Wolf Pack Post-Evaluation for Adults ID# (Please insert the number from the evaluation form included in your wolfpack) Use the following scale to answer question 1 1 = not at all 2 = once in a while 3 = sometimes 4 = a lot 5 = all the time 1. I can talk to my family members about: a. My fears about lupus 1 2 3 4 5 b. My feelings in general 1 2 3 4 5 c. My problems in general 1 2 3 4 5 d. My aches and pains 1 2 3 4 5 e. What's different in my life since I got sick 1 2 3 4 5 f. Helping me find solutions to problems when I get sick 1 2 3 4 5 Comments: 2. When I feel sick or down or tired, I (check all that apply) Rest Talk to my family Talk to friends Do something quiet like read or watch TV Cry, get mad, or otherwise show my feelings Push myself to work or play harder Get away from everybody Try to do or think of something funny Get upset and feel sorry for myself Other Comments: Use the following scale to answer question 3. 1 = not at all 2 = a little confident 3 = fairly confident 4 = usually confident 5 = very confident 3. How confident are you in your knowledge of: a. Lupus symptoms 1 2 3 4 5 b. Lupus treatments 1 2 3 4 5 c. Lupus laboratory tests 1 2 3 4 5 d. How Lupus affects families 1 2 3 4 5 e. Legal or employment issues 1 2 3 4 5 f. Insurance issues related to Lupus 1 2 3 4 5 g. Psychological or emotional issues related to Lupus 1 2 3 4 5 Comments: Use the following scale to answer questions 4 - 7. 1. not at all 2. a little 3. somewhat 4. a lot 5. extremely 4. I found __________________ to be helpful. a. Tame the Wolf Game 1 2 3 4 5 b. Coloring book 1 2 3 4 5 c. "Are You Tired Again? I Understand" book 1 2 3 4 5 5. The Wolf Pack kit was easy to read and understand 1 2 3 4 5 6. I would be comfortable telling my friends about the kit 1 2 3 4 5 7. My family and I enjoyed using the Wolf Pack 1 2 3 4 5 8. I liked other contents of the Wolf Pack (please list below) 9. The thing I liked best about the Wolf Pack was: 10. The thing I liked least about the Wolf Pack was: Additional Comments:
