This survey will be used to explore the ways in which being able to play video games through the use of Warfighter Engaged's adaptive video game controllers after finger, hand, or limb loss and/or limiting upper extremity injury have impacted different aspects of your quality of life. This survey will take approximately 10 minutes to complete.

Participation in this study is completely voluntary and you may discontinue participation at any time. If completion of this survey brings about any difficult feelings or memories, it is recommended that counseling services be sought. No identifying information will be recorded and anonymity will be maintained throughout your participation. The completion of this survey constitutes informed consent to participate in this study. If you have any questions regarding your participation in this study please contact Kaitlyn Jones at or 973-513-3165. If you have questions about your rights as a research participant, contact Dr. Tabbi Miller-Scandle, IRB Administrator, Office of Research and Sponsored Programs, University of Scranton, 570-941-5824.”

This study was approved by the University of Scranton Institutional Review Board on 12/29/17.

* 1. Please write which branch of the military you served in:

* 2. Please write your current age:

* 3. Please indicate your gender


* 4. Using the picture above,  identify which of the following best describes the location of your right side amputation.

* 5. Using the picture above,  identify which of the following best describes the location of your left side amputation.

* 6. Please identify any other health conditions or diagnoses you may have

* 7. Please indicate the capacity in which you use video games. You may select as many boxes as are applicable:

* 8. Please select which of the following pieces of equipment appear on your adapted video controller. You may select as many as applicable:

* 9. How often did you engage in video game play before your injury?

* 10. How often do you currently engage in video game play with your adapted controller?

* 11. Please indicate which gaming consoles you use your adapted controller for:

* 12. The following question is a standardized assessment tool for adaptive devices in general, therefore, not all items on the assessment may be directly related to the effect of adaptive video game controllers on that specific item. Please try your best to view each item in the context of the following phrase:
"how does being able to play video games with my adapted controller influence my overall  ____________ (competence, happiness, independence, etc.)"

-3 indicates that this device causes a significant decrease in this item 
-2 indicates that this device causes a moderate decrease in this item
-1 indicates that this device causes a  minimal decrease in this item
0 indicates that this device has neither a positive nor negative impact on this item
1 indicates that this device causes a minimal increase in this item
2 indicates that this device causes a moderate increase in this item
3 indicates that this device causes a significant increase in this item

Psychosocial Impact of Assistive Devices Scale

"Each word and phrase below describes how using an assistive device may affect a user. Some might seem unusual but it is important that you answer every one of the 26 items. For each word and phrase, please check off the appropriate box to show how you are affected by using adapted video game controllers given these subcategories."

  -3 -2 -1 0 1 2 3
competence (ability to do well the important things you need to do in)
happiness (gladness, please, satisfaction with life)
independence (not dependent on, or not always needing help from someone)
adequacy (capable of handling life situations, and handling little crises) 
confusion (unable to think clearly, act decisively) 
efficiency (effective management of day to day tasks)
self-esteem (how you feel about yourself, and like yourself as a person)
productivity (able to get more things done in a day) 
security (feeling safe rather than feeling vulnerable or insecure)
frustration (being upset about lack of progress in achieving your desires; feeling disappointed) 
usefulness (help yourself and others; can get things done) 
self-confidence (self-reliance; trust in yourself and your abilities)
expertise (knowledge in a particular area or occupation) 
skillfulness (able to perform tasks well) 
well-being (feeling well; optimistic about your life and future) 
capability (feeling more capable; able to cope) 
quality of life (how good your life is) 
performance (able to demonstrate your skills) 
sense of power (sense of inner strength; feeling that you have significant influence over your life)
sense of control (sense of being able to do what you want in your environment) 
embarrassment (feeling awkward or ashamed) 
willingness to take chances (willing to take some risks; willing to take on new challenges) 
ability to participate (ability to join in on activities with other people) 
eagerness to try new things (feeling adventurous and open to new experiences) 
ability to adapt to the activities of daily living (ability to cope with change; ability to make basic tasks more manageable) 
ability to take advantage of opportunities (ability to act quickly and confidently when there is a chance to improve something in your life) 

* 13. Please feel free to provide any additional comments or feedback on how adaptive video game controllers have impacted your life since your injury, whether it be a positive or negative impact. Your insights are greatly appreciated.