Index

Please help us understand the importance of your goals in the current treatment of your wound/wounds by filling out the following survey.

For each of the following statements, please mark how important this treatment goal is to you. If a statement does not apply to you (for example, because you do not have pain), please mark "does not apply to me“. Please mark only one answer choice per statement.

As a result of therapy, how important is it for you to...

not at all

somewhat

moderately

quite

very

does not apply to me

...be free from pain

1) ...be free from pain

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...have no drainage from the wound(s)

2) ...have no drainage from the wound(s)

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...not have an unpleasant smell from the wound(s)

3) ...not have an unpleasant smell from the wound(s)

not at all not at all

somewhat somewhat

moderately moderately

quite

very very

does not apply to me does not apply to me

...be healed from the wound(s)

4) ...be healed from the wound(s)

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...be able to sleep better

5) ...be able to sleep better

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...feel less depressed

6) ...feel less depressed

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...experience greater enjoyment of life

7) ...experience greater enjoyment of life

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...not be afraid that the problem(s) will get worse

8) ...not be afraid that the problem(s) will get worse

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...be able to lead a normal life

9) ...be able to lead a normal life

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...be more productive in everyday life

10) ...be more productive in everyday life

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...not be a burden to friends and family

11) ...not be a burden to friends and family

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...be able to enjoy your spare time like a normal person

12) ...be able to enjoy your spare time like a normal person

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...be able to lead a normal working life

13) ...be able to lead a normal working life

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...be able to have more contact with other people

14) ...be able to have more contact with other people

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...be more comfortable being out in public

15) ...be more comfortable being out in public

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...not have the relationship with your partner affected by the wound

16) ...not have the relationship with your partner affected by the wound

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...not have to rely on doctor visits

17) ...not have to rely on doctor visits

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...not spend so much time taking care of these problems

18) ...not spend so much time taking care of these problems

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...not have to spend so much of your own money on treatment

19) ...not have to spend so much of your own money on treatment

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...have fewer side effects

20) ...have fewer side effects

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...feel certain about the diagnosis and therapy

21) ...feel certain about the diagnosis and therapy

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

...feel certain that the treatment will work

22) ...feel certain that the treatment will work

not at all not at all

somewhat somewhat

moderately moderately

quite quite

very very

does not apply to me does not apply to me

PBI – Patient Benefit Index (index of benefits and needs in therapy), Augustin 2006

Please review your answers to make sure you have marked one answer choice per statement.

Done – show results

The result based on your statements on the importance of treatment goals is:

no treatment goals

many treatment goals

PBI-W – Patient Benefit Index, wound version

Importance of treatment goals

As a result of therapy, how important is it for you to...

The result based on your statements on the importance of treatment goals is: