EQ-5D-5L surveys

Thank you for taking the time to complete this survey. It is part of the evaluation for the South East London Enhanced Sickle Cell Community Service and should take no more than five minutes to complete. You will be asked questions about your health today.

This survey covers five dimensions of health: mobility, looking after myself, doing usual activities, having pain or discomfort, and feeling worried, sad or unhappy. You will be asked to rate the severity of each dimension. Please answer honestly.

Confidentiality: All responses will be kept confidential and used solely for the stated purposes. All recorded responses and published data will be anonymized, and no personally identifiable information will be shared.

To learn more about this survey, visit the EQ-5D-Y-5L website. If you have any questions, please contact gst-tr.selsicklecommunity@nhs.net.

Thank you for taking the time to complete this survey. It is part of the evaluation for the South East London Enhanced Sickle Cell Community Service and should take no more than five minutes to complete. You will be asked questions about your health today.

This survey covers five dimensions of health: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. You will be asked to rate the severity of each dimension. Please answer honestly.

We would like to follow up with you in 4–6 months to repeat the survey. Completing both surveys will help us assess whether the Enhanced Sickle Cell Community Service is having a positive impact on the quality of life within the sickle cell community. To allow us to contact you for the follow-up survey, please provide your email address in the survey.

Confidentiality: All responses will be kept confidential and used solely for the stated purposes. All recorded responses and published data will be anonymized, and no personally identifiable information will be shared.

To learn more about this survey, visit the EQ-5D-5L website. If you have any questions, please contact gst-tr.selsicklecommunity@nhs.net.

Thank you for taking the time to complete this survey. It is part of the evaluation for the South East London Enhanced Sickle Cell Community Service and should take no more than five minutes to complete. You will be asked questions about the child’s health today.

This survey covers five dimensions of health: mobility, looking after myself, doing usual activities, having pain or discomfort, and feeling worried, sad, or unhappy. It is important that the child’s own perspective is reflected in the responses. Please involve the child in answering each question and encourage them to share their honest feelings.

We would like to follow up with the child in 4–6 months to repeat the survey. Completing both surveys will help us assess whether the Enhanced Sickle Cell Community Service is having a positive impact on the quality of life within the sickle cell community. To allow us to contact you for the follow-up survey, please provide your email address in the survey.

Confidentiality: All responses will be kept confidential and used solely for the stated purposes. All recorded responses and published data will be anonymised, and no personally identifiable information will be shared.

To learn more about this survey, visit the EQ-5D-Y-5L website. If you have any questions, please contact gst-tr.selsicklecommunity@nhs.net. 

This is for parents/guardians of children ages 13-15 who have filled in the EQ-5D-Y-5L survey. We would like to follow up with you in 4–6 months for your child to repeat the survey. Completing both surveys will help us assess whether the Enhanced Sickle Cell Community Service is having a positive impact on the quality of life within the sickle cell community. To allow us to contact you for the follow-up survey, please provide your email address in the survey.

Confidentiality: All responses will be kept confidential and used solely for the stated purposes. All recorded responses will be anonymized, and no personally identifiable information will be shared.

To learn more about this survey, visit the EQ-5D-5L website. If you have any questions, please contact gst-tr.selsicklecommunity@nhs.net.