1. | Usual intensity of pain | 560 | 100 | | | 2. | How bad is the pain at its worst? |
|
| None | 139 | 25 | 0 | 0 | | No pain |
|
| Mild | 163 | 29 | 0 | 3 | | Mild |
|
| Moderately intense | 162 | 29 | 10 | 7 | | Moderate |
|
| Very intense | 80 | 14 | 12 | 11 | | Severe |
|
| Extremely intense | 16 | 3 | 12 |
|
|
2. | Usual intensity of other forms of suffering | 546 | 100 | | 3. | Usual intensity of other forms of suffering |
|
| None | 174 | 32 | 0 | 0 | | None |
|
| Mild | 129 | 24 | 4 | 4 | | Mild |
|
| Moderately intense | 177 | 32 | 7 | 8 | | Moderate |
|
| Very intense | 55 | 10 | 10 | 12 | | Severe |
|
| Extremely intense | 11 | 2 | 15 |
|
3. | Usual frequency of painful episodes/suffering | 561 | 100 | | | 1. | Usual frequency of painful episodes/suffering |
|
| No pain | 148 | 26 | 0 | 0 | | None |
|
| Infrequent episodes of pain | 240 | 43 | 0 | 3 | | Occasional |
|
| In pain about half the time | 118 | 21 | 0 |
|
| Only short episodes pain-free | 42 | 8 | 3 | 6 | | Often |
|
| Constant, never pain-free | 13 | 2 | 7 | 9 | | Constant |
|
4. | Usual degree of impairment in role function | 559 | 100 | | | 4. | Degree of impairment in usual activities due to surgical condition |
|
| Not impaired at all | 175 | 31 | 0 | 0 | | Not impaired at all/mildly impaired |
|
| Mildly impaired | 236 | 42 | 0 |
|
| Able but difficult and/or somewhat impaired | 99 | 18 | 9 | 5 | | Able but difficult and/or somewhat impaired |
|
| Able but very difficult and at much reduced level | 47 | 9 | 16 | 10 | | Able but very difficult and at much reduced level |
|
| Totally dependent (unable to perform any role function) | 2 | 0 | 16 | 15 | | Totally dependent (unable to perform any usual activities) |
|
5. | Usual degree of impairment in social activities | 560 | 100 | | Items 4 and 5 were combined |
|
| Not impaired at all | 215 | 39 | 0 |
|
| Mildly impaired | 224 | 40 | 0 |
|
| Able but difficult and/or somewhat impaired | 83 | 15 | 2 |
|
| Able but very difficult and at much reduced level | 36 | 6 | 2 |
|
| Unable to perform any social activity | 2 | 0 | 2 |
|
6. | History of major complications of the condition | 557 | 100 | | | 5. | Recent history of major complications or additional significant physical examination or test results |
|
| No | 461 | 83 | 0 | 0 | | No |
|
| Yes, but not recently | 51 | 9 | 4 | 8 | | Yes |
|
| Yes, recently | 45 | 8 | 4 |