Outcome
Type |
Measure |
Description |
Time frame |
Safety issue |
Other |
Simple Physical Activity Questionnaire |
Questionnaire to survey physical activity: It should show a snapshot of hours per day of an average day in the past week. The time in bed, the time while doing sedentary work (including dozing), while walking, while exercising and during other physical activities (such as household chores) is interrogated. The test does not measure the intensity of physical activity, but rather sorts it into the groups walking, sport and other categories. |
Before intervention |
|
Other |
Short Form Health Survey (SF-12) |
Questionnaire on health-related quality of life. It consists of twelve questions relating to the last four weeks and yields statements about eight different dimensions of subjective health: general health perception, physical health, physically-conditioned role function, physical pain, vitality, mental health, emotionally-related role function, social functionality. Different Likert-Scales are used. A physical sum scale and a psychological sum scale can be calculated. The polarity of four items must be reversed so that higher values in all items and total scales reflect a better state of health. Normative data are available. |
Before intervention |
|
Other |
Brief Symptom Inventory |
Questionnaire on the burden of symptoms. The BSI is also called the Brief Symptom Check List (BSCL), it is a short form of the SCL-90 (Derogatis, 1993). The BSI consists of 53 items (physical as well as psychological symptoms), which are assessed subjectively on a Likert scale in relation to the last seven days from 0 = "not at all" to 5 = "very strong". The items result in nine scales: somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. |
Before intervention |
|
Other |
Beck Depression Inventory II (BDI-II) |
The BDI-II represents a self-rating instrument to assess the severity of depression. Four statements are given for each of 21 questions, from which the one that best describes how the person has felt in the past week is to be selected. In scoring, each item is given a score of 0 to 3, depending on the choice (higher number means higher depression scores), and after directly adding the scores of the individual items, a total score of 0 to 63 is obtained. |
Before intervention |
|
Other |
Body Mass Index |
Relation of body weight to the square of body height |
Before intervention |
|
Other |
Like/Dislike Body Chart |
As an extension to the ABC, this questionnaire is intended to answer the question of whether there are areas of the body that one particularly likes about oneself or that one dislikes about oneself. If yes, one can draw these with a purple color pencil ("particularly like") and/or with a gray color pencil ("do not like") in an extra Body Chart. |
Before intervention |
|
Other |
Additional questions |
Questions on demographic data and chronic complaints and current illnesses |
Before intervention |
|
Other |
Charlson Comorbidity Index |
Questionnaire on comorbidities |
Before intervention |
|
Other |
Feedback form |
Personal feedback on questionnaires and measures |
Immediately after investigation |
|
Primary |
Awareness Body Chart Questionnaire |
Body charts to fill in with colours according to intensity of body awareness. In sum, 51 body regions to colour with 5 different colour pencils (orange = "I can perceive with much detail", yellow = "I can perceive distinctly", green = "I can perceive", blue = "I can perceive indistinctly", black = "I cannot perceive"). To quantify the information, every region of the body will be coded as an extra item and the data of the colours will be transcribed: orange (= 5), yellow (= 4), green (= 3), blue (= 2), black (= 1). Higher values mean higher intensity of body awareness. |
Before intervention |
|
Primary |
Awareness Body Chart Questionnaire |
Body charts to fill in with colours according to intensity of body awareness. In sum, 51 body regions to colour with 5 different colour pencils (orange = "I can perceive with much detail", yellow = "I can perceive distinctly", green = "I can perceive", blue = "I can perceive indistinctly", black = "I cannot perceive"). To quantify the information, every region of the body will be coded as an extra item and the data of the colours will be transcribed: orange (= 5), yellow (= 4), green (= 3), blue (= 2), black (= 1). Higher values mean higher intensity of body awareness. |
Immediately after intervention |
|
Secondary |
Short questionnaire on self-perception of the body |
Verbal questionnaire concerning body awareness. 20 items (5 = "I can perceive with much detail", 4 = "I can perceive distinctly", 3 = "I can perceive", 2 = "I can perceive indistinctly", 1 = "I cannot perceive"). Higher values mean higher intensity of body awareness. |
Before intervention |
|
Secondary |
Short questionnaire on self-perception of the body |
Verbal questionnaire concerning body awareness. 20 items (5 = "I can perceive with much detail", 4 = "I can perceive distinctly", 3 = "I can perceive", 2 = "I can perceive indistinctly", 1 = "I cannot perceive"). Higher values mean higher intensity of body awareness. |
Immediately after intervention |
|
Secondary |
Self-rating mood scale - revised |
Verbal questionnaire concerning mood status. 24 pairs of oppositional adjectives concerning mood: One of them or
Before intervention |
|
|
Secondary |
Self-rating mood scale - revised |
Verbal questionnaire concerning mood status. 24 pairs of oppositional adjectives concerning mood: One of them or
Immediately after intervention |
|
|