| Very dissatisfied | Dissatisfied | Neither satisfied nor dissatisfied | Satisfie d | Very satisfied | |
|---|---|---|---|---|---|
| 21. How satisfied are you with your sleep? | 1 | 2 | 3 | 4 | 5 |
| 22. How satisfied are you with your ability to Perform your daily living activities? |
1 | 2 | 3 | 4 | 5 |
| 23. How satisfied are you with your capacity for Work? |
1 | 2 | 3 | 4 | 5 |
| 24. How satisfied are you with yourself? | 1 | 2 | 3 | 4 | 5 |
| 25. How satisfied are you with your personal relationships? |
1 | 2 | 3 | 4 | 5 |
| 26. How satisfied are you with your sex life? | 1 | 2 | 3 | 4 | 5 |
| 27. How satisfied are you with the support you get from your friends? |
1 | 2 | 3 | 4 | 5 |
| 28. How satisfied are you with the conditions of your living place? |
1 | 2 | 3 | 4 | 5 |
| 29. How satisfied are you with your access to health services? |
1 | 2 | 3 | 4 | 5 |
| 30. How satisfied are you with your transport? | 1 | 2 | 3 | 4 | 5 |