Harmony Check

is an academic, well-rounded, and comprehensive socio-psychological questionnaire whose aim is to find suitable caregivers for patients in 24-hour care. The questionnaire is divided into 4 parts:

  • 1. demographic information;
  • 2. general information about emotions;
  • 3. social preferences;
  • 4. personal and emotional traits.

Mark the degree of urbanization of the place you live in:

densely-populated (urban) area

intermediate area

thinly-populated (rural) area

Are you:

an only child

have one sibling

have two or more siblings

Please mark each of the activities on a scale 1 to 5, where the numbers signify the following:

  • 1 I dislike entirely
  • 2 I dislike slightly
  • 3 I neither like nor dislike
  • 4 I like slightly
  • 5 I like very much
  • I dislike entirely
  • I dislike slightly
  • I neither like nor dislike
  • I like slightly
  • I like very much

I spend fondly time with individual hobbies (knitting, sawing, sculpting, doing crosswords, puzzles, etc.)

  • 1
  • 2
  • 3
  • 4
  • 5

I talk fondly about the past and days gone by

  • 1
  • 2
  • 3
  • 4
  • 5

Can you remember names and faces of family members and loved ones:

I can do it easily alone

I cannot do it easily alone

I need help to do it

I wish that my caregiver is relaxed and handless stress well

  • 1
  • 2
  • 3
  • 4
  • 5

I wish that my caregiver is calculated and set on following strict plans

  • 1
  • 2
  • 3
  • 4
  • 5

I wish that my caregiver is restrained

  • 1
  • 2
  • 3
  • 4
  • 5

Following is a list of different activities which people do in everyday life. Next to each activity there is an answer scale. Please mark the frequency of your undertaking for these activities. The values of the scale are as numbered:

  • 1 Never
  • 2 Not during the last year
  • 3 Once or twice during the last year
  • 4 Three to ten times during the last year
  • 5 More than ten times during the last year
  • Never
  • Not during the last year
  • Once or twice during the last year
  • Three to ten times during the last year
  • More than ten times during the last year

How often do you or did you grow houseplants?

  • 1
  • 2
  • 3
  • 4
  • 5

How often do you or did you buy an additional piece for your collection?

  • 1
  • 2
  • 3
  • 4
  • 5

How often do you or did you visit a museum or a gallery?

  • 1
  • 2
  • 3
  • 4
  • 5

How often do you or did you keep a diary?

  • 1
  • 2
  • 3
  • 4
  • 5