COVER PAGE: to invite the appropriate patients to complete the screening tool | |
• Attention-capturing sentences | |
INSIDE PAGE: to allow the patients to describe their pain, fatigue and other symptoms | |
Question 1* | • Location of the pain (body diagram to complete) |
Question 2 | • Frequency of the pain |
Question 3 | • Description of the pain (list of sensations/perceptions) |
Question 4 | • Frequency of tiredness |
Question 5 | • Impact of physical effort on tiredness |
Question 6 | • Symptoms patients experienced that are associated with their condition (list of symptoms) |
INSIDE PAGE: to capture the link between patients' condition and life, and the impact of fibromyalgia on their everyday life, personality and attitude | |
Question 7 | • Impact of situations on patients' condition (list of physical, psychological and external situations) |
Question 8 | • Impact of patients' condition on their everyday life areas (list of life areas) |
Questions 9 and 10 | • Assessment of traumatic or stressful events in patients' life |
Question 11 | • Attitude and behaviour of patients faced with their condition (list) |
Question 12 | • Statements about the disease |
Question 13 | • Extent to which patients recognise themselves in the questions being asked |
Question 14 | • Content of the tool allowing report of current health status |