Patient questionnaire
Phase
text
Report completion date
date
Physical Exertion
integer
Ability to walk
Walking (activity)
Bed rest
Assistance with eating
Work ability
Free time activity limited
Dyspnea
Pain
Need Rest
Sleep disturbances
Weakness
Loss of appetite
Nausea
Vomiting
Congestion
Diarrhea
Fatigue
Impaired
Unable to concentrate
Emotional Strain
Grief reaction
Excitability
Mental Depression
Memory performance
Disruptive family life
Living together impaired
Financial problems
Personal health
Quality of life