King’s Sarcoidosis Questionnaire

This questionnaire is designed to assess the impact of sarcoidosis on various aspects of your life. Read each question carefully and select the answer that best applies to you. Please answer ALL questions, as honestly as you can. This questionnaire is confidential. All questions relate to how SARCOIDOSIS has affected your health.

General Health Status

In the last 2 weeks ...

1. I have felt frustrated
2. I have had trouble concentrating
3. I have lacked motivation
4. I have felt tired
5. I have felt anxious
6. I have felt aches and pains in my muscles/joints
7. I have felt embarrassed
8. I have worried about my weight
9. I have worried about my sarcoidosis
10. Tiredness has interfered with my normal social activities such as going out with friends/family


Does sarcoidosis affect your lungs? yes   no (go to next section)

In the last 2 weeks ...

11. My cough has caused pain/discomfort
12. I have been breathless climbing stairs or walking up slight inclines
13. I have had to take deep breaths, also known as ‘air hunger’
14. My chest has felt tight
15. I have had episodes of breathlessness
16. I have experienced chest pains


Are you taking any medication for sarcoidosis? yes   no (go to next section)

In the last 2 weeks ...

17. I have worried about side effects of my medication for sarcoidosis
18. I have felt worse because of my medication
19. I have gained weight because of my medication


Does sarcoidosis affect your skin? yes   no (go to next section)

In the last 2 weeks ...

20. I have been bothered by my skin problems
21. I have been concerned about changes in colour of my skin lesions
22. I have been embarrassed about my skin


Does sarcoidosis affect your eyes? yes   no (go to the end of the questionnaire)

In the last 2 weeks ...

23. I have had dry eyes
24. I have had difficulty with bright lights
25. My eyes have been red
26. I have had pain in/or around the eyes
27. I have had difficulty reading
28. I have had blurred vision
29. I have been worried about my eyesight



By Gosker Digital Solutions          © Dr S Birring 2010 (v8). King’s College Hospital NHS Trust         Enquiries from study investigators to

Patel AS et al. The development and validation of the King's Sarcoidosis Questionnaire for the assessment of health status. Thorax. 2013; 68 (1):57-65.