Item | Category | Incorrectly Paraphrased | ItCR |
---|---|---|---|
INITIAL ASSESSMENT | Title | 3 | 97.9% |
Each patient is unique and has different treatment goals depending on the symptoms experienced, lifestyle, and any other health concerns. | Instructions | 3 | 97.9% |
A goal is something that you would like to improve by treatment. | Instructions | 1 | 99.3% |
It may be a symptom that you would like to improve, or an activity that you cannot do because of your urinary symptoms. | Instructions | 1 | 99.3% |
This questionnaire, the Self-Assessment Goal Achievement Questionnaire, is designed to record your goals for the treatment of your urinary problems. | Instructions | 10 | 93.0% |
There are two sections to complete. | Instructions | 3 | 97.9% |
The first, symptom goals, relates to the typical urinary symptoms of patients like you; you may have all or some of these symptoms. | Instructions | 2 | 98.6% |
The second section, other personal goals, relates to the specific impact on your life from your urinary symptoms. | Instructions | 2 | 98.6% |
Examples of other personal goals include being able to visit family and friends for a longer period of time before having to find a restroom, or to reduce the number of times it is necessary to change clothes due to urine loss. | Instructions | 1 | 99.3% |
Please use the questionnaire to indicate which goals are important to you and how important each goal is by marking the appropriate box beside each goal. | Instructions | 3 | 97.9% |
Finally, circle the three most important goals in the combined symptom and other personal goals sections, as shown below. | Instructions | 17 | 88.1% |
Take the completed form with you when you see your healthcare provider so that together you can discuss your urinary problems, your treatment goals, review your treatment options, and develop and commit to your treatment plan. | Instructions | 1 | 99.3% |
Your treatment goals - First Visit | Title | 1 | 99.3% |
Use the scale below which ranges from 1 (not important goal) to 5 (very important goal). | Instructions | 1 | 99.3% |
Circle the three goals from the combined sections below (Symptom and Other personal goals) which are the most important for you. | Question | 17 | 88.1% |
Reduce my urine loss when I have a sudden need to rush to the bathroom | Response Option | 1 | 99.3% |
Other personal goals | Response Option | 1 | 99.3% |
(not included above and important to me) | Response Option | 3 | 97.9% |
Once you and your healthcare provider have discussed your goal(s) and developed a plan of action, mark the actions below which will apply to you. | Question | 7 | 95.1% |
Sign your name to confirm your commitment to working towards your own better health. | Instructions | 1 | 99.3% |
Read health tips about my condition | Response Option | 2 | 98.6% |
Keep record of my progress | Response Option | 5 | 96.5% |
FOLLOW-UP ASSESSMENT | Title | 11 | 92.3% |
The initial assessment provided you with an opportunity to discuss your treatment goals related to your urinary problems with your healthcare provider. | Instructions | 1 | 99.3% |
Since that discussion, have you reached your goals? | Question | 1 | 99.3% |
First, look over the treatment goals you and your healthcare provider discussed during your last visit. | Instructions | 1 | 99.3% |
Much worse than expected | Response Option | 2 | 98.6% |
As expected | Response Option | 2 | 98.6% |
Much better than expected | Response Option | 2 | 98.6% |
After you have completed the questionnaire, take it with you when you see your healthcare provider so that together you can discuss your treatment goal achievement and further management of your urinary symptoms. | Instructions | 2 | 98.6% |
Your treatment goal achievement - Follow-up Visit | Title | 1 | 98.6% |
CUT OUT THE GRAY SQUARE to see your other personal goals | Administrative | 12 | 99.3% |
When answering the following question, please think about all of your goals. | Question | 1 | 97.6% |
Overall, to what extent have you achieved your goals? | Question | 1 | 99.3% |