The Big BSF Survey

1. The Questions

The British Skin Foundation survey should take no more than a couple of minutes to complete. Please be as honest as you can. For those questions that do not apply, please ignore and move to the next. Thank you!

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* 1. Do you currently or have in the past lived with a skin condition?

Yes

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* 2. If yes, which of the following has had the biggest effect on your life?

Eczema

Psoriasis

Dermatitis

Acne

Skin Cancer

Vitiligo

Ichthyosis

Birthmarks

Leg ulcers

Rosacea

Impetigo

Other (please specify)

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* 3. Have you been hospitalised as a result of your skin disease?

Yes

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* 4. If you have been hospitalised because of your condition, how long was this for?

One to three days

Up to a week

A month

Between one and three months

More than four months but less than a year

Over a year

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* 5. How would you categorise the level of pain you have as a result of your condition?

I do not suffer pain

Low amounts of pain – tolerable pain that does not hinder you from day to day activities

Medium amounts of pain –but still tolerable

High amounts of pain – intense enough to hinder you from doing what you want – but recedes given time

Constant pain that never stops

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* 6. On average how much sleep do you lose on an average week as a result of your skin disease?

I have no problems sleeping

I lose about an hour to 2 hours

I lose about 3 to 5 hours

I lose over 5 hours a week in sleep

I barely sleep

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* 7. What area of your life does skin disease have the biggest impact on? (Please indicate your top three)

	The most	Second Most	Third Most
Relationship with your family	Relationship with your family The most	Relationship with your family Second Most	Relationship with your family Third Most
Relationship with your friends	Relationship with your friends The most	Relationship with your friends Second Most	Relationship with your friends Third Most
Sexual relations	Sexual relations The most	Sexual relations Second Most	Sexual relations Third Most
Self confidence	Self confidence The most	Self confidence Second Most	Self confidence Third Most
Work life	Work life The most	Work life Second Most	Work life Third Most
Your children	Your children The most	Your children Second Most	Your children Third Most
Making new friends	Making new friends The most	Making new friends Second Most	Making new friends Third Most
Finding a partner	Finding a partner The most	Finding a partner Second Most	Finding a partner Third Most

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* 8. If you are affected by someone else’s skin disease, how much time would you say you spend caring for this person (e.g. applying cream, bathing, taking to hospital, caring for at night etc):

Less than an hour a week in total

Between one and four hours a week

Between four and eight hours a week

Between eight and twelve hours a week

Over twelve hours a week

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* 9. Have you ever had a relationship end because of your skin disease?

Yes