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Pdq-39 Questionnaire: Please Complete The Following

This document contains a 39-question PDQ-39 questionnaire for patients with Parkinson's disease. The questionnaire asks patients to rate how often in the last month they experienced difficulties with various activities of daily living, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort due to their Parkinson's symptoms. Patients select responses of never, occasionally, sometimes, often, or always/cannot do at all for each question.

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Cindy Katherine Llanos
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810 views3 pages

Pdq-39 Questionnaire: Please Complete The Following

This document contains a 39-question PDQ-39 questionnaire for patients with Parkinson's disease. The questionnaire asks patients to rate how often in the last month they experienced difficulties with various activities of daily living, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort due to their Parkinson's symptoms. Patients select responses of never, occasionally, sometimes, often, or always/cannot do at all for each question.

Uploaded by

Cindy Katherine Llanos
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
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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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