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Nebulizer Questionnaire

    Nebulizer Questionnaire


    The Feeling of Satisfaction with Inhaler (SOSD Group). We simply want to know your opinion on certain features of the inhaler.


    The primary outcome variable was quality of life measured by the validated, self-administered Respiratory Questionnaire, completed at baseline, 2 weeks, and 4 weeks.

    We simply want to know your opinion on certain features of the inhaler


    Choose only 1 response, the one that best reflects your opinion. There are no Right or Wrong answers. Please answer honestly and do not leave any questions unanswered.

    1. Full Name

    2. Remarks

    3. Date of Birth

    4. Your Age (Years)

    5. When the condition was first diagnosed? (Years)

    Please select between options
    1. 1. Has it been easy to learn and prepare how to use the inhaler? VeryFairlySomewhatNot veryHardly at all

    2. 2. Was it easy to continue normal activities with the use of the inhaler? VeryFairlySomewhatNot veryHardly at all

    3. 3. Carrying my asthma inhaler(s) can be cumbersome (e.g. size/weight). VeryFairlySomewhatNot veryHardly at all

    4. 4. My inhaler(s) helps me feel in control of my asthma symptoms VeryFairlySomewhatNot veryHardly at all

    5. 5. When I take my medication, I feel confident that my asthma Symptoms will be controlled VeryFairlySomewhatNot veryHardly at all

    6. 6. My asthma medication leaves a bad taste in my mouth VeryFairlySomewhatNot veryHardly at all

    7. 7. My asthma medication affects my voice VeryFairlySomewhatNot veryHardly at all

    8. 8. I feel confident in using my inhaler(s). VeryFairlySomewhatNot veryHardly at all

    9. 9. I worry that my inhaler is not giving me enough medication. VeryFairlySomewhatNot veryHardly at all

    10. 10. My asthma medication provides fast relief of my asthma symptoms. VeryFairlySomewhatNot veryHardly at all

    11. 11. I would recommend my inhaler(s) to other people with asthma VeryFairlySomewhatNot veryHardly at all

    12. 12. Ability to perform daily activities; VeryFairlySomewhatNot veryHardly at all

    13. 13. Breathlessness over the past 24 hours VeryFairlySomewhatNot veryHardly at all

    14. 14. Waking at night due to respiratory symptoms VeryFairlySomewhatNot veryHardly at all

    15. 15. Cough VeryFairlySomewhatNot veryHardly at all

    16. 16. Breathlessness on arising VeryFairlySomewhatNot veryHardly at all

    17. 17. Sputum production VeryFairlySomewhatNot veryHardly at all

    18. 18. Optional: What asthma treatment do you use and how much are you paying for it?