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5-QSI-AP English

The document outlines the 5-Question Stigma Indicator designed to assess the stigma faced by individuals affected by leprosy. It includes a series of questions regarding employment, social interactions, and personal feelings related to having leprosy, with a scoring system for responses. Additionally, it contains sections for respondent details and a disclaimer about the intellectual property of the tool.

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cherry136971
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7 views1 page

5-QSI-AP English

The document outlines the 5-Question Stigma Indicator designed to assess the stigma faced by individuals affected by leprosy. It includes a series of questions regarding employment, social interactions, and personal feelings related to having leprosy, with a scoring system for responses. Additionally, it contains sections for respondent details and a disclaimer about the intellectual property of the tool.

Uploaded by

cherry136971
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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The 5-QSI-AP in English

Often/ usually

Do not know
5-Question Stigma Indicator - Affected People

Sometimes

SCORE
Never
In the past year:
No

Have you experienced problems in finding or keeping work because


1 0 1 2 0
you have (had) Leprosy?
Have you been worried about others finding out you have (had)
2 0 1 2 0
leprosy?
3 Have you ever felt ashamed because you have (had) leprosy? 0 1 2 0
Have you had problems getting married / in your marriage because of
4 0 1 2 0
having (had) leprosy
5 Have people tried to avoid you because you have (had) leprosy? 0 1 2 0

Total

Time:
Comment: _________________________________________________

___________________________________________________________

Respondent Name: __________________________________________

Respondent number: _________________________________________

Interviewer: _________________________________________________

Date of interview: ____ / ____ / ____

Disclaimer: The 5 – Questions Stigma Indicator – Affected Persons is the intellectual property of the NTD-Toolkit development team.
Neither the team nor its sponsors can be held responsible for any consequences of the use of the 5 – Questions Stigma Indicator –
Affected Persons.

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