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  1. Appendix C
    1. PARTICIPANT QUESTIONNAIRE
    2. QUESTIONS:
    3. Thank you again for helping us with our research project, we truly appreciate this opportunity to learn about your experience using Sherish℠ Connect.

Appendix C

PARTICIPANT QUESTIONNAIRE

Thank you for agreeing to participate in our study. We are conducting this research to study the effect of Sherish℠ Connect on residents at (Residential Living Facility). I will read you the questions and answer options and you may follow along on your copy. Please answer the questions out loud to the best of your ability. Are you ready to begin?

QUESTIONS:

  1. How frequently are you in contact with your family? (including physical visit, phone calls, electronic conversations, or other modes of communication) 1= never, 2= yearly, 3= monthly, 4= weekly, 5= daily

  2. How do you stay connected with your family outside of visits? (choose all that apply, may be more than one) a. Phone calls; b. Sherish℠ Connect; c. letters/cards; d. email/social technology

  3. How often does your family come to visit in person? 1= never, 2= yearly, 3= monthly, 4= weekly, 5= daily

  4. How often do you use Sherish℠ Connect? 1= never, 2= yearly, 3= monthly, 4= weekly, 5= daily

  5. When you view Sherish℠ Connect photos do they cause an emotional response? (emotional response and include, but are not limited to: joy, sadness, anger, excitement) 1= never, 2=rarely, 3=occasionally, 4=often, 5= always

  6. Which emotion do you feel most often when seeing photos? a. Happy; b. Sad; c. Sentimental; d. Angry; e. Other ____

  7. How often does Sherish℠ Connect bring you comfort? 1= never, 2= rarely, 3= occasionally, 4= often, 5= always

  8. How do you most enjoy seeing photos? Please list your answers from most preferred to least preferred. a. Albums, b. Frames, c. TV, d. Loose Prints (prioritize)

  9. Do photos help you remember past events or people? 1 = not at all, 2 = rarely, 3 = occasionally, 4 = often, 5 = always

  10. Do you feel like you are missing out on current activities with loved ones? 1 = never, 2 = rarely, 3 = occasionally, 4 = often, 5 = always

  11. Can you enjoy your old photos easily? (are they easily accessible and available to you?) 1 = not at all, 2 = with much difficulty, 3 = with some difficulty, 4 = with almost no difficulty, 5= with ease

  12. Do you share photos and memories during in person family visits? 1 = never, 2 = rarely, 3 = occasionally, 4 = often, 5 = every visit

  13. Do you find yourself waiting for your loved ones to upload new pictures to Sherish℠ Connect? 1 = never, 2 = rarely, 3 = occasionally, 4 = often, 5 = always

  14. How often do you feel that you connect, or have a lot in common with those around you? 1 = never, 2 = rarely, 3 = occasionally, 4 = often, 5 = always

  15. How often do you feel lonely, or isolated from others? 1 = never, 2 = rarely, 3 = occasionally, 4 = often, 5 = always

Thank you again for helping us with our research project, we truly appreciate this opportunity to learn about your experience using Sherish℠ Connect.


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