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Adult Sickle Cell Quality of Life Measurement System – Emotional Impact Short Form (ASCQ-Me Emotional Impact)
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Please respond to each question or statement by marking one box per row.
| Never | Rarely | Sometimes | Often | Always | ||
| EmotionalImpactQ11 | In the past 7 days, how often did you feel completely hopeless because of your health? ………………………………….. | 
5 |

4 |

3 |

2 |

1 |
| Not at all | A little | Somewhat | Quite | Very | ||
| EmotionalImpactQ12 | In the past 7 days, how lonely did you feel because of your health problems? .. | 
5 |

4 |

3 |

2 |

1 |
| EmotionalImpactQ16 | In the past 7 days, how depressed were you about your health problems? ……………………………………. | 
5 |

4 |

3 |

2 |

1 |
| Not at all | A little bit | Somewhat | Quite a bit | Very much | ||
| EmotionalImpactQ9 | In the past 7 days, how much did you worry about getting sick? …………………. | 
5 |

4 |

3 |

2 |

1 |
| Never | Rarely | Sometimes | Often | Always | ||
| EmotionalImpactQ17 | In the past 7 days, how often were you very worried about needing to go
to the hospital?………………………………… |

5 |

4 |

3 |

2 |

1 |
Cite this article
Mohammed looti (2026). Emotional Impact – Short Form (ASCQ-Me). PSYCHOLOGICAL SCALES. Retrieved from https://scales.arabpsychology.com/s/emotional-impact-short-form-ascq-me/
Mohammed looti. "Emotional Impact – Short Form (ASCQ-Me)." PSYCHOLOGICAL SCALES, 2 Apr. 2026, https://scales.arabpsychology.com/s/emotional-impact-short-form-ascq-me/.
Mohammed looti. "Emotional Impact – Short Form (ASCQ-Me)." PSYCHOLOGICAL SCALES, 2026. https://scales.arabpsychology.com/s/emotional-impact-short-form-ascq-me/.
Mohammed looti (2026) 'Emotional Impact – Short Form (ASCQ-Me)', PSYCHOLOGICAL SCALES. Available at: https://scales.arabpsychology.com/s/emotional-impact-short-form-ascq-me/.
[1] Mohammed looti, "Emotional Impact – Short Form (ASCQ-Me)," PSYCHOLOGICAL SCALES, vol. X, no. Y, ص Z-Z, April, 2026.
Mohammed looti. Emotional Impact – Short Form (ASCQ-Me). PSYCHOLOGICAL SCALES. 2026;vol(issue):pages.