From: Validation of a questionnaire measuring the regulation of autonomic function
Non-validated items on autonomic regulation | Responses | ||
---|---|---|---|
At what age did you need your first pair of glasses?I | |||
If you tend towards vertigo, how long do your vertigo attacks usually last?I | seconds | minutes | hours |
Do you take laxatives?II | frequently | occasionally | never |
At what time of day do you usually have bowel movements?II | morning | midday | evening |
You need your glasses – if at all – to see things in focus... (this question does not distinguish between farsightedness in old age and youth).III | nearby | no glasses necessary | in the distance |
What type of flavours do you prefer at breakfast?III | sweet | indifferent | salty |
Until 35 years of age you needed glasses to improve your vision because you were...III | short-sighted | no glasses necessary | far-sighted |
Do you drink sweetened tea or coffee?III | rarely | occasionally | frequently |
When taking a walk, do you usually notice anything of interest ...III | close by (i.e. on indifferent far away the ground etc.) (horizon etc.) | ||
Do you usually have bowel movements after meals?III | rarely | occasionally | frequently |
Do you remember dreaming?IV | frequently | occasionally | rarely |
Did you experience dental problems early in your youthIV | frequently | occasionally | rarely |
Do you consider yourself to be skilful and dexterous?IV | rarely | occasionally | frequently |
Can you cope with eating big meals?IV | hardly | reasonably well | very well |
Validated items | Possible answers On autonomic regulation | ||
Low = 1 | average = 2 | high = 3 | |
Do you suffer from dizzy spells? | frequently | occasionally | never |
Do you suffer from dizziness when you look down from a height? | frequently | occasionally | never |
Do you suffer from dizziness when you get up in the morning? | frequently | occasionally | never |
Do you suffer from dizziness when you straighten up or bend down? | frequently | occasionally | never |
Do you tend to have cold or cold-sweaty hands even in the warmer months? | frequently | occasionally | rarely |
Do you suffer from travel sickness (e.g. sea sickness)? | frequently | occasionally | almost/never |
Do you get dizzy from circular motions (when on a roundabout, for example)? | frequently | occasionally | almost/never |
Orthostatic-circulatory regulation | |||
Do you have to pull yourself together to go to work? | frequently | occasionally | rarely |
Do you feel rested in the morning | rarely | occasionally | frequently |
Do you have problems falling asleep? | frequently | occasionally | rarely |
Do you tend to sweat? | frequently | occasionally | rarely |
Do you suffer from disturbed sleep? | frequently | occasionally | rarely |
At what time of the day do you feel most comfortably? | evening | in the middle of the day | morning |
Do you tend to sweat at night? | frequently | occasionally | rarely |
Do you tend to have stomach growling? | frequently | occasionally | rarely |
Rest/activity regulation | |||
How often do you have bowel movements? | <1/day | approx. 1/day | >1/day |
Do you normally have bowel movements at regular times? | rarely | occasionally | frequently |
Do you suffer from constipation? | frequently | occasionally | rarely |
Digestive regulation | |||
18 item sumscale |