Table 1.
Self-administered questionnaires sent out before the home visit
| Variable | Questionnaire | Number of items | Number of response categories (scoring) | Total score range (interpretation) | Time reference when rating |
|---|---|---|---|---|---|
| Activities in Daily Living (ADL) |
PADLS |
1 |
5 (1–5) |
1-5 (higher = worse) |
last month |
| Walking difficulties in daily life |
Walk-12G |
12 |
3 (0–2): items 1–3 5 (0–4): items 4-12 |
0-42 (higher = worse) |
last two weeks |
| Freezing of gait |
FOG-Qsa |
6 |
5 (0–4) |
0-24 (higher = worse) |
last week (except item 3) |
| Fall-related self-efficacy |
FES-I |
16 |
4 (1–4) |
16-64 (higher = worse) |
- |
| Activity avoidance due to a risk of falling |
mSAFFE |
17 |
3 (1–3) |
17-51 (higher = worse) |
- |
| General self-efficacy |
GSE |
10 |
4 (1–4) |
10-40 (higher = better)* |
- |
| Non-motor symptoms |
NMSQuest |
30 |
3: Yes/Don’t know/No |
Not applicable |
last month |
| Fatigue | NHP-EN | 3 | 2: Yes/No | 0-100 (higher = worse)** | at present |
*A mean score can be used as an alternative to using a summed total score.
**Alternatively, those that respond yes to at least one item are considered to have fatigue.
Abbreviations: FES-I Falls Efficacy Scale-International, FOG-Qsa self-administered version of the Freezing of Gait Questionnaire.
GSE General Self-Efficacy Scale, NHP-EN the Energy section of the Nottingham Health Profile (items number 1, 12 and 26 in NHP).
NMSQuest The Nonmotor Symptoms Questionnaire (this screening renders no total score), mSAFFE = modified Survey of Activities and Fear of Falling in the Elderly,
PADLS Parkinson’s Disease Activities of Daily Living Scale, Walk-12G the generic Walk-12.