Открыть главное меню

Изменения

Методика «Тип отношения к болезни»/Регистрационный лист

6494 байта добавлено, 11:59, 20 февраля 2013
Новая страница: «ФИО _______________________________________________ Возраст _______ Пол __________ В графе «Номера выбранных ответов…»
ФИО _______________________________________________

Возраст _______

Пол __________


В графе «Номера выбранных ответов» обведите кружком для каждой темы номера тех двух утверждении, которые наиболее для Вас подходят.



{| class="wikitable" width="600px"
! Темы утверждений
! colspan="17" | Номера выбранных ответов

|-
| 1. Самочувствие
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
| <center>12</center>
|
|
|
|
|

|-
| 2. Настроение
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
| <center>12</center>
| <center>13</center>
|
|
|
|

|-
| 3. Сон и пробуждение ото сна
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
| <center>12</center>
| <center>13</center>
| <center>14</center>
| <center>15</center>
| <center>16</center>
| <center>17</center>

|-
| 4. Аппетит и отношение к еде
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
|
|
|
|
|
|

|-
| 5. Отношение к болезни
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
| <center>12</center>
| <center>13</center>
| <center>14</center>
| <center>15</center>
| <center>16</center>
|

|-
| 6. Отношение к лечению
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
| <center>12</center>
| <center>13</center>
| <center>14</center>
| <center>15</center>
| <center>16</center>
|

|-
| 7. Отношение к врачам и медперсоналу
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
| <center>12</center>
| <center>13</center>
| <center>14</center>
|
|
|

|-
| 8. Отношение к родным и близким
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
| <center>12</center>
| <center>13</center>
|
|
|
|

|-
| 9. Отношение к работе (к учебе)
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
| <center>12</center>
| <center>13</center>
| <center>14</center>
| <center>15</center>
|
|

|-
| 10. Отношение к окружающим
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
| <center>12</center>
| <center>13</center>
| <center>14</center>
| <center>15</center>
| <center>16</center>
|

|-
| 11. Отношение к одиночеству
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
|
|
|
|
|
|

|-
| 12. Отношение к будущему
| <center>1</center>
| <center>2</center>
| <center>3</center>
| <center>4</center>
| <center>5</center>
| <center>6</center>
| <center>7</center>
| <center>8</center>
| <center>9</center>
| <center>10</center>
| <center>11</center>
| <center>12</center>
|
|
|
|
|

|}


{| class="wikitable"
| width="50px" | <div align="right">I</div>
| width="25px" |
| width="25px" |
| width="25px" |
| width="25px" |
| width="25px" |
| width="25px" |
| width="25px" |
| width="25px" |
| width="25px" |
| width="25px" |
| width="25px" |
| width="25px" |
| width="25px" |

|-
| <div align="right">II</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
| <div align="right">III</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
| <div align="right">IV</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
| <div align="right">V</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
| <div align="right">VI</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
| <div align="right">VII</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
| <div align="right">VIII</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
| <div align="right">IX</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
| <div align="right">X</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
| <div align="right">XI</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
| <div align="right">XII</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|-
|
| <center>Г</center>
| <center>Р</center>
| <center>З</center>
| <center>Т</center>
| <center>И</center>
| <center>Н</center>
| <center>М</center>
| <center>А</center>
| <center>Я</center>
| <center>С</center>
| <center>Э</center>
| <center>П</center>
| <center>Д</center>

|-
| <div align="right">Сумма</div>
|
|
|
|
|
|
|
|
|
|
|
|
|

|}


[[Файл:ТОБОЛ - Графический профиль.png|600px]]