Items common to pre- and post-revascularisation versions
|
Symptoms (7 items) | • During the past four weeks, how much were you bothered by each of the following problems related to your heart condition? |
– Chest pain due to angina |
– Discomfort in chest due to angina |
– Shortness of breath |
– Angina pain that radiates to other parts of body |
– Palpitations (strong or irregular heart beat) |
| • During the past four weeks, on average, how many times have you taken nitros (glyceryl trinitrate tablets or spray) for your chest pain, chest tightness or angina? |
| • During the past four weeks, how much trouble has your heart condition caused you? |
Physical functioning (8 items) | • The following questions ask about activities that you might do during a typical day. During the past four weeks, has your heart condition limited you in your usual daily activities? Please indicate whether your heart condition limits you a lot, limits you a little, or does not limit you at all in the activities listed below: |
| – Moderate activities |
| – Lifting or carrying groceries |
| – Climbing several flights of stairs |
| – Climbing one flight of stairs |
| – Bending, kneeling, or stooping |
| – Walking half a mile |
| – Walking one hundred yards |
| – Bathing or dressing yourself |
Psychosocial functioning (14 items) | • The next questions ask about the impact of your heart condition on your family and friends and the extent to which it has interfered with your social activities. During the past four weeks, how often have you experienced the following as a result of your heart condition: |
– Family or friends being overprotective |
– Feeling like you are a burden on others |
– Feeling restricted in your social activities |
– Feeling worried about going too far from home |
| • The next questions ask about your feelings about your heart condition. During the past four weeks, how often have you felt: |
| – Worried about your heart condition |
| – Worried about doing too much or overdoing it |
| – Worried that you might have a heart attack or die suddenly |
| – Frightened by the pain or discomfort of your heart condition |
| – Uncertain about the future |
| – Depressed |
| – Frustrated or impatient |
| – Heart condition interfered with enjoyment of life |
| – Difficult to keep a positive outlook about your health |
| – Difficult to plan ahead (for vacations, social events, etc) |
Cognitive functioning (3 items) | • The next questions ask about problems related to your heart condition. During the past four weeks, how much of the time did you: |
– Have difficulty reasoning and solving problems |
– Forget, for example, things that happened recently |
– Have difficulty doing activities involving concentration and thinking |
Not scored (1 item) | • During the past four weeks, have you had chest pain, chest tightness, or angina at rest or on exertion? |
Additional post-revascularisation items
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Satisfaction (6 items) | • How satisfied are you with the: |
– Results of your heart operation |
– Information about your heart operation |
– Information about how you might feel while recovering |
| • Overall, how would you describe your heart condition now compared with before you had your heart operation? |
| • Has your recovery from your heart operation so far been faster/slower than expected? |
| • Are the results from your heart operation better/worse than expected? |
Adverse effects | • The next questions ask about problems you might have had since your heart operation. During the past four weeks, how much were you bothered by the following problems? |
(CROQ-CABG, 11 items) | • CROQ-CABG_Post only |
– Pain in chest wound |
– Infection in chest wound |
– Tenderness around chest wound |
– Numbness or tingling around chest wound |
– Bruising on chest |
– Pain in leg or arm wound |
– Any other pain in leg or arm due to operation |
– Infection in leg or arm wound |
– Numbness or tingling in leg or arm due to operation |
– Bruising on leg or arm where a vein was removed |
– Swollen feet or ankles |
(CROQ-PTCA, 6 items) | • CROQ-PTCA_Post only |
– Pain in groin wound |
– Tenderness around groin wound |
– Numbness or tingling in groin area |
– Bruising around groin wound or thigh |
– Problems in groin where the catheter was inserted |
– Concern over the appearance of bruises |
Not scored (2 items) | • During the past four weeks, how often have you felt worried your symptoms might return? |
• Since your heart operation, have you been readmitted to hospital for an overnight stay for any reason to do with your heart condition or heart operation? |