288 lines
16 KiB
Markdown
288 lines
16 KiB
Markdown
# Wheel of Wellness — Full Question Bank
|
||
|
||
Each audience variant contains 18 questions (3 per dimension). Items are mapped to their source instrument and adapted at or below a 4th-grade reading level. Response options use a consistent 4-point scale per audience.
|
||
|
||
---
|
||
|
||
## 1. Generalized (All Audiences)
|
||
|
||
**Source instruments:** WHO-5 Well-Being Index (WHO, 1998); PROMIS Global Health-10 (NIH, 2009)
|
||
**Response scale:** Almost all the time · More than half the time · Some of the time · Once in a while
|
||
|
||
### Physical Wellness 💪
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| G1 | In the past month, how often have you felt tired or worn out? | PROMIS Global08 | Fatigue item (reverse-scored) |
|
||
| G2 | How would you rate your overall physical health right now? | PROMIS Global01 | General health rating |
|
||
| G3 | In a typical week, how often do you move your body in a way that feels good (walking, stretching, playing)? | PROMIS Global06 | Everyday physical activities |
|
||
|
||
### Emotional Wellness 💗
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| G4 | In the past two weeks, how often have you felt calm and at ease? | WHO-5 Item 2 | Calm and relaxed |
|
||
| G5 | In the past two weeks, how often have you felt cheerful or in good spirits? | WHO-5 Item 1 | Cheerful and in good spirits |
|
||
| G6 | How often have you felt worried, sad, or upset in a way that was hard to shake? | PROMIS Global10 | Emotional problems (reverse-scored) |
|
||
|
||
### Social Wellness 🤝
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| G7 | Do you have people in your life you can count on when things get hard? | PROMIS Global05 | Satisfaction with social activities and relationships |
|
||
| G8 | How satisfied are you with how you get along with the people closest to you? | PROMIS Global05 | Social relationships |
|
||
| G9 | In the past month, how often have you felt alone even when other people were around? | WHO-5 (adapted) | Social connectedness (reverse-scored) |
|
||
|
||
### Daily Life Wellness 📋
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| G10 | How confident are you that you can handle everyday tasks like bills, forms, and schedules? | PROMIS Global06 | Everyday activities capacity |
|
||
| G11 | In the past two weeks, how often has your sleep been restful? | PROMIS Global09 | Sleep quality |
|
||
| G12 | How safe do you feel in your home and neighborhood? | PROMIS (adapted) | Personal safety |
|
||
|
||
### Purpose Wellness ⭐
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| G13 | In the past two weeks, how often has your daily life been filled with things that interest you? | WHO-5 Item 5 | Daily life filled with interest |
|
||
| G14 | How would you rate your quality of life right now? | PROMIS Global02 | Quality of life |
|
||
| G15 | Do you feel like your life has meaning or direction? | WHO-5 (adapted) | Purpose and meaning |
|
||
|
||
### Growth Wellness 🌱
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| G16 | In the past two weeks, how often have you felt active and full of energy? | WHO-5 Item 3 | Active and vigorous |
|
||
| G17 | Are you learning or trying anything new right now? | WHO-5 (adapted) | Interest and engagement |
|
||
| G18 | How often do you make time for things that help you grow (reading, classes, hobbies)? | PROMIS (adapted) | Personal development |
|
||
|
||
---
|
||
|
||
## 2. Parent / Caregiver
|
||
|
||
**Source instruments:** CWBS-SF (Tebb & Berg-Weger, 2016); CAREPAL-8 (Ullrich et al., 2024); Preparedness for Caregiving Scale (Archbold et al., 1990)
|
||
**Response scale:** Almost every day · More days than not · Once in a while · Rarely
|
||
|
||
### Physical Wellness 💪
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| P1 | When did you last see a doctor for YOUR own health check? | CWBS-SF | Basic needs: self-care |
|
||
