|
|
| Very poor | Poor | Neither poor nor good | Good | Very good |
| 15. | How well are you able to get around? | 1 | 2 | 3 | 4 | 5 |
|
|
| Very dissatisfied | Dissatisfied | Neither satisfied nor dissatisfied | Satisfied | Very satisfied |
| 16. | How satisfied are you with your sleep? | 1 | 2 | 3 | 4 | 5 |
| 17. | How satisfied are you with your ability to perform your daily living activities? |
1 |
2 |
3 |
4 |
5 |
| 18. | How satisfied are you with your capacity for work? | 1 | 2 | 3 | 4 | 5 |
| 19. | How satisfied are you with yourself? | 1 | 2 | 3 | 4 | 5 |
| 20. | How satisfied are you with your personal relationships? | 1 | 2 | 3 | 4 | 5 |
| 21. | How satisfied are you with your sex life? | 1 | 2 | 3 | 4 | 5 |
| 22. | How satisfied are you with the support you get from your friends? |
1 |
2 |
3 |
4 |
5 |
| 23. | How satisfied are you with the conditions of your living place? | 1 | 2 | 3 | 4 | 5 |
| 24. | How satisfied are you with your access to health services? | 1 | 2 | 3 | 4 | 5 |
| 25. | How satisfied are you with your transport? | 1 | 2 | 3 | 4 | 5 |