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Diabetes Burnout Questionnaire

Assess Your Risk of Diabetes Burnout

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Updated August 07, 2009

Diabetes Burnout Questionnaire
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Sometimes it is difficult to accurately assess whether we are experiencing diabetes burnout. Here is a brief questionnaire that might help you make that call.

Designed by William H. Polonsky, author of Diabetes Burnout: What to Do When You Can't Take It Anymore. Used with permission.

Please choose a number from 1 and 6 that indicates the degree to which you experience these items not whether you ever experience them.

Scale: Not a problem (1) (2); Moderate problem (3) (4); Serious problem (5) (6)

1. I feel that diabetes takes up a large part of my mental and physical energy each day.
Score: 1 2 3 4 5 6

2. I feel “burned out” by the constant effort to manage my diabetes.
Score: 1 2 3 4 5 6

3. I feel that I am often failing in what I know I should be doing with my diabetes routine.
Score: 1 2 3 4 5 6

4. I feel that diabetes controls my life.
Score: 1 2 3 4 5 6

5. I struggle with motivation to keep practicing my diabetes management routine.
Score: 1 2 3 4 5 6

6. I feel overwhelmed with all that I have to learn and practice on a daily basis to maintain my diabetes.
Score: 1 2 3 4 5 6

Moderately distressed -- A total score of 13 to 20 is somewhat higher than average, indicating that you are feeling more unhappy about your diabetes than do most people.

Very distressed -- If your total score is 21 to 26, your emotional emotional battle with diabetes is pretty serious. There is a good likelihood that you are struggling with diabetes burnout.

Extremely distressed -- If you scored 27 or higher, there can be little doubt that you are at war with your diabetes. Scores this high are rare. Diabetes burnout is all but certain.

Learn how you can begin to fight against diabetes burnout with five proactive tips to help you stay hopeful and healthy.

Source:

Polonsky, William H. Diabetes Burnout: What to Do When You Can’t Take It Anymore. Alexandria: American Diabetes Association. 1999.

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