Romantic Relationships, Sexual Satisfaction, and Perceived QOL in Individuals with SCI
Please complete our survey if you are currently in or have previously been involved in a romantic relationship while living with a SCI. The purpose of this study is to examine the perceived quality of life of individuals with SCI through the perspective of sexual satisfaction and quality of romantic relationships. If at any time you feel uncomfortable you may stop the survey.
What is your date of birth? *
MM
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YYYY
By clicking on the "Yes" button below indicates that: *
1.) You have read the above information and have had a chance to ask any questions you may have about the study 2.) You agree to be in the study and have been told that you can change your mind and withdraw your consent at any time 3.) You meet the inclusion criteria for the study
What is the highest education you received?
What is your gender? *
Are you currently ill?
If something is wrong with your health what do you think it is?
Your answer
What is your marital status? *
Do you get the kind of support from others that you need? *
For the following questions, please select the response that best fits how much support you've received from others within the LAST 2 WEEKS.
Not at all
Completely
How would you rate your quality of life? *
Very poor
Very good
How satisfied are you with your health? *
Very dissatisfied
Very satisfied
To what extent do you feel that physical pain prevents you from doing what you need to do? *
Not at all
An extreme amount
How much do you need any medical treatment to function in your daily life? *
Not at all
An extreme amount
How much do you enjoy life? *
Not at all
An extreme amount
To what extent do you feel your life to be meaningful? *
Not at all
An extreme amount
How well are you able to concentrate? *
Not at all
Extremely
How safe do you feel in your daily life? *
Not at all
Extremely
How healthy is your physical environment? *
Not at all
Extremely
Do you have enough energy for everyday life? *
Not at all
Completely
Are you able to accept your bodily appearance? *
Not at all
Completely
Have you enough money to meet your needs? *
Not at all
Completely
How available to you is the information that you need in your day to day life? *
Not at all
Completely
To what extent do you have the opportunity for leisure activities? *
Not at all
Completely
How well are you able to get around?
Very poor
Very good
How satisfied are you with your sleep? *
Very dissatisfied
Very satisfied
How satisfied are you with your ability to perform your daily living activities? *
Very dissatisfied
Very satisfied
How satisfied are you with your capacity for work? *
Very dissatisfied
Very satisfied
How satisfied are you with yourself? *
Very dissatisfied
Very satisfied
How satisfied are you with your personal relationships? *
Very dissatisfied
Very satisfied
How satisfied are you with your sex life? *
Very dissatisfied
Very satisfied
How satisfied are you with the support you get from your friends? *
Very dissatisfied
Very satisfied
How satisfied are you with the conditions of your living place? *
Very dissatisfied
Very satisfied
How satisfied are you with your access to health services? *
Very dissatisfied
Very satisfied
How satisfied are you with your transport? *
Very dissatisfied
Very satisfied
How often do you have negative feelings such as blue mood, despair, anxiety, depression? *
The following question refers to HOW OFTEN you have felt or experienced certain things in the last two weeks.
Never
Always
How is your sexual desire now compared to before injury? *
**For the remaining survey questions, please answer according to your current OR previous relationship**
How important is sexuality to you now compared to before injury? *
How is your relationship, most of the time, with your sexual partner after injury? *
Please rate question on a scale of 1-7.
Very dissatisfying
Very satisfying
How was your relationship, most of the time, with your sexual partner before injury? *
Please rate question on a scale of 1-7.
Very dissatisfying
Very satisfying
How are your possibilities and your ability to enjoy sexuality yourself? *
How are your possibilities and your ability to give your partner sexual fulfillment? *
Please indicate the degree of happiness, all things considered, of your relationship. *
Extremely unhappy
Perfect
Amount of time spent together. *
Please indicate the approximate extent of agreement or disagreement between you and your partner.
Always disagree
Always agree
Making major decisions. *
Please indicate the approximate extent of agreement or disagreement between you and your partner.
Always disagree
Always agree
Demonstrations of affection. *
Please indicate the approximate extent of agreement or disagreement between you and your partner.
Always disagree
Always agree
In general, how often do you think that things between you and your partner are going well? *
Never
All the time
How often do you wish you hadn't gotten into this relationship? *
All the time
Never
I still feel a strong connection with my partner. *
Not at all true
Completely true
If I had my life to live over, I would marry (or live with/date) the same person. *
Not at all true
Completely true
Our relationship is strong. *
Not at all true
Completely true
I sometimes wonder if there is someone else out there for me. *
Not at all true
Completely true
My relationship with my partner makes me happy. *
Not at all true
Completely true
I have a warm and comfortable relationship with my partner. *
Not at all true
Completely true
I can't imagine ending my relationship with my partner. *
Not at all true
Completely true
I feel that I can confide in my partner about virtually anything. *
Not at all true
Completely true
I have second thoughts about this relationship recently. *
Completely true
Not at all true
For me, my partner is the perfect romantic partner. *
Not at all true
Completely true
I really feel like part of a team with my partner. *
Not at all true
Completely true
I cannot imagine another person making me as happy as my partner does. *
Not at all true
Completely true
How rewarding is your relationship with your partner? *
Not at all
Completely
How well does your partner meet your needs? *
Not at all
Completely
To what extent has your relationship met your original expectations? *
Not at all
Completely
In general, how satisfied are you with your relationship? *
Not at all
Completely
How good is your relationship compared to most? *
Worse than others (extremely bad)
Better than all others (extremely good)
Do you enjoy your partner's company? *
How often do you and your partner have fun together? *
Select the answer that best describes how you feel about your relationship. Base your responses on your first impressions and immediate feelings about the item. *
Boring
Interesting
Select the answer that best describes how you feel about your relationship. Base your responses on your first impressions and immediate feelings about the item. *
Bad
Good
Select the answer that best describes how you feel about your relationship. Base your responses on your first impressions and immediate feelings about the item. *
Empty
Full
Select the answer that best describes how you feel about your relationship. Base your responses on your first impressions and immediate feelings about the item. *
Lonely
Friendly
Select the answer that best describes how you feel about your relationship. Base your responses on your first impressions and immediate feelings about the item. *
Fragile
Sturdy
Select the answer that best describes how you feel about your relationship. Base your responses on your first impressions and immediate feelings about the item. *
Discouraging
Hopeful
Select the answer that best describes how you feel about your relationship. Base your responses on your first impressions and immediate feelings about the item. *
Miserable
Enjoyable
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