Assessment of Quality of Life (AQoL)

AQoL-8D
INDEPENDENT LIVING
Q1 How much help do you need with jobs around the house [your place of residence] (e.g.‚ preparing food‚ cleaning the house‚ or gardening)?
·         I can do all these tasks very quickly and efficiently without any help
·         I can do these tasks relatively easily without help
·         I can do these tasks only very slowly without help
·         I cannot do most of these tasks unless I have help
·         I can do none of these tasks by myself
Q2 Thinking about how easy or difficult it is for you to get around by yourself outside your house (e.g.‚ shopping‚ visiting):
·         getting around is enjoyable and easy
·         I have no difficulty getting around outside my house
·         a little difficulty
·         moderate difficulty
·         a lot of difficulty
·         I cannot get around unless somebody is there to help me
Q3 Thinking about your mobility‚ including using any aids or equipment such as wheelchairs‚ frames‚ and sticks: [How easy or difficult is it for you to move around (using any aids or equipment you need eg a wheelchair‚ frame or stick)?]
·         I am very mobile
·         I have no difficulty with mobility
·         I have some difficulty with mobility (for example‚ going uphill)
·         I have difficulty with mobility. I can go short distances only
·         I have a lot of difficulty with mobility. I need someone to help me
·         I am bedridden.
Q4 Thinking about washing yourself‚ toileting‚ dressing‚ eating‚ or looking after your appearance: [How difficult is it for you to wash‚ toilet‚ dress yourself‚ eat or care for your appearance?]
·         these tasks are very easy for me
·         I have no real difficulty in carrying out these tasks
·         I find some of these tasks difficult‚ but I manage to do them on my own
·         many of these tasks are difficult‚ and I need help to do them
·         I cannot do these tasks by myself at all.
LIFE SATISFACTION
Q5 How content are you with your life?
·         extremely
·         mainly
·         moderately
·         slightly
·         not at all
Q6 How enthusiastic do you feel?
·         extremely
·         very
·         somewhat
·         not much
·         not at all
Q7 How often do you feel happy?
·         all the time
·         mostly
·         sometimes
·         almost never
·         never
Q8 How often do you feel pleasure?
·         always
·         usually
·         sometimes
·         almost never
·         never
MENTAL HEALTH
Q9 How often do you feel depressed?
·         never
·         almost never
·         sometimes
·         often
·         very often
·         all the time
Q10 How often do you have trouble sleeping?
·         never
·         almost never
·         sometimes
·         often
·         all the time
Q11 How often do you feel angry?
·         never
·         almost never
·         sometimes
·         often
·         all the time
Q12 Do you ever feel like hurting yourself?
·         never
·         rarely
·         sometimes
·         often
·         all the time
Q13 How often did you feel in despair over the last seven days?
·         never
·         occasionally
·         sometimes
·         often
·         all the time
Q14 And still thinking about the last seven days‚ how often did you feel worried? [How often did you feel worried in the last seven days?]
·         never
·         occasionally
·         sometimes
·         often
·         all the time
Q15 How often do you feel sad?
·         never
·         rarely
·         some of the time
·         usually
·         nearly all the time
Q16 When you think about whether you are calm and tranquil or agitated [Do you normally feel calm and tranquil or agitated?]: I am:
·         always calm and tranquil
·         usually calm and tranquil
·         sometimes calm and tranquil‚ sometimes agitated
·         usually agitated
·         always agitated.
COPING
Q17 Thinking about how much energy you have to do the things you want to do [How much energy do you have to do the things you want to do?]: I am:
·         always full of energy
·         usually full of energy
·         occasionally energetic
·         usually tired and lacking energy
·         always tired and lacking energy
Q18 How often do you feel in control of your life?
·         always
·         mostly
·         sometimes
·         only occasionally
·         never
Q19 How much do you feel you can cope with life’s problems?
·         completely
·         mostly
·         partly
·         very little
·         not at all
RELATIONSHIPS
Q20 How much do you enjoy your close relationships (family and friends)?
·         immensely
·         a lot
·         a little
·         not much
·         I hate it
Q21 Your close relationships (family and friends) are: [How satisfying are your close relationships (family and friends)?]
·         very satisfying
·         satisfying
·         neither satisfying nor dissatisfying
·         dissatisfying
·         unpleasant
·         very unpleasant
Q22 How often do you feel socially isolated?
·         never
·         rarely
·         sometimes
·         often
·         always
Q23 How often do you feel socially excluded or left out?
·         never
·         rarely
·         sometimes
·         often
·         always
Q24 Your close and intimate relationships (including any sexual relationships) make you: [How happy are you with your close and intimate relationships?]
·         very happy
·         generally happy
·         neither happy nor unhappy
·         generally unhappy
·         very unhappy
Q25 Thinking about your health and your relationship with your family: [Does your health affect your relationship with your family?]
·         my role in the family is unaffected by my health
·         there are some parts of my family role I cannot carry out
·         there are many parts of my family role I cannot carry out
·         I cannot carry out any part of my family role.
Q26 Thinking about your health and your role in your community (that is to say neighborhood‚ sporting‚ work‚ church‚ or cultural groups): [Does your health affect your role in your community (eg. residential‚ sporting‚ church or cultural activities)?]
·         my role in the community is unaffected by my health
·         there are some parts of my community role I cannot carry out
·         there are many parts of my community role I cannot carry out
·         I cannot carry out any part of my community role.
SELF-WORTH
Q27 How much of a burden do you feel you are to other people?
·         not at all
·         a little
·         a moderate amount
·         a lot
·         totally
Q28 How often do you feel worthless?
·         never
·         almost never
·         sometimes
·         usually
·         always
Q29 How much confidence do you have in yourself?
·         complete confidence
·         a lot
·         a moderate amount
·         a little
·         none at all
PAIN
Q30 Thinking about how often you experience serious pain: [How often do you experience serious pain?]
I experience it:
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