| P2 | In the past month, how often have you felt tired or worn out from caregiving? | CAREPAL-8 Item 2 | PHQ-9 fatigue item |
|
||
| P3 | In a typical week, how often do you get enough sleep? | CWBS-SF | Physical well-being |
|
||
|
||
### Emotional Wellness 💗
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| P4 | How often do you feel worn out or weighed down by all you have to do? | CAREPAL-8 Item 2 | PHQ-9 fatigue / burden |
|
||
| P5 | In the past two weeks, how often have you been bothered by not being able to stop or control worrying? | CAREPAL-8 Item 1 | GAD-7 worry item |
|
||
| P6 | How often do you feel like you are doing a good job as a caregiver? | Preparedness Scale | Perceived competence |
|
||
|
||
### Social Wellness 🤝
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| P7 | Do you have someone who can watch your kids so you can take a break? | CWBS-SF | Respite and support |
|
||
| P8 | Is there someone you can talk to honestly about how hard caregiving can be? | CAREPAL-8 (adapted) | Emotional support |
|
||
| P9 | How often do you spend time with friends or do something fun for yourself? | CWBS-SF | Personal time |
|
||
|
||
### Daily Life Wellness 📋
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| P10 | How confident are you about handling school meetings, doctor visits, and paperwork for your family? | Preparedness Scale | System navigation readiness |
|
||
| P11 | Does your family have the money and resources to cover your basic needs? | CAREPAL-8 Items 5-8 (adapted) | Financial / material needs |
|
||
| P12 | Are you able to get the services and supports your family member with a disability needs? | CAREPAL-8 Items 5-7 | Information and service needs |
|
||
|
||
### Purpose Wellness ⭐
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| P13 | Do you feel accepted and respected by the professionals who work with your family? | CAREPAL-8 Item 8 | Professional acceptance |
|
||
| P14 | How often do you feel like your role as a caregiver gives your life meaning? | Preparedness Scale (adapted) | Role meaning |
|
||
| P15 | Is there anything outside of caregiving that is important to who you are? | CWBS-SF | Identity beyond caregiving |
|
||
|
||
### Growth Wellness 🌱
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| P16 | Are you learning new things about how to support your family member? | Preparedness Scale | Knowledge growth |
|
||
| P17 | How often do you feel stuck or like nothing you do makes a difference? | CAREPAL-8 (adapted) | Helplessness / stagnation (reverse-scored) |
|
||
| P18 | In the past month, have you done anything just for you (a class, a hobby, time with a friend)? | CWBS-SF | Personal growth activity |
|
||
|
||
---
|
||
|
||
## 3. Family Member / Household
|
||
|
||
**Source instruments:** Beach Center FQOL (Hoffman et al., 2006); FQoLS (Brown et al., 2006)
|
||
**Response scale:** Very satisfied · Satisfied · Neither satisfied nor dissatisfied · Dissatisfied
|
||
|
||
### Physical Wellness 💪
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| F1 | Do members of your family get the medical care they need when they need it? | FQOL Item 19 | Physical/Material: medical care |
|
||
| F2 | Does your family feel safe at home, work, school, and in the neighborhood? | FQOL Item 21 | Physical/Material: safety |
|
||
| F3 | Does your family have transportation to get to the places you need to be? | FQOL Item 17 | Physical/Material: transportation |
|
||
|
||
### Emotional Wellness 💗
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| F4 | Does your family have the support you need to handle stress? | FQOL Item 13 | Emotional Well-Being: stress support |
|
||
| F5 | Do family members have some time to pursue their own interests? | FQOL Item 15 | Emotional Well-Being: personal time |
|
||
| F6 | Do family members have outside help available for special needs? | FQOL Item 16 | Emotional Well-Being: outside help |
|
||
|
||
