |
I have been short of breath |
|
PAL5 |
I am constipated |
|
C2 |
I am losing weight |
|
O2 |
I have been vomiting |
|
PAL6 |
I have swelling in parts of my body |
|
PAL7 |
My mouth and throat are dry |
|
Br7 |
I feel independent |
|
PAL8 |
I feel useful |
|
PAL9 |
I make each day count |
|
PAL10 |
I have peace of mind |
|
Sp21 |
I feel hopeful |
|
PAL12 |
I am able to make decisions |
|
L1 |
My thinking is clear |
|
PAL13 |
I have been able to reconcile (make peace) with other people |
|
PAL14 |
I am able to openly discuss my concerns with the people closest to me |
