Table 2.
Item | None | Mild | Moderate | Severe |
---|---|---|---|---|
1. My breath does not go in all the way | ||||
2. My breathing requires more work | ||||
3. I feel short of breath | ||||
4. I have difficulty catching my breath | ||||
5. I cannot get enough air | ||||
6. My breathing is uncomfortable | ||||
7. My breathing is exhausting | ||||
8. My breathing makes me feel depressed | ||||
9. My breathing makes me feel miserable | ||||
10. My breathing is distressing | ||||
11. My breathing makes me agitated | ||||
12. My breathing is irritating |
This questionnaire is designed to help us learn more about how your breathing is troubling you. Please read each item and then tick in the box that best matches your breathing these days. If you do not experience an item tick the "none" box. Please respond to all items.
Scores: none (0), mild (1), moderate (2) and severe (3). Total scores range from 0 to 36, with higher scores corresponding to greater severity.