Table 2.

Final HRQoL Survey for Patients with Bloodstream Infection and Link to PROMIS

Please respond to each item by marking one box per row.
Global (PROMIS Scale v1.2 – Global Health)			Excellent	Very Good	Good	Fair	Poor
Global01	1	In general, would you say your health is:	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
Global02	2	In general, would you say your quality of life is:	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
Thinking of your bloodstream infection, please answer the following questions to best capture your experiences.
Fatigue (PROMIS Item Bank v1.0 –Fatigue – Short Form 4a)			Not at all	A little bit	Somewhat	Quite a bit	Very much
HI7	3	During the past 7 days, I feel fatigued	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
AN3	4	During the past 7 days, I have trouble starting things because I am tired	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
FATEXP41	5	In the past 7 days, how run-down did you feel on average?	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
FATEXP40	6	In the past 7 days, how fatigued were you on average?	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
Gastrointestinal Nausea and Vomiting (PROMIS Scale v1.0 – Gastrointestinal Nausea and Vomiting 4a)			Never	Rarely	Sometimes	Often	Always
GISX49	7	In the past 7 days, how often did you have nausea—that is, a feeling like you could vomit? (If never, skip to 9)	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
GISX52	8	In the past 7 days, how often did you know that you would have nausea before it happened?	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
GISX55	9	In the past 7 days, how often did you have a poor appetite?	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
			Never	One day	2-6 days	Once a day	More than once a day
GISX59	10	In the past 7 days, how often did you throw up or vomit?	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
Pain Intensity (PROMIS Item Bank v.1.0 – Pain Intensity – Scale)			Had no pain	Mild	Moderate	Severe	Very severe
PAINQU6	11	In the past 7 days, how intense was your pain at its worst?	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
PAINQU8	12	In the past 7 days, how intense was your average pain?	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
			No pain	Mild	Moderate	Severe	Very severe
PAINQU21	13	What is your level of pain right now?	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
Sleep Disturbance (PROMIS Item Bank v1.0 –Sleep Disturbance – Short Form 4a)			Very poor	Poor	Fair	Good	Very Good
Sleep109	14	In the past 7 days, my sleep quality was	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
			Not at all	A little bit	Somewhat	Quite a bit	Very much
Sleep116	15	In the past 7 days, my sleep was refreshing	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
Sleep20	16	In the past 7 days, I had a problem with my sleep	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
Sleep44	17	In the past 7 days, I had difficulty falling asleep	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
Emotional Distress – Depression (PROMIS Item Bank v1.0 – Emotional Distress-Depression – Short Form 4a)			Never	Rarely	Sometimes	Often	Always
EDDEP04	18	In the past 7 days, I felt worthless	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
EDDEP06	19	In the past 7 days, I felt helpless	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
EDDEP29	20	In the past 7 days, I felt depressed	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
EDDEP41	21	In the past 7 days, I felt hopeless	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
Emotional Distress – Anxiety (PROMIS Item Bank v1.0-Emotional Distress-Anxiety – Short Form 4a)			Never	Rarely	Sometimes	Often	Always
EDANX01	22	In the past 7 days, I felt fearful	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
EDANX40	23	In the past 7 days, I found it hard to focus on anything other than my anxiety	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
EDANX41	24	In the past 7 days, my worries overwhelmed me	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
EDANX53	25	In the past 7 days, I felt uneasy	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
Cognitive Function – Abilities (PROMIS Item Bank v2.0 – Cognitive Function - Abilities Subset—Short Form 4a)			Not at all	A little bit	Somewhat	Quite a bit	Very much
PC43_2r	26	In the past 7 days, my mind has been as sharp as usual	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
PC44_2r	27	In the past 7 days, my memory has been as good as usual	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
PC45_2r	28	In the past 7 days, my thinking has been as fast as usual	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
PC47_2r	29	In the past 7 days, I have been able to keep track of what I am doing, even if I am interrupted	☐ 1	☐ 2	☐ 3	☐ 4	☐ 5
Physical Function (PROMIS Item Bank v2.0 – Physical Function – Short Form 6b)			Without any difficulty	With a little difficulty	With some difficulty	With much ­difficulty	Unable to do
PFA11	30	Are you able to do chores such as vacuuming or yard work?	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
PFA21	31	Are you able to go up and down stairs at a normal pace?	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
PFA23	32	Are you able to go for a walk of at least 15 minutes?	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
PFA53	33	Are you able to run errands and shop?	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
			Not at all	Very little	Somewhat	Quite a lot	Cannot do
PFC12	34	Does your health now limit you in doing two hours of physical labor?	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
PFB1	35	Does your health now limit you in doing moderate work around the house like vacuuming, sweeping floors or carrying in groceries?	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
Ability to Participate in Social Roles and Activities (PROMIS Item Bank v2.0 - Ability to Participate in Social Roles and Activities- Short Form 4a)			Never	Rarely	Sometimes	Often	Always
SRPPER11_CaPS	36	I have trouble doing all of my regular leisure activities with others	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
SRPPER18_CaPS	37	I have trouble doing all of the family activities that I want to do	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
SRPPER23_CaPS	38	I have trouble doing all of my usual work (include work at home)	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
SRPPER46_CaPS	39	I have trouble doing all of the activities with friends that I want to do	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
Adapted from Global Health			Excellent	Very Good	Good	Fair	Poor
	40	Because of your bloodstream infection, would you say your health is...	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1
	41	Because of your bloodstream infection, would you say your quality of life is...	☐ 5	☐ 4	☐ 3	☐ 2	☐ 1

Abbreviations: HRQoL, health-related quality of life; PROMIS, Patient-Reported Outcomes Measurement Information System.