DigiPRO

Questionnaire on the quality of life of patients with Recurrent Swelling Episodes

This questionnaire asks a number of questions. Please read each question carefully and choose from the five answers the one that fits best for you. Please do not think too long about the questions; be sure to answer all of the questions and to give only one answer to each question.

1. Indicate how often within the last 4 weeks you have been restricted in work because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

Never Rarely Occasionally Often Very often

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Questionnaire on the quality of life of patients with Recurrent Swelling Episodes

1. Indicate how often within the last 4 weeks you have been restricted in work because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

2. Indicate how often within the last 4 weeks you have been restricted in physical activity because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

3. Indicate how often within the last 4 weeks you have been restricted in leisure time because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

4. Indicate how often within the last 4 weeks you have been restricted in social relations because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

5. Indicate how often within the last 4 weeks you have been restricted in eating and drinking because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

6. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do you have difficulty falling asleep?

7. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do you wake up during the night?

8. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Are you tired during the day because you are not sleeping well at night?

9. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do you have trouble concentrating?

10. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do you feel depressed?

11. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do you have to limit your choices of food or beverages?

12. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do the swelling episodes place a burden on you?

13. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Are you afraid that a swelling episode could occur suddenly?

14. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Are you afraid that the frequency of the swelling episodes might increase?

15. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Are you ashamed to go out in public because of the swelling episodes?

16. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do the swelling episodes make you embarrassed or self-conscious?

Questionnaire on the quality of life of patients with Recurrent Swelling Episodes

1. Indicate how often within the last 4 weeks you have been restricted in work because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

2. Indicate how often within the last 4 weeks you have been restricted in physical activity because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

3. Indicate how often within the last 4 weeks you have been restricted in leisure time because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

4. Indicate how often within the last 4 weeks you have been restricted in social relations because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

5. Indicate how often within the last 4 weeks you have been restricted in eating and drinking because of swelling episodes (angioedema). (regardless of whether or not you have actually experienced swelling episodes during that time period)

6. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Do you have difficulty falling asleep?

7. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Do you wake up during the night?

8. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Are you tired during the day because you are not sleeping well at night?

9. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Do you have trouble concentrating?

10. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Do you feel depressed?

11. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Do you have to limit your choices of food or beverages?

12. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Do the swelling episodes place a burden on you?

13. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Are you afraid that a swelling episode could occur suddenly?

14. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Are you afraid that the frequency of the swelling episodes might increase?

15. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Are you ashamed to go out in public because of the swelling episodes?

16. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).Do the swelling episodes make you embarrassed or self-conscious?

6. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do you have difficulty falling asleep?

7. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do you wake up during the night?

8. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Are you tired during the day because you are not sleeping well at night?

9. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do you have trouble concentrating?

10. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do you feel depressed?

11. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do you have to limit your choices of food or beverages?

12. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do the swelling episodes place a burden on you?

13. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Are you afraid that a swelling episode could occur suddenly?

14. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Are you afraid that the frequency of the swelling episodes might increase?

15. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Are you ashamed to go out in public because of the swelling episodes?

16. In the following questions we would like to get more details about the difficulties and problems that may be associated with your recurrent swelling episodes (angioedema) (during the last 4 weeks).

Do the swelling episodes make you embarrassed or self-conscious?