Instructions: This is a questionnaire for patients who have breathing problems caused by the voice box during exercise. Please complete the following questions without the assistance of parents considering the past 2 weeks. | |||||
In the past 2 weeks when I exercised really hard, | |||||
my breathing problem occurred | Score: | ||||
| 1 = Less than half of the time | 2 = About half of the time | 3 = Most of the time | 4 = Every time | _____ |
my breathing problem typically lasted _____ minutes once I stopped | Score: | ||||
| 1 = 1 to 3 minutes | 2 = 4 to 6 minutes | 3 = 7 to 10 minutes | 4 = More than 10 minutes | _____ |
For the rest of the items, please use the following scoring: | |||||
0 = Never | 1 = Almost never | 2 = Sometimes | 3 = Almost always | 4 = Always | Score: |
I avoid really hard exercise because of my breathing problem | _____ | ||||
I am nervous about my breathing problem before I exercise | _____ | ||||
When I exercise, | |||||
my throat feels tight | _____ | ||||
my breathing is noisy | _____ | ||||
I do not have control of my breathing problem | _____ | ||||
During exercise, my breathing problem | |||||
prevents me from performing how I want | _____ | ||||
frustrates me | _____ | ||||
causes me to take extra breaks | _____ | ||||
makes me feel lightheaded | _____ | ||||
scares me | _____ | ||||
Total:_____ |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