Emotion Reference Sheet

Angry Sad Anxious Hurt Embarrassed Happy

Grumpy Disappointed Afraid Jealous Isolated Thankful

Frustrated Mournful Stressed Betrayed Self-conscious Trusting

Annoyed Regretful Vulnerable Isolated Lonely Comfortable

Defensive Depressed Confused Shocked Inferior Content

Spiteful Paralyzed Bewildered Deprived Guilty Excited

Impatient Pessimistic Skeptical Victimized Ashamed Relaxed

Disgusted Tearful Worried Aggrieved Repugnant Relieved

Offended Dismayed Cautious Tormented Pathetic Elated

Irritated Disillusioned Nervous Abandoned Confused Confident

Source: Susan David
 Emotional seven-point scale

Strong negative Negative Slightly Neutral Slightly Positive Strong positive

emotions emotions negative positive emotions emotions
emotions emotions
 Symptom four-point scale

No symptoms Mild symptoms Moderate symptoms Severe symptoms

Resource reference sheet:
A few examples of relationships

Family Doctors Counselors Faith-based

(e.g. spouse, children) (e.g. family doctor, hematologist, (e.g. financial, emotional, Support
oncologist) mental health) (e.g. church, temple)

Caregivers & Caretakers Nurses Patient Support Case Managers

(e.g. family, friends, hired support) (e.g. infusion nurse, nurse Groups (e.g. advocacy, (e.g. drug manufacturer
foundations, societies) services, insurance)
practitioner)

?Other
Friends & Acquaintances Pharmacists Coworkers
Who is it and what is
(e.g. others living with the same (e.g. local or specialty pharmacies) (e.g. employers or colleagues)
your relationship?
disease)
Resource reference sheet:
Tools & Resources

Websites Medication Trackers Hospitals Patient Support Groups

(e.g. WebMD, blogs) (e.g. journals, alarm apps, smart pill bottles) (e.g. clinics, seminars, workshops) (e.g. advocacy, foundations, societies)

?
Print Materials Chat Rooms & Pharmacy Other
(e.g. informative materials from Forums (e.g. online (e.g. local drug stores, Who is it and what is
doctors or other sources) anonymous discussions) specialty pharmacies) your relationship?

Apps Research Journals Drug

(e.g. on phones or tablets) (e.g. academic studies, clinical Manufacturer
trials, papers)
(e.g. pharmaceuticals)