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Hello:
You are invited to participate in my culminating student project. For my culminating project, approximately 10 people will be asked to complete questionnaires that ask questions about Chronic Pain, participate in a Progressive Muscle Relaxation exercise, and a Sessions Rating Scale. It will take approximately 15 minutes to complete participation in my student project.
Your participation in this project is completely voluntary. The only foreseeable risks associated with this project may include physical or emotional discomfort. However, if you feel any discomfort you may skip any portion of the Progressive Muscle Relaxation exercise and/or withdraw from the project at any point.
Your responses to the questionnaires used in this project will be strictly confidential and data from this project will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the project or the procedures, you may contact Jennifer M. Burruel, MC, LPC, NCC at by email at the email address specified below. Your participation in this project will be considered your consent.
Thank you for your time and support.
Jennifer M. Burruel, MC, LPC, NCC
[email protected]
Please rate how confident you are that you can do the following things at present, despite the pain, where 0 = not at all confident and 6 = completely confident.
Remember, this questionnaire is not asking whether or not you have been doing these things, but rather how confident you are that you can do them at present, despite the pain.
Please start with the first questionnaire now by clicking on the Continue button below.
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| I can enjoy things, despite the pain. |
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| I can do most of the household chores (e.g. tidying-up, washing dishes, etc.), despite the pain. |
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| 3. I can socialize with my friends or family members as often as I used to do, despite the pain. |
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| I can cope with my pain in most situations. |
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| I can do some form of work, despite the pain. (“work” includes housework, paid and unpaid work). |
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| I can still do many of the things I enjoy doing, such as hobbies or leisure activity, despite pain. |
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| I can cope with my pain without medication. |
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| I can still accomplish most of my goals in life, despite the pain. |
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| I can live a normal lifestyle, despite the pain. |
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