Rehabilitation Potential of the Individual Test - the question form
Questions: 28 · 6 minutes
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1. How often do you think about your illness?
Constantly.
Often.
Rarely.
2. Does your mood depend on your illness?
Yes.
No.
Hard to say.
3. How have you related to everyday problems lately?
Sometimes I get involved in solving them.
I try to distance myself from them.
They are still interesting to me.
4. Do you need to tell family and friends about your health problems?
Yes, they will definitely support me.
Yes, but only a few; few people will understand me.
No, no one is capable of understanding or empathizing.
5. Have your interests changed during your illness?
Yes, I am now interested in very little.
Yes, my interests have broadened.
No, my interests have stayed the same.
6. Do you think the life of a healthy person differs from the life of a person who is ill?
Yes, of course.
Not always.
Practically not at all.
7. How often do you feel joyful?
Yes, I find many reasons to feel joyful.
It is hard to make me feel joyful.
Sometimes I am in a very good mood.
8. Are you easily upset?
Yes, I often find myself getting upset.
I get upset only for serious reasons.
It is hard to upset me.
9. Does your illness interfere with living the way you would like to?
Yes, it interferes.
It causes some inconvenience.
I live without letting my illness guide my life.
10. Do you have close people with whom you have deep relationships?
Yes, I have a loved one (or a close friend).
I have acquaintances.
No one ever has stable deep relationships.
11. How would you rate your intellectual potential?
Relatively low.
Average.
Fairly high.
12. Do you enjoy your work (studies)?
Yes, I enjoy it.
I do not work (I do not study).
I work (study), but without much interest.
13. Do you currently have any hobbies or leisure interests?
Yes.
Not sure.
No.
14. Who is to blame for your illness?
No one; it just happened.
I am.
The people around me.
15. Are you able to control your emotions and behavior?
Yes, always.
Not in all situations.
Recently, control has been completely disrupted.
16. Have your family relationships changed?
No, they have not changed.
Yes, people care for me more now.
Yes, there is no longer mutual understanding.
17. How do you deal with problems when they arise?
I am not able to solve all problems.
I handle them on my own without involving anyone.
I deal with them together with family or friends.
18. Do you experience painful physical symptoms?
Yes, I do.
Sometimes, for various reasons.
I experience them all the time.
19. Have your views about yourself changed during your illness?
Yes, and I have gained more self-respect.
Yes, and I have become more self-pitying.
No, practically nothing has changed.
20. How important is it for you to maintain your health?
For me, right now, it is the only important thing in life.
It is one of my most important goals.
I have this desire from time to time.
21. Do you consider yourself a happy person?
Yes, I am a happy person despite all my problems.
Yes, although with some reservations.
No.
22. Do you believe that treatment for your illness will be effective?
Yes, of course.
No.
Modern medicine can do a lot, but not everything.
23. Has your mood changed during the course of your illness?
I have become more irritable.
I have become more even-tempered.
I don't know.
24. How do you cope with your illness?
I fight the illness and the difficulties it causes persistently.
I capitulate to it.
I try to maintain a balance of energy.
25. Can this illness cause death in the near future?
Yes, people with this illness do not live long.
The course of the illness can vary.
With the right lifestyle and treatment, it is possible to live a long time.
26. How do you feel about yourself?
As someone who is seriously ill.
As a strong person who can overcome difficulties.
As someone who lives the way they want.
27. Have your relationships with other people changed during your illness?
They have changed for the better.
They have remained the same as before.
They have changed for the worse.
28. Is your life different from the lives of your peers?
No, my life is as full and satisfying as other people's.
Yes, my illness reduces my quality of life.
Each of us has our own problems.
1. How often do you think about your illness?
Constantly.
Often.
Rarely.
2. Does your mood depend on your illness?
Yes.
No.
Hard to say.
3. How have you been dealing with everyday problems lately?
I sometimes get involved in solving them.
I try to distance myself from them.
They are still interesting to me.
4. Do you need to talk to family and friends about your health problems?
Yes, they will definitely support me.
Yes, but only to a few people—few will understand me.
No, no one is capable of understanding or empathizing.
5. Have your interests changed during your illness?
Yes, I am now interested in very little.
Yes, my interests have broadened.
No, my interests have stayed the same.
6. Do you think a healthy person's life differs from that of a person who is ill?
Yes, definitely.
Not always.
Hardly at all.
7. Do you often feel happy?
Yes, I find many reasons to feel happy.
It is hard to make me happy.
Sometimes I am in a very good mood.
8. Are you easily upset?
Yes, I often get upset.
I get upset for serious reasons.
It is hard to upset me.
9. Does your illness prevent you from living the way you want to?
Yes, it interferes.
It causes some inconvenience.
I live without letting my illness guide how I live.
10. Do you have close people with whom you have deep relationships?
Yes, I have a partner (or a friend).
I have acquaintances.
No one ever has lasting deep relationships.
11. How would you rate your intellectual potential?
Relatively low.
Average.
Fairly high.
12. Do you enjoy your work (or studies)?
Yes, I enjoy it.
I do not work (or study).
I work (or study), but without much interest.
13. Do you currently have any hobbies or interests?
Yes.
Hard to say.
No.
14. Who is to blame for your illness?
No one—it just happened.
I am.
The people around me.
15. Are you able to control your emotions and behavior?
Yes, always.
Not in all situations.
Recently, I have completely lost control.
16. Have your family relationships changed?
No, they have not changed.
Yes, people now take more care of me.
Yes, mutual understanding has disappeared.
17. How do you deal with problems that come up for you?
Not all problems are within my ability to solve.
I handle them on my own without involving anyone.
I deal with them together with family or friends.
18. Do you experience painful physical symptoms?
Yes, I do.
Sometimes, for different reasons.
I experience them all the time.
19. Has your view of yourself changed during the course of your illness?
Yes, and I have come to respect myself more.
Yes, and I have come to feel more sorry for myself.
No, almost nothing has changed.
20. How important is it for you to maintain your health?
For me, right now, this is the only thing that matters in life.
This is one of my most important goals.
This desire comes to me from time to time.
21. Do you consider yourself a happy person?
Yes, I am a happy person despite all my problems.
Yes, but with some reservations.
No.
22. Do you believe that treatment for your condition will be effective?
Yes, of course.
No.
Modern medicine can do a lot, but not everything.
23. Has your mood changed during the course of your illness?
I have become more irritable.
I have become more even-tempered.
I do not know.
24. How do you cope with your illness?
I fight persistently against the illness and the difficulties it causes.
I give in to it.
I try to maintain a balance of strength and energy.
25. Can this illness lead to an early death?
Yes, people with this illness do not live long.
The course of the illness can vary.
With appropriate lifestyle changes and treatment, it is possible to live a long time.
26. How do you feel about yourself?
As a seriously ill person.
As a strong person who can overcome difficulties.
As someone who lives the way they want.
27. Have your relationships with other people changed during your illness?
They have changed for the better.
They have stayed the same as before.
They have changed for the worse.
28. Is your life different from the life of your peers?
No, my life is as full as other people's.
Yes, my illness reduces my quality of life.
Each of us has our own problems.