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CareGiver Oncology Quality of Life (CarGOQoL)

Quality of Life Questionnaire: CarGOQoL

CarGOQoL- 1.2
If questions, please contact:

MD Patricia Minaya / Pr. Pascal Auquier

Service de Santé Publique - Faculté de Médecine
27, Boulevard Jean Moulin
13385 Marseille
Phone: +33 (0)4 91 32 45 20 - Fax: +33 (0)4 91 38 44 82
Email: patriciaminaya1@gmail.com

Eur J Cancer. 2011 Oct 25

The CareGiver Oncology Quality of Life questionnaire (CarGOQoL): Development and validation of an instrument to measure the quality of life of the caregivers of patients with cancer.

Minaya P, Baumstarck K, Berbis J, Goncalves A, Barlesi F, Michel G, Salas S, Chinot O, Grob JJ, Seitz JF, Bladou F, Clement A, Mancini J, Simeoni MC, Auquier P.

CarGOQoL © CareGiver Oncology Quality of Life (CarGOQoL), 2011.

Answer each question by selecting the response that comes closest to what you thought or felt during the last four weeks. Some of the questions concern your private life. These questions are necessary to evaluate every aspect of your quality of life. However, if you do not know how to respond to a question or if a question does not concern you, skip to the next question.

During the last four weeks, in connection with the person you help, have you …
1 Been worried, anxious?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
2 Been sad, depressed?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
3 Been emotionally tired, worn out?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
4 Been stressed?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
5 Felt a lack of freedom?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
6 Been bothered by the feeling of being confined?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
7 Been bothered by the fact that your life was entirely devoted to the care recipient?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
8 Been bothered to be the only person to provide assistance?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
9 Been satisfied with information given by health care providers (doctors, nurses…)?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
10 Been reassured by the health care providers (doctors, nurses…)?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
11 Felt that your role as caregiver was recognized by health care providers (doctors, nurses…)?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
12 Had financial difficulties (lodging, transportation…)?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
13 Had other difficulties (lodging, transportation…)?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
14 Encountered difficulties in the administrative process (health insurance paperwork and other paperwork related to the cancer illness)?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
15 Experienced feelings of guilt?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
16 Been bothered by a feeling of helplessness against disease?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
17 Felt a feeling of injustice, anger or rebellion?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
18 Had sleeping difficulties?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
19 Had problems with your appetite?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
20 Been physically tired, worn out?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
21 Had the impression that your health was fragile?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
22 Felt you made a difference for the person you are helping?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
23 Felt useful?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
24 Been able to rest, relax?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
25 Been able to take care of yourself, pay attention to your own health?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
26 Been assisted, supported, understood by your family?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
27 Been assisted, supported, understood by your friends?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
28 Had difficulties in your intimate, emotional life?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

During the last four weeks, in connection with the person you help, have you …
29 Had a satisfying love and sexual life?
- Never - Not at all
- Rarely - A little
- Sometimes - Moderately
- Often - A lot
- Always - Enormously

Thank you for your participation

For any information on the use of the CarGOQoL, please contact Mapi Research Trust, Lyon, France.

Internet: https://eprovide.mapi-trust.org

You have provided a response to all questionnaire items.

If you would like to review or change your responses tap Back. Tap Submit if you are ready to save your responses.

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CareGiver Oncology Quality of Life (CarGOQoL)

Quality of Life Questionnaire: CarGOQoL

CarGOQoL- 1.2

If questions, please contact:

MD Patricia Minaya / Pr. Pascal Auquier

Service de Santé Publique - Faculté de Médecine 27, Boulevard Jean Moulin 13385 Marseille Phone: +33 (0)4 91 32 45 20 - Fax: +33 (0)4 91 38 44 82 Email: patriciaminaya1@gmail.com

During the last four weeks, in connection with the person you help, have you …

1 Been worried, anxious?

During the last four weeks, in connection with the person you help, have you …

2 Been sad, depressed?

During the last four weeks, in connection with the person you help, have you …

3 Been emotionally tired, worn out?

During the last four weeks, in connection with the person you help, have you …

4 Been stressed?

During the last four weeks, in connection with the person you help, have you …

5 Felt a lack of freedom?

During the last four weeks, in connection with the person you help, have you …

6 Been bothered by the feeling of being confined?

During the last four weeks, in connection with the person you help, have you …

7 Been bothered by the fact that your life was entirely devoted to the care recipient?

During the last four weeks, in connection with the person you help, have you …

8 Been bothered to be the only person to provide assistance?

During the last four weeks, in connection with the person you help, have you …

9 Been satisfied with information given by health care providers (doctors, nurses…)?

During the last four weeks, in connection with the person you help, have you …

10 Been reassured by the health care providers (doctors, nurses…)?

During the last four weeks, in connection with the person you help, have you …

11 Felt that your role as caregiver was recognized by health care providers (doctors, nurses…)?

During the last four weeks, in connection with the person you help, have you …

12 Had financial difficulties (lodging, transportation…)?

During the last four weeks, in connection with the person you help, have you …

13 Had other difficulties (lodging, transportation…)?

During the last four weeks, in connection with the person you help, have you …

14 Encountered difficulties in the administrative process (health insurance paperwork and other paperwork related to the cancer illness)?

During the last four weeks, in connection with the person you help, have you …

15 Experienced feelings of guilt?

During the last four weeks, in connection with the person you help, have you …

16 Been bothered by a feeling of helplessness against disease?

During the last four weeks, in connection with the person you help, have you …

17 Felt a feeling of injustice, anger or rebellion?

During the last four weeks, in connection with the person you help, have you …

18 Had sleeping difficulties?

During the last four weeks, in connection with the person you help, have you …

19 Had problems with your appetite?

During the last four weeks, in connection with the person you help, have you …

20 Been physically tired, worn out?

During the last four weeks, in connection with the person you help, have you …

21 Had the impression that your health was fragile?

During the last four weeks, in connection with the person you help, have you …

22 Felt you made a difference for the person you are helping?

During the last four weeks, in connection with the person you help, have you …

23 Felt useful?

During the last four weeks, in connection with the person you help, have you …

24 Been able to rest, relax?

During the last four weeks, in connection with the person you help, have you …

25 Been able to take care of yourself, pay attention to your own health?

During the last four weeks, in connection with the person you help, have you …

26 Been assisted, supported, understood by your family?

During the last four weeks, in connection with the person you help, have you …

27 Been assisted, supported, understood by your friends?

During the last four weeks, in connection with the person you help, have you …

28 Had difficulties in your intimate, emotional life?

During the last four weeks, in connection with the person you help, have you …

29 Had a satisfying love and sexual life?

Thank you for your participation

Service de Santé Publique - Faculté de Médecine
27, Boulevard Jean Moulin
13385 Marseille
Phone: +33 (0)4 91 32 45 20 - Fax: +33 (0)4 91 38 44 82
Email: patriciaminaya1@gmail.com