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SSCH Wellbeing Questionnaire
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Email
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Occupation
Carer
Nurse
Manager
Domestic & Housekeeping
Kitchen & Catering
Maintenance
Activities
Other
Your age
I have been feeling optimistic about the future
None of the time
Rarely
Some of the time
Often
All of the time
I have been feeling useful
None of the time
Rarely
Some of the time
Often
All of the time
I have been feeling relaxed
None of the time
Rarely
Some of the time
Often
All of the time
I have been feeling interested in other people
None of the time
Rarely
Some of the time
Often
All of the time
I have had energy to spare
None of the time
Rarely
Some of the time
Often
All of the time
I've been dealing with problems well.
None of the time
Rarely
Some of the time
Often
All of the time
I have been thinking clearly
None of the time
Rarely
Some of the time
Often
All of the time
I have been feeling good about myself
None of the time
Rarely
Some of the time
Often
All of the time
I've been feeling close to other people
None of the time
Rarely
Some of the time
Often
All of the time
I've been feeling confident
None of the time
Rarely
Some of the time
Often
All of the time
I have been able to make up my own mind about things
None of the time
Rarely
Some of the time
Often
All of the time
I've been interested in new things
None of the time
Rarely
Some of the time
Often
All of the time
I've been feeling cheerful
None of the time
Rarely
Some of the time
Often
All of the time
I've been feeling loved
None of the time
Rarely
Some of the time
Often
All of the time
How much physical pain or discomfort are you experiencing currently?
Selected Value:
0
0: None 5: Severe
How fatigued or low in energy do you feel today?
Selected Value:
0
0: Full of energy 5: Completely exhausted
How would you rate your overall mental health and emotional state right now?
Excellent
Good
OK
Not great
Very poor
Are you happy with your current diet?
Yes, I eat well and healthy. I don't need any help on this.
I eat well but my diet could be better.
My diet is not the best but I know what needs changing.
My diet is poor and I am unsure how to improve it.
My diet needs radical changes.
Is there anything specific you would like to discuss in this session.
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