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    Escala PedsQL 5-7

    Uploaded by

    Natalia Gullón
    Escala para 5 a 7 años

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Escala PedsQL 5-7

    Uploaded by

    Natalia Gullón
    135 views2 pages
    Escala para 5 a 7 años

    Original Title

    escala PedsQL 5-7

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    Escala para 5 a 7 años

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    135 views2 pages

    Escala PedsQL 5-7

    Uploaded by

    Natalia Gullón
    Escala para 5 a 7 años

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    ID#

    Date:

    ™
    PedsQL
    Paediatric Quality of Life
    Inventory
    Version 4.0 English (United Kingdom)

    PARENT REPORT for YOUNG CHILDREN (ages 5-7)

    INSTRUCTIONS

    On the following page is a list of things that might be a problem for your child.
    Please tell us how much of a problem each one has been for your child
    during the past ONE month by circling:

    0 if it is never a problem
    1 if it is almost never a problem
    2 if it is sometimes a problem
    3 if it is often a problem
    4 if it is almost always a problem

    There are no right or wrong answers.


    If you do not understand a question, please ask for help.

    PedsQL 4.0 Parent (5-7) Not to be reproduced without permission Copyright © 1998 JW Varni, Ph.D.
    All rights reserved
    PedsQL-4.0-Core-PYC - United Kingdom/English - Version of 14 Mar 11 - Mapi Research Institute.
    ID6014 / PedsQL-4.0-Core-PYC_AU4.0_eng-GB.doc
    PedsQL 2
    In the past ONE month, how much of a problem has your child had with …
    PHYSICAL FUNCTIONING (problems with…) Never Almost Some- Often Almost
    Never times Always
    1. Walking 100 metres 0 1 2 3 4
    2. Running 0 1 2 3 4
    3. Participating in sports activities or exercise 0 1 2 3 4
    4. Lifting something heavy 0 1 2 3 4
    5. Taking a bath or shower by him or herself 0 1 2 3 4
    6. Doing chores, like picking up his or her toys 0 1 2 3 4
    7. Having aches or pains 0 1 2 3 4
    8. Feeling tired 0 1 2 3 4

    EMOTIONAL FUNCTIONING (problems with…) Never Almost Some- Often Almost


    Never times Always
    1. Feeling afraid or scared 0 1 2 3 4
    2. Feeling sad 0 1 2 3 4
    3. Feeling angry 0 1 2 3 4
    4. Trouble sleeping 0 1 2 3 4
    5. Worrying about what will happen to him or her 0 1 2 3 4

    SOCIAL FUNCTIONING (problems with…) Never Almost Some- Often Almost


    Never times Always
    1. Getting on with other children 0 1 2 3 4
    2. Other children not wanting to be his or her friend 0 1 2 3 4
    3. Getting teased by other children 0 1 2 3 4
    4. Not being able to do things that other children his or
    0 1 2 3 4
    her age can do
    5. Keeping up when playing with other children 0 1 2 3 4

    SCHOOL FUNCTIONING (problems with…) Never Almost Some- Often Almost


    Never times Always
    1. Paying attention in class 0 1 2 3 4
    2. Forgetting things 0 1 2 3 4
    3. Keeping up with school activities 0 1 2 3 4
    4. Missing school because of not feeling well 0 1 2 3 4
    5. Missing school to go to the doctor or hospital 0 1 2 3 4

    PedsQL 4.0 Parent (5-7) Not to be reproduced without permission Copyright © 1998 JW Varni, Ph.D.
    All rights reserved
    PedsQL-4.0-Core-PYC - United Kingdom/English - Version of 14 Mar 11 - Mapi Research Institute.
    ID6014 / PedsQL-4.0-Core-PYC_AU4.0_eng-GB.doc

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