Index

Questionnaire on cumulative impairments in skin diseases – DermCLCI-p

The following questions will help us to understand how much you have experienced the following impairments due to your skin disease in the last two weeks.

In the last two weeks, I experienced the following disease-related problems as burdensome:

not at all

somewhat

quite

very

1 ...limitations of physical performance

Not at all

Somewhat

Quite

Very

2 ...effort with the treatment of the disease

Not at all

Somewhat

Quite

Very

3 ...the idea of continuing the current treatment for the rest of my life

Not at all

Somewhat

Quite

Very

4 ...insufficient care by the attending physicians

Not at all

Somewhat

Quite

Very

5 ...other diseases

Not at all

Somewhat

Quite

Very

6 ...impairments of professional life/education

Not at all

Somewhat

Quite

Very

7 ...negative financial impacts

Not at all

Somewhat

Quite

Very

8 ...nervousness, anxiety or tenseness

Not at all

Somewhat

Quite

Very

9 ...not being able to stop or control worries

Not at all

Somewhat

Quite

Very

10 ...anxiety about the progression of the disease

Not at all

Somewhat

Quite

Very

11 ...feeling stressed by the disease

Not at all

Somewhat

Quite

Very

12 ...little interest or pleasure in my activities

Not at all

Somewhat

Quite

Very

13 …depression, melancholy or hopelessness

Not at all

Somewhat

Quite

Very

14 ...thoughts of no longer wanting to live

Not at all

Somewhat

Quite

Very

15 …problems in my family

Not at all

Somewhat

Quite

Very

16 …problems in (previous) intimate partner relationships

Not at all

Somewhat

Quite

Very

17 …problems in other social relations (friends, colleagues)

Not at all

Somewhat

Quite

Very

18 …impairments in sex life

Not at all

Somewhat

Quite

Very

19 …in terms of fulfilling my desire to have children

Not at all

Somewhat

Quite

Very

20 ...restrictions in leisure activities

Not at all

Somewhat

Quite

Very

21 ...impairments regarding choice of clothing

Not at all

Somewhat

Quite

Very

22 ...feelings of shame

Not at all

Somewhat

Quite

Very

23 ...prejudices of others

Not at all

Somewhat

Quite

Very

24 ...nutritional disadvantages

Not at all

Somewhat

Quite

Very

25 ...increased use of tobacco, alcohol, drugs, or the internet

Not at all

Somewhat

Quite

Very

26 ...sleep disorders

Not at all

Somewhat

Quite

Very

27 ...impairments in the quality of life

Not at all

Somewhat

Quite

Very

28 ...Other:

Not at all

Somewhat

Quite

Very

not at all

somewhat

moderately

quite

very

29 I have come to terms with my disease and its associated impairments.

Not at all

Somewhat

Moderately

Quite

Very

30 Through coping strategies or avoidance behaviors, I have learned to deal better with the disease.

Not at all

Somewhat

Moderately

Quite

Very

Done – show results

Your eDermCLCI-p sumscore is:

Score

no impairment due to skin disease

severe impairment due to skin disease

S10

S11

S12

S13

S14

S15

S16

S17

S18

S19

S20

S21

S22

S23

S24

S25

S26

S27

S28

S29

s30

Your proportion of the answers „quite“ and „very“ is:

Item score for "Quite" and "Very"

Thank you very much for your cooperation!

Questionnaire on cumulative impairments in skin diseases – DermCLCI-p, Augustin 2022
Version: UK-English for use in UK. 1.0

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Questionnaire on cumulative impairments in skin diseases – DermCLCI-p

Your eDermCLCI-p sumscore is:

Your proportion of the answers „quite“ and „very“ is: