| Construct | Item | Response Options | Frequency of Item | |
|---|---|---|---|---|
| Urinary Urgency | How would you rate your level of urinary urgency over the last hour? | Sliding scale 0-10 10 = unbearable urgency |
Four times per day | |
| Stress | What is your stress level right now? | Sliding scale 0-10 10 = unbearable stress |
Four times per day | |
| Negative Emotion | How intense are your negative emotions right now, including things like sadness, anxiety, and anger? | Sliding scale 0-10 | Four times per day | |
| Positive Emotion | How intense are your positive emotions right now, including things like happiness, joy, and relaxation? | Sliding scale 0-10 | Four times per day | |
| Pain | Are you experiencing pain in any body area right now? | Yes No |
Four times per day | |
| If yes… | ||||
| Pain | Looking at the front view, which areas have pain? | Body map front view | If ‘Yes’ on 190, four times per day | |
| Pain | Looking at the back view, which areas have pain? | Body map back view | If ‘Yes’ on 190, four times per day | |
| Pain | How intense is the pain in your Buttocks area right now? | Sliding scale 0-10 | If marked on body map, four times per day | |
| Pain | How intense is the pain in your Back right now? | Sliding scale 0-10 | If marked on body map, four times per day | |
| Pain | How intense is the pain in your Hips/Legs right now? | Sliding scale 0-10 | If marked on body map, four times per day | |
| Pain | How intense is the pain in your Pelvis/Genitalia/Anal area right now? | Sliding scale 0-10 | If marked on body map, four times per day | |
| Pain | How intense is the pain in your Chest/Abdomen right now? | Sliding scale 0-10 | If marked on body map, four times per day | |
| Pain | How intense is the pain in your Shoulders/Arms right now? | Sliding scale 0-10 | If marked on body map, four times per day | |
| Pain | How intense is the pain in your Head/Neck right now? | Sliding scale 0-10 | If marked on body map, four times per day | |