| **** *** CIS20R **** *** | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Checklist Individual Strength | |||||||||
| University Hospital Nijmegen | |||||||||
| Department of Medical Psychology | |||||||||
| Instruction: | |||||||||
| On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the past two weeks. For example: | |||||||||
| I feel relaxed | |||||||||
| If you feel that this statement is not true at all, place a cross in the right box; like this: | |||||||||
| I feel relaxed | yes, that is true | X | no, that is not true | ||||||
| If you feel that this statement is not true at all, place a cross in the right box; like this: | |||||||||
| I feel relaxed | yes, that is true | X | no, that is not true | ||||||
| If you feel that this statement in not “yes, that is true”, but also not “no, that is not true”, place a cross in the box that is most in accordance with how you have felt. | |||||||||
| For example, if you feel relaxed, but not very relaxed, place a cross in one of the boxes close to “yes, that is true": like this: | |||||||||
| I feel relaxed | yes, that is true | X | no, that is not true | ||||||
| Do not skip any statement and place only one cross for each statement. | |||||||||
| 1. I feel tired | yes, that is true | no, that is not true | |||||||
| 2. I feel very active | yes, that is true | no, that is not true | |||||||
| 3. Thinking requires effort | yes, that is true | no, that is not true | |||||||
| 4. Physically I feel exhausted | yes, that is true | no, that is not true | |||||||
| 5. I feel like doing all kinds of nice things | yes, that is true | no, that is not true | |||||||
| 6. I feel fit | yes, that is true | no, that is not true | |||||||
| 7. I do quite a lot within a day | yes, that is true | no, that is not true | |||||||
| 8. When I am doing something, I can concentrate quite well | yes, that is true | no, that is not true | |||||||
| 9. I feel weak | yes, that is true | no, that is not true | |||||||
| 10. I don't do much during the day | yes, that is true | no, that is not true | |||||||
| 11. I can concentrate well | yes, that is true | no, that is not true | |||||||
| 12. I feel rested | yes, that is true | no, that is not true | |||||||
| 13. I have trouble concentrating | yes, that is true | no, that is not true | |||||||
| 14. Physically I feel I am in a bad condition | yes, that is true | no, that is not true | |||||||
| 15. I am full of plans | yes, that is true | no, that is not true | |||||||
| 16. I get tired very quickly | yes, that is true | no, that is not true | |||||||
| 17. I have a low output | yes, that is true | no, that is not true | |||||||
| 18. I feel no desire to do anything | yes, that is true | no, that is not true | |||||||
| 19. My thoughts easily wander | yes, that is true | no, that is not true | |||||||
| 20. Physically I feel in a good shape | yes, that is true | no, that is not true | |||||||
| SCORING CIS20R | |||||||||
| For the items:2, 5, 6, 7, 8, 11, 12, 15, 20 is the scoring as follows: | |||||||||
| yes, that is true | 1 | 2 | 3 | 4 | 5 | 6 | 7 | no, that is not true | |
| For the items: 1, 3, 4, 9, 10, 13, 14, 16, 17, 18, 19is the scoring as follows: | |||||||||
| yes, that is true | 7 | 6 | 5 | 4 | 3 | 2 | 1 | no, that is not true | |
| Subsequently the four subscales are calculated by summing the respective items | |||||||||
| subscale 1: Subjective feeling of fatigue | items 1, 4, 6, 9, 12, 14, 16, 20 | ||||||||
| subscale 2: Concentration | items 3, 8, 11, 13, 19 | ||||||||
| subscale 3: Motivation | items 2, 5, 15, 18 | ||||||||
| subscale 4: Physical activity | items 7, 10, 17 | ||||||||
- Paper
Fatigue among working people: validity of a questionnaire measure
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