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| 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 relationship? | 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 |