(1) How would you evaluate your health today? |
Health |
(2) How much do you think your bladder problem hampers your life? |
Bladder problems, hampering your life |
(3) Frequency: do you go the bathroom too often? |
Frequency going to the bathroom |
(4) Nocturia: do you get up at night to urinate? |
Nocturia, getting up |
(5) Urgency: do you feel urgency to urinate and have difficulty controlling it? |
Urinary urgency |
(6) Hyperactive bladder: do you lose urine when you feel urgency to urinate? |
Hyperactive bladder |
(7) Urinary incontinence by exertion: do you lose urine during physical activities? |
Urinary incontinence, physical activities |
(8) Nocturnal enuresis: do you wet your bed at night? |
Nocturnal enuresis |
(9) Incontinence during sexual intercourse: do you lose urine during sexual intercourse? |
Incontinence during sexual intercourse |
(10) Frequent infections: do you have many urinary infections? |
Urinary infections |
(11) Pain in the bladder: do you feel pain in the bladder? |
Pain in the bladder |
(12) Do you have any other problem related to your bladder? |
Problem related to your bladder |
(13) How intensely do your bladder problems hinder your house chores? (cleaning, washing, and cooking, etc.) |
House chores (cleaning, washing, cooking, etc.) |
(14) How intensely do your bladder problems hinder your work or your daily activities outside the house? (shopping, taking children to school, etc.) |
Work, daily activities outside the house (shopping, taking children to school, etc.) |
(15) Do your bladder problems hinder your physical activities? (walking, running, or any other sport?) |
Physical activities (walking, running, or any other sport) |
(16) Do your bladder problems hinder you when you want to travel? |
Travelling |
(17) Do your bladder problems hinder you when go to the church, a meeting, a party? |
Church, meeting, and party |
(18) Do you avoid visiting friends because of your bladder problems? |
Visiting friends |
(19) Do your bladder problems hinder your sexual life? |
Sex life |
(20) Do your bladder problems hinder your life with your partner/husband? |
Partner/husband |
(21) Do your bladder problems disturb your family members? |
Disturbing family members |
(22) Do you feel depressed with your bladder problems? |
Depression |
(23) Do you feel anxious or nervous with your bladder problems? |
Anxious, nervous |
(24) Do you feel bad about yourself because of your bladder problems? |
Feeling bad about yourself |
(25) Do your bladder problem hinder your sleep? |
Sleep |
(26) Do you use any kind of hygienic protection such as diapers, pads, or lining to keep yourself dry? |
Hygienic protection |
(27) Do you control the amount of liquids you drink? |
Controlling the amount of liquids, drinking |
(28) Do you need to change your underwear (panties) when you get wet? |
Changing underwear |
(29) Do you worry about smelling like urine? |
Smelling of urine |