### Social Wellness 🤝
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| F7 | Do family members have friends or others outside the home they can lean on? | FQOL Item 14 | Emotional Well-Being: external support |
|
||
| F8 | Does your family enjoy spending time together? | FQOL Item 1 | Family Interaction: enjoyment |
|
||
| F9 | Do family members show that they love and care for each other? | FQOL Item 5 | Family Interaction: affection |
|
||
|
||
### Daily Life Wellness 📋
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| F10 | Are you able to get the services and supports your family member with a disability needs? | FQOL Items 22-25 | Disability-Related Support |
|
||
| F11 | Does your family have a way to take care of expenses? | FQOL Item 20 | Physical/Material: finances |
|
||
| F12 | Does your family have a good relationship with the service providers who work with your family member? | FQOL Item 25 | Disability-Related Support: providers |
|
||
|
||
### Purpose Wellness ⭐
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| F13 | Does your family solve problems together? | FQOL Item 3 | Family Interaction: problem-solving |
|
||
| F14 | Do family members support each other to accomplish goals? | FQOL Item 4 | Family Interaction: goal support |
|
||
| F15 | Does your family feel like it is handling life's ups and downs well? | FQOL Item 6 | Family Interaction: resilience |
|
||
|
||
### Growth Wellness 🌱
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| F16 | Do family members help the children learn to be independent? | FQOL Item 7 | Parenting: independence |
|
||
| F17 | Do adults in the family know other people in the children's lives (friends, teachers)? | FQOL Item 11 | Parenting: involvement |
|
||
| F18 | Do family members talk openly with each other? | FQOL Item 2 | Family Interaction: communication |
|
||
|
||
---
|
||
|
||
## 4. Professional (Therapists, Counselors, Coaches, Educators, Healthcare Workers)
|
||
|
||
**Source instruments:** ProQOL-5 (Stamm, 2010); OLBI (Demerouti et al., 2003)
|
||
**Response scale:** Almost every day · Several days a week · Once in a while · Rarely
|
||
|
||
### Physical Wellness 💪
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| PR1 | How often do you feel physically drained after your workday? | ProQOL-5 Item 19 (adapted) | Burnout: worn out |
|
||
| PR2 | In the past month, how often have you lost sleep over the experiences of people you help? | ProQOL-5 Item 8 | Burnout: sleep disruption |
|
||
| PR3 | How often do you feel on edge or jumpy because of things you hear at work? | ProQOL-5 Item 5 | STS: startle response |
|
||
|
||
### Emotional Wellness 💗
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| PR4 | I find my work as a helper to be deeply satisfying. | ProQOL-5 Item 3 (adapted) | CS: satisfaction from helping |
|
||
| PR5 | How often do you feel depressed because of the experiences of people you help? | ProQOL-5 Item 13 | STS: depression from trauma |
|
||
| PR6 | How often do you feel overwhelmed because your workload seems endless? | ProQOL-5 Item 21 | Burnout: overwhelm |
|
||
|
||
### Social Wellness 🤝
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| PR7 | Do you have colleagues or peers you can talk with honestly about difficult cases? | ProQOL-5 (adapted) | Peer consultation / support |
|
||
| PR8 | How often do you feel connected to the people around you at work? | ProQOL-5 Item 4 (adapted) | Burnout-R: connectedness |
|
||
| PR9 | How often do you feel trapped by your job? | ProQOL-5 Item 10 | Burnout: trapped |
|
||
|
||
### Daily Life Wellness 📋
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| PR10 | How well do you maintain a boundary between your work and your personal life? | OLBI (adapted) | Disengagement: work-life boundary |
|
||
| PR11 | I am pleased with how I keep up with professional techniques and protocols. | ProQOL-5 Item 16 | CS: professional competence |
|
||
| PR12 | How often do you feel bogged down by the systems and rules at work? | ProQOL-5 Item 26 | Burnout: systemic frustration |
