Tugas Mengetik Instrumen Penelitian Kesehatan

Dosen Pengampu : Johan Budhiana, M.Stat

Nama : Hasna Nuralifah

NIM : 32722001D18047

Kelas : 3A / D3 Keperawatan

Mata Kuliah : Metode Penelitian

Questionnaire English

The Diabetic Peripheral Neuropathic Pain Impact Measure

1. How often were you bothered by excessive thirst and urination during the past
month?
2. During the past month, have you been anxious or worried?
3. During the past month, have you felt optimistic about your diabetes?
4. How good has your muscular strength and endurance been during the past month?
5. Over the past month, have you been bothered by blurring of vision?
6. Over the past month, how much exercise could you do without developing low
blood sugar?
7. During the past month, have you felt that you were good at doing the most
important things you do (for example, your work, school, homemaking,
parenting, handling personal affairs)?
8. Over the past month, how much have you felt personally in charge of managing
your diabetes?
9. Over the past month, how much energy have you had?
10. During the past month, how well have you slept?
11. During the past month, how worried have you been about having an insulin
reaction or dangerously low blood sugar?
12. Have you met the obligations and responsibilities you feel toward your family
during the past month?
13. During the past month, have you been bothered by constipation?
14. Have you felt depressed during the past month?
15. During the past month, was it an inconvenience or bother to you to take your
diabetes medicine (pills or insulin)?
16. During the past month, have you eaten too much?
17. During the past month, were you bothered by burning, tingling, pain, or numbness
in your feet or hands?
18. During the past month, how worried or fearful have you been about your future?
19. Have you eaten what you wanted to during the past month?
20. During the past month, have you felt it was worth the effort to take care of your
diabetes?
21. During the past month, how often were you able to function sexually as well as
you wanted to?
22. Over the past month did you develop low blood sugar with exercise?
23. Have you functioned well, not limited by your health, in your usual occupation
(homemaking, school, work, etc) during the past month?
24. How often did you vomit after eating during the past month?
25. During the past month, my whole schedule of activities was restricted by my
diabetes
26. Over the past month, have you been bothered by feeling faint or dizzy on sitting
up or standing up?
27. How much of the time, during the past month, has your daily life been full of
things that were interesting to you?
28. Overall, during the past month, how do you think your diabetes has been doing?
29. Has your appetite been good during the last month?
30. During the past month, have you participated in and enjoyed family life?
31. During the past month, how often have you been able to function welling your
usual occupation (homemaking, school, work, etc.)?
32. How high has your interest in sex been over the past month?
33. How often did you have abdominal discomfort after eating during the past month?
34. How often during the past month have you been uncertain about how much to eat
and/or how much insulin to take?
35. Have you enjoyed social and recreational activities during the past month?
36. During the past month, have you felt useful?
37. During the past month, how much of the time were you lacking enough energy?
38. How often did you have diarrhea during the past month?
39. During the past month, have you been able to follow medical recommendations
concerning your diabetes?
40. During the past month, was your diabetes monitoring an inconvenience or bother
to you?
41. During the past month, how much of the time did you feel that things were going
well for you?
42. Have you eaten when you wanted to during the past month?
43. During the past month, how often did you feel nauseated after eating?
44. Over the past month, how well do you feel you have understood your diabetes?
Kuesioner Indonesia

