Scale | Questions | |
---|---|---|
Physical functioning | 1 | Do you have any trouble doing strenuous activities, like carrying a heavy shopping bag or a suitcase? |
2 | Do you have any trouble taking a long walk? | |
3 | Do you have any trouble taking a short walk outside of the house? | |
4 | Do you need to stay in bed or a chair during the day? | |
5 | Do you need help with eating, dressing, washing yourself or using the toilet? | |
6 | Do you have any trouble doing light household work, like cooking, washing dishes, and ironing? | |
7 | Do you have any trouble doing light activities, like carrying light objects, sitting/standing with some walking, e.g. a desk job? | |
8 | Do you have any mobility troubles? | |
Role functioning | 9 | Were you limited in doing either your work or other daily activities? |
10 | Were you limited in pursuing your hobbies or other leisure time activities? | |
Emotional functioning | 11 | Did you feel tense? |
12 | Did you worry? | |
13 | Did you feel irritable? | |
14 | Did you feel depressed? | |
Cognitive functioning | 15 | Have you had difficulty in concentrating on things, like reading a newspaper or watching television? |
16 | Have you had difficulty remembering things? | |
Unspecified psychological functioning | 17 | Have you had trouble sleeping? |
18 | Were you worried about your health in the future? | |
19 | Have you worried about your weight? | |
20 | Did you feel guilty? | |
21 | Did you feel sad about being ill? | |
22 | Did you feel insecure? | |
23 | Did you worry about your future health? | |
24 | Did you worry about people's concern? | |
Social functioning | 25 | Has your physical condition or medical treatment interfered with your family life? |
26 | Has your physical condition or medical treatment interfered with your social activities? | |
27 | Has your physical condition or medical treatment caused you financial difficulties? | |
Body image | 28 | Have you felt physically less attractive as a result of your disease or treatment? |
29 | Have you been feeling less feminine/masculine as a result of your disease or treatment? | |
30 | Have you been dissatisfied with your body? | |
Pain | 31 | Have you had pain? |
32 | Did pain interfere with your daily activities? | |
Fatigue | 33 | Did you need to rest? |
34 | Have you felt weak? | |
35 | Were you tired? | |
Upper gastrointestinal tract | 36 | Have you felt nauseated? |
37 | Have you vomited? | |
Lower gastrointestinal tract | 38 | Have you been constipated? |
39 | Have you had diarrhoea? | |
40 | Have you had blood in your stools? | |
41 | Have you had mucus in your stools? | |
Unspecified gastrointestinal tract | 42 | Did you have abdominal pain? |
43 | Did you have pain in your buttocks/anal area/rectum? | |
44 | Did you have a bloated feeling in your abdomen? | |
45 | Did you have a dry mouth? | |
Stoma‐related | 46 | Have you had unintentional release of gas/flatulence from your stoma bag? |
47 | Have you had leakage of stools from your stoma bag? | |
48 | Have you had sore skin around your stoma? | |
49 | Did frequent bag changes occur during the day? | |
50 | Did frequent bag changes occur during the night? | |
51 | Did you feel embarrassed because of your stoma? | |
52 | Did you have problems caring for your stoma? | |
Bowel‐related (no stoma) | 46 | Have you had unintentional release of gas/flatulence from your back passage? |
47 | Have you had leakage of stools from your back passage? | |
48 | Have you had sore skin around your anal area? | |
49 | Did frequent bowel movements occur during the day? | |
50 | Did frequent bowel movements occur during the night? | |
51 | Did you feel embarrassed because of your bowel movement? | |
Urinary tract | 53 | Did you urinate frequently during the day? |
54 | Did you urinate frequently during the night? | |
55 | Have you had any unintentional release (leakage) of urine? | |
56 | Did you have pain when you urinated? | |
Chemotherapy‐related | 57 | Have you lost hair as a result of your treatment? |
58 | Have you had problems with your sense of taste? | |
59 | Have you had tingling in hand/feet? | |
Sexual‐related (men) | 60 | To what extent were you interested in sex? |
61 | Did you have difficulty getting or maintaining an erection? | |
Sexual‐related (women) | 62 | To what extent were you interested in sex? |
63 | Did you have pain or discomfort during intercourse? | |
Single item | 64 | Have you lacked appetite? |
Single item | 65 | Were you short of breath? |
Single item | 66 | Have you had fevers? |
Single item | 67 | Have you felt unwell? |
Note: Symptom, functioning scales and single items according to the EORTC QLQ‐C30 and QLQ‐CR29 scoring manuals (Aaronson et al., 1993; Whistance et al., 2009), which has been complemented with items of other validated questionnaires (Eypasch et al., 1995; Tuinman et al., 2008; Ward et al., 1999; Wendel‐Vos et al., 2003).