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