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. 2010 Spring;21(1):45–52. doi: 10.1155/2010/178036

TABLE 3.

Zoster Brief Pain Inventory

  1. Have you had any pain caused by your shingles in the last 24 h?

    (yes, no)

  2. Shade in the areas where you feel pain on the diagram

    (face and back body anatomy diagrams)

  3. Rate your worst pain in the last 24 h

    (scale of 0–10)

  4. Rate your least pain in the last 24 h

    (scale of 0–10)

  5. Rate your average pain in the last 24 h

    (scale of 0–10)

  6. Rate your current pain

    (scale of 0–10)

  7. Are you receiving treatments or medication for your shingles pain?

    (yes, no)

  8. How much relief have these treatments provided in the last 24 h?

    (scale of 0%–100%)

  9. How your shingles pain has interfered with (last 24 h):
    1. General activity
    2. Mood
    3. Walking ability
    4. Normal work
    5. Relations with other people
    6. Sleep
    7. Enjoyment of life

    (scale of 0–10 for each item)

Adapted with permission from reference 38