Parts to questionnaire:
(1) symptoms severity scale
(2) functional status scale
Symptom Severity Scale - over the past 2 weeks
(1) severity of pain at night
(2) waking up from pain
(3) pain during daytime
(4) frequency of daytime pain
(5) duration of daytime pain
(6) numbness
(7) weakness
(8) tingling sensation
(9) loss of sensation or tingling at night
(10) being wakened by numbness or tingling
(11) difficult grasping
Each item is graded from 1 (normal) to 5 (very abnormal)
symptom severity score
= SUM(points for all 11 questions)
Functional Status Scale Activities:
(1) writing
(2) buttoning of clothes
(3) holding a book while reading
(4) gripping of a telephone handle
(5) opening of jars
(6) household chores
(7) carrying of grocery bags
(8) bathing and dressing
Responses:
|
Response
|
Points
|
|
no difficulty
|
1
|
|
mild difficulty
|
2
|
|
moderate difficulty
|
3
|
|
severe difficulty
|
4
|
|
cannot do at all due to hand or wrist symptoms
|
5
|
functional status score =
= SUM(points for all 8 activities)
Interpretation:
• minimum functional severity scale: 11
• maximum functional severity scale: 55
• minimum functional status scale: 8
• maximum functional status scale: 40
• The lower the score in each scale, the better the patient's status.