Pengukuran Dampak Nyeri Neuropatik Perifer Diabetik

1. Seberapa sering Anda merasa terganggu oleh rasa haus dan buang air kecil yang
berlebihan selama sebulan terakhir?
2. Selama sebulan terakhir, apakah Anda pernah merasa cemas atau khawatir?
3. Selama sebulan terakhir, pernahkah Anda merasa optimis dengan diabetes Anda?
4. Seberapa baik kekuatan dan daya tahan otot Anda selama sebulan terakhir?
5. Selama sebulan terakhir, apakah Anda merasa terganggu dengan penglihatan yang
kabur?
6. Selama sebulan terakhir, berapa banyak olahraga yang dapat Anda lakukan tanpa
mengembangkan gula darah rendah?
7. Selama sebulan terakhir, pernahkah Anda merasa bahwa Anda pandai melakukan
hal terpenting yang Anda lakukan (misalnya, pekerjaan, sekolah, mengurus
rumah, mengasuh anak, menangani urusan pribadi)?
8. Selama sebulan terakhir, seberapa banyak Anda merasa secara pribadi
bertanggung jawab untuk mengelola diabetes Anda?
9. Selama sebulan terakhir, berapa banyak energi yang Anda miliki?
10. Selama sebulan terakhir, seberapa nyenyak Anda tidur?
11. Selama sebulan terakhir, seberapa khawatir Anda terhadap reaksi insulin atau
gula darah yang sangat rendah?
12. Sudahkah Anda memenuhi kewajiban dan tanggung jawab yang Anda rasakan
terhadap keluarga Anda selama sebulan terakhir?
13. Selama sebulan terakhir, apakah Anda pernah mengalami gangguan sembelit?
14. Apakah Anda pernah merasa tertekan selama sebulan terakhir?
15. Selama sebulan terakhir, apakah Anda merasa tidak nyaman atau repot meminum
obat diabetes (pil atau insulin)?
16. Selama sebulan terakhir, apakah Anda makan terlalu banyak?
17. Selama sebulan terakhir, apakah Anda merasa terganggu dengan rasa terbakar,
kesemutan, nyeri, atau mati rasa di kaki atau tangan Anda?
18. Selama sebulan terakhir, seberapa khawatir atau takut Anda terhadap masa
depan?
19. Apakah Anda sudah makan apa yang Anda inginkan selama sebulan terakhir?
20. Selama sebulan terakhir, apakah Anda merasa upaya untuk merawat diabetes
Anda sepadan?
21. Selama sebulan terakhir, seberapa sering Anda bisa berfungsi secara seksual
sebaik yang Anda inginkan?
22. Selama sebulan terakhir, apakah Anda mengembangkan gula darah rendah
dengan olahraga?
23. Apakah Anda berfungsi dengan baik, tidak dibatasi oleh kesehatan Anda, dalam
pekerjaan Anda yang biasa (mengurus rumah, sekolah, bekerja, dll ) selama
sebulan terakhir ?
24. Seberapa sering Anda muntah setelah makan selama sebulan terakhir?
25. Selama sebulan terakhir, seluruh jadwal aktivitas saya dibatasi oleh diabetes saya
26. Selama sebulan terakhir, apakah Anda pernah merasa pusing atau pusing saat
duduk atau berdiri?
27. Berapa kali, selama sebulan terakhir, kehidupan sehari-hari Anda dipenuhi
dengan hal-hal yang menarik bagi Anda?
28. Secara keseluruhan, selama sebulan terakhir, menurut Anda bagaimana kondisi
diabetes Anda?
29. Apakah nafsu makan Anda baik selama sebulan terakhir?
30. Selama sebulan terakhir, apakah Anda pernah berpartisipasi dan menikmati
kehidupan keluarga?
31. Selama sebulan terakhir, seberapa sering Anda dapat berfungsi dengan baik
dalam pekerjaan yang biasa Anda lakukan (mengurus rumah, sekolah, bekerja,
dll.)?
32. Seberapa tinggi minat Anda terhadap seks selama sebulan terakhir?
33. Seberapa sering Anda mengalami ketidaknyamanan perut setelah makan selama
sebulan terakhir?
34. Seberapa sering selama sebulan terakhir Anda merasa tidak yakin tentang berapa
banyak yang harus dimakan dan / atau berapa banyak insulin yang harus
dikonsumsi?
35. Apakah Anda menikmati kegiatan sosial dan rekreasi selama sebulan terakhir?
36. Selama sebulan terakhir, apakah Anda merasa berguna?
37. Selama sebulan terakhir, seberapa sering Anda kekurangan energi?
38. Seberapa sering Anda mengalami diare selama sebulan terakhir?
39. Selama sebulan terakhir, apakah Anda sudah bisa mengikuti rekomendasi medis
terkait diabetes Anda?
40. Selama sebulan terakhir, apakah pemantauan diabetes Anda mengganggu atau
mengganggu Anda?
41. Selama sebulan terakhir, berapa banyak waktu yang Anda rasakan bahwa segala
sesuatunya berjalan baik untuk Anda?
42. Apakah Anda sudah makan kapan pun Anda mau selama sebulan terakhir?
43. Seberapa sering Anda merasa mual setelah makan selama sebulan terakhir?
44. Selama sebulan terakhir, seberapa baik Anda merasa memahami diabetes Anda?