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PDQ39

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LOVELY ANGELICA GOPEZ
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23 views

PDQ39

Uploaded by

LOVELY ANGELICA GOPEZ
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

PDQ-39 QUESTIONNAIRE

Please complete the following

Please tick one box for each question

Due to having Parkinson’s disease,


how often during the last month
have you.... Never Occasionally Sometimes Often Always
or cannot do
1 Had difficulty doing at all
the leisure activities which
you would like to do? ✓
2 Had difficulty looking after
your home, e.g. DIY, ✓
housework, cooking?

3 Had difficulty carrying bags ✓


of shopping?

4 Had problems walking half


a mile?
✓

5 Had problems walking 100


yards?
✓

6 Had problems getting


around the house as easily ✓
as you would like?

7 Had difficulty getting


around in public?
✓

8 Needed someone else to


accompany you when you ✓
went out?

9 Felt frightened or worried


about falling over in ✓
public?

10 Been confined to the


house more than you ✓
would like?

11 Had difficulty washing ✓


yourself?

12 Had difficulty dressing ✓


yourself?

13 Had problems doing up


your shoe laces?
✓

Please check that you have ticked one box for each question before going on to the next page

Page 3 of 12 Questionnaires for patient completion


Due to having Parkinson’s disease, Please tick one box for each question
how often during the last month
have you.... Never Occasionally Sometimes Often Always
or cannot do
at all
14 Had problems writing
clearly? ✓
15 Had difficulty cutting up
your food? ✓
16 Had difficulty holding a
drink without spilling it? ✓
17 Felt depressed? ✓
18 Felt isolated and lonely?
✓
19 Felt weepy or tearful?
✓
20 Felt angry or bitter?
✓
21 Felt anxious? ✓
22 Felt worried about your
future?
✓
23 Felt you had to conceal
your Parkinson's from ✓
people?

24 Avoided situations which


involve eating or drinking ✓
in public?

25 Felt embarrassed in public


due to having Parkinson's ✓
disease?

26 Felt worried by other


people's reaction to you?
✓

27 Had problems with your


close personal
relationships?
✓

28 Lacked support in the


ways you need from your
spouse or partner?
✓
If you do not have a spouse or
partner tick here

29 Lacked support in the


ways you need from your
family or close friends? ✓

Please check that you have ticked one box for each question before going on to the next page

Page 4 of 12 Questionnaires for patient completion


Due to having Parkinson’s disease, Please tick one box for each question
how often during the last month
have you.... Never Occasionally Sometimes Often Always

30 Unexpectedly fallen asleep


during the day?
✓
31 Had problems with your
concentration, e.g. when
reading or watching TV?
✓
32 Felt your memory was
bad?
✓
33 Had distressing dreams or
hallucinations?
✓
34 Had difficulty with your
speech?
✓
35 Felt unable to
communicate with people
properly? ✓
36 Felt ignored by people?
✓
37 Had painful muscle
cramps or spasms?
✓
38 Had aches and pains in
your joints or body?
✓
39 Felt unpleasantly hot or
cold?
✓
Please check that you have ticked one box for each question before going on to the next page

Thank you for completing the PDQ 39 questionnaire

Page 5 of 12 Questionnaires for patient completion

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