|
||
|
||
### Purpose Wellness ⭐
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| PR13 | I believe I can make a difference through my work. | ProQOL-5 Item 22 | CS: impact |
|
||
| PR14 | How often do you have happy thoughts about the people you help? | ProQOL-5 Item 20 | CS: positive regard |
|
||
| PR15 | Are you happy that you chose this line of work? | ProQOL-5 Item 30 | CS: career satisfaction |
|
||
|
||
### Growth Wellness 🌱
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| PR16 | I am pleased with how I am able to keep up with helping techniques and protocols. | ProQOL-5 Item 16 | CS: professional growth |
|
||
| PR17 | How often do you avoid situations that remind you of frightening things people you help have told you? | ProQOL-5 Item 23 | STS: avoidance (reverse-scored) |
|
||
| PR18 | Are you the person you always wanted to be in this work? | ProQOL-5 Item 17 (adapted) | Burnout-R: self-concept |
|
||
|
||
---
|
||
|
||
## 5. Special Needs / Accessible Format (Person with Disability)
|
||
|
||
**Source instruments:** PWI-ID (Cummins & Lau, 2005); adapted from WHO-5
|
||
**Response scale (emoji):** 😟 Not Good · 😐 Okay · 🙂 Pretty Good · 😊 Good · 😄 Very Good
|
||
**Note:** 12 items (2 per dimension). Support person may assist with reading.
|
||
|
||
### My Body 💪
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| SN1 | How do you feel about your health? | PWI-ID: Health | Health domain |
|
||
| SN2 | How do you feel about how safe you feel? | PWI-ID: Personal Safety | Safety domain |
|
||
|
||
### My Feelings 💗
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| SN3 | In the past two weeks, how often have you felt happy? | WHO-5 Item 1 (simplified) | Cheerful and in good spirits |
|
||
| SN4 | In the past two weeks, how often have you felt calm? | WHO-5 Item 2 (simplified) | Calm and relaxed |
|
||
|
||
### My People 🤝
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| SN5 | How do you feel about how you get along with people? Like your family and friends. | PWI-ID: Personal Relationships | Relationships domain |
|
||
| SN6 | How do you feel about doing things outside your home? Like in your community or neighborhood. | PWI-ID: Community Connectedness | Community domain |
|
||
|
||
### My Day 📋
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| SN7 | How do you feel about the things you have? Like your money and the things you own. | PWI-ID: Standard of Living | Material well-being |
|
||
| SN8 | How do you feel about how your day goes? Like your routine and what you do. | WHO-5 Item 5 (simplified) | Daily life filled with interest |
|
||
|
||
### What Matters ⭐
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| SN9 | How do you feel about the things you do or make? | PWI-ID: Life Achievement | Achievement domain |
|
||
| SN10 | How do you feel about your life as a whole? | PWI-ID: Global | Life as a whole (validity check) |
|
||
|
||
### Growing 🌱
|
||
|
||
| # | Question | Source | Adapted From |
|
||
|---|----------|--------|-------------|
|
||
| SN11 | How do you feel about what will happen to you later in your life? | PWI-ID: Future Security | Future security domain |
|
||
| SN12 | In the past two weeks, how often have you felt like doing things? | WHO-5 Item 3 (simplified) | Active and vigorous |
|
||
|
||
---
|
||
|
||
## Scoring Notes
|
||
|
||
- **Generalized, Parent/Caregiver, Family, Professional:** 18 items. Score per dimension = mean of 3 items × 25 (range: 0-100). Overall score = mean of all 6 dimension scores.
|
||
- **Special Needs:** 12 items. Score per dimension = mean of 2 items × 20 (range: 0-100). Overall score = mean of all 6 dimension scores.
|
||
- **Thresholds:** 0-39 = Needs Attention · 40-59 = Moderate · 60-100 = Strong
|
||
- All instruments are screening tools for self-reflection. Not diagnostic.
|
||
|
||
---
|
||
|
||
*Last updated: July 2026*
|
||
*Compiled for HELPipedia Wheel of Wellness / SpecialNeeds.help*
|