Table 4.
The Modifications to the NIH-HEALS Following Feedback for the Cognitive Interviews.
| Strongly Disagree | Disagree | Neither Agree or Disagree | Agree | Strongly Agree | ||
|---|---|---|---|---|---|---|
| 1. I am content with my life. [similar terms include satisfied and happy] | 1 | 2 | 3 | 4 | 5 | |
| 2. I have a sense of purpose in my life | 1 | 2 | 3 | 4 | 5 | |
| 3. The connection with a higher power is important to me. [A higher power could be God or gods or the larger than the self that you believe in] | 1 | 2 | 3 | 4 | 5 | |
| 4. I gain awareness from self-reflection | 1 | 2 | 3 | 4 | 5 | |
| 5. I enjoy activities that involve both mind/body such as meditation, [praise and worship], prayer, yoga, tai chi, chanting | 1 | 2 | 3 | 4 | 5 | |
| 6. I feel isolated | 1 | 2 | 3 | 4 | 5 | |
| 7. I feel calm even though I am not in control of my situation | 1 | 2 | 3 | 4 | 5 | |
| 8. I accept things that I cannot change | 1 | 2 | 3 | 4 | 5 | |
| 9. Working through thoughts about the possibility of dying brought meaning to my life | 1 | 2 | 3 | 4 | 5 | |
| 10. Difficult circumstances in my life have increased my compassion towards others | 1 | 2 | 3 | 4 | 5 | |
| 11. I want to make the most of my life | 1 | 2 | 3 | 4 | 5 | |
| 12. I survive difficult circumstances because of a higher power. [A higher power could be God or gods or the larger than the self that you believe in] | 1 | 2 | 3 | 4 | 5 | |
| 13. My situation strengthened my connection to a higher power. [A higher power could be God or gods or the larger than the self that you believe in] | 1 | 2 | 3 | 4 | 5 | |
| Strongly Disagree | Disagree | Neither Agree or Disagree | Agree | Strongly Agree | ||
| 14. My religious/[spiritual] beliefs help me feel calm when faced with difficult circumstances in life | 1 | 2 | 3 | 4 | 5 | |
| 15. My personal religious/[spiritual] practice is important to me | 1 | 2 | 3 | 4 | 5 | |
| 16. My participation in a religious/[spiritual]community is an important aspect of my life | 1 | 2 | 3 | 4 | 5 | |
| 17. I get support from my religious/[spiritual]community | 1 | 2 | 3 | 4 | 5 | |
| 18. My religious/[spiritual] beliefs [and practices] give me hope | 1 | 2 | 3 | 4 | 5 | |
| 19. Doing something I am passionate about gives me purpose during difficult times (e.g., work, hobbies, volunteering, my religious institution, reading groups) | 1 | 2 | 3 | 4 | 5 | |
| 20. I find meaning in helping others | 1 | 2 | 3 | 4 | 5 | |
| 21. Connection with my family has become my highest priority | 1 | 2 | 3 | 4 | 5 | |
| 22. Support from my family lifts my spirits, which gives me hope during difficult times in life | 1 | 2 | 3 | 4 | 5 | |
| 23. I am not getting the support I need [from my community/family/friends] | 1 | 2 | 3 | 4 | 5 | |
| 24. I am confident that my medical caregivers will respond to my needs | 1 | 2 | 3 | 4 | 5 | |
| Strongly Disagree | Disagree | Neither Agree or Disagree | Agree | Strongly Agree | ||
| 25. My friends provide the support I need during difficult times | 1 | 2 | 3 | 4 | 5 | |
| 26. I seek more of a connection in my relationships | 1 | 2 | 3 | 4 | 5 | |
| 27. I take more time to be in the [present] moment | 1 | 2 | 3 | 4 | 5 | |
| 28. My experience with multiple losses has made it hard to be hopeful during difficult times (such as death, divorce, competency, and physical disability) | 1 | 2 | 3 | 4 | 5 | |
| 29. Working through my own grief has brought meaning to my life | 1 | 2 | 3 | 4 | 5 | |
| 30. I have a sense of peace in my life | 1 | 2 | 3 | 4 | 5 | |
| 31. I have an increased sense of gratitude | 1 | 2 | 3 | 4 | 5 | |
| 32. Being surrounded by nature is meaningful | 1 | 2 | 3 | 4 | 5 | |
| 33. Creative arts bring peace to my life. [such as music, drama, art, or theatre] | 1 | 2 | 3 | 4 | 5 | |
| 34. Life challenges interfere with activities that are important to me | 1 | 2 | 3 | 4 | 5 | |
| 35. Life challenges raised my desire to be more positive | 1 | 2 | 3 | 4 | 5 |
The modifications/adaptations are in square brackets.