Page 150 - IJB-8-1

3D Printed Hand Splints
Appendix

Questionnaire 1 for patients Questionnaire 2 for patients
Patient ID: Patient ID:
The following questionnaire will ask various questions. The following questionnaire will ask various questions.
Please answer these truthfully and completely. You will Please answer these truthfully and completely. Please judge
be asked about the properties of your splint as well as the the proprieties of the splints on a scale 1-10 (1=minimum,
manufacturing process. You should assign a grade from 1 10= maximum) and explain more specifically where
to 10 for each question (1= minimum, 10 = maximum). needed. Please relate your answers to the time interval
Feel free to contact us if you have any questions or from the last questionnaire. Feel free to contact us if you
difficulties. Thank you very much! have any questions or difficulties. Thank you very much!

A. How do you rate the general fit of your new splint? A. How do you rate the general fit of your splint?

B. How much pain do you have with the new splint? B. How much pain do you have with the splint?

C. How heavy is the new splint? C. How heavy is the splint?

D. Is the splint aesthetically pleasing? a. Did you have neck pain due to splint wearing? O
never O sometimes O often O always
D. How easy do you find putting the splint on and off?
E. How was the adjustment process overall?

E. Is the splint aesthetically pleasing?
_____________________________________________
_____________________________________________

Place and date: Patient signature: F. Is the splint causing pain?
_____________________________________________
____________________________________________
a. If yes, where?
Assessment 1 (by investigator)
Patient ID: _____________________________________________
A. Satisfied with fit? yes / no
G. Is the splint itchy?
a. If no, why not? ______________________

B. Adjustments made? yes / no
a. If yes, where?
a. If yes, which? ______________________
_____________________________________________
C. Any change of procedure? yes / no
H. Do you sweat under the splint?
a. If yes, which? ______________________

D. Next appointment:______________________ at
Occupational therapy/Consultation with doctor I. Is the splint smelly?

_____________________________________________
__________________________________________ J. How easy is it to clean the splint?

Place and date: Investigator signature:
136 International Journal of Bioprinting (2022)–Volume 8, Issue 1