The Patient Reported Measures surveys listed here are available for users within the HOPE platform.
Assessment of Quality of Life – 6 Dimensions (AQoL-6D)
(The AQoL-6D questionnaire is designed to measure a person’s self-reported health and wellbeing across 6 areas: Independent Living, Mental Health, Coping, Relationships, Pain, Senses.
Cardiff Wound Impact Schedule
This questionnaire is concerned with the effects that your wound has on your daily life.
Catquest- Short Form 9
Catquest-9SF is a Rasch scaled 9-item questionnaire used to measure activity limitations in daily life due to poor vision because of cataracts. The questionnaire is used to measure patients’ self-assessed visual function before and six months after a cataract extraction to evaluate the benefit of the surgery.
Chronic Obstructive Pulmonary Disease (CAT)
This questionnaire will help you and your healthcare professional measure the impact COPD (Chronic Obstructive Pulmonary Disease) is having on your wellbeing and daily life.
COVID-19 Yorkshire Rehabilitation Scale (C19-YRS)
A survey to capture persistent symptoms of post-acute sequelae of COVID-19 (long COVID).
COVID-19 Yorkshire Rehabilitation Screening Tool
A survey to capture persistent symptoms of post-acute sequelae of COVID-19 (long COVID).
Depression Anxiety Stress Scale-21
The Depression, Anxiety and Stress Scale - 21 Items (DASS-21) is a set of three self-report scales designed to measure the emotional states of depression, anxiety and stress.
Diabetes Distress scale
Diabetes Distress Scale (DDS) questionnaire and scoring sheet.
Health Questionnaire (EQ-5D-5L)
Health Questionnaire EQ-5D-5L for mobility, self-care, usual activities, pain/discomfort and anxiety depression.
Falls Efficacy Scale (FES-I)
The questionnaire is intended to be used in adult population to measure the level of concern about falling during social and physical activities inside and outside the home.
Hip Dysfunction and Osteoarthritis Outcome Score (HOOS)
The hip disability and osteoarthritis outcome score (HOOS) is a questionnaire intended to be used to assess the patient’s opinion about their hip and associated problems.
Integrated Palliative Outcome Scale (IPOS) Renal
The questionnaire is intended for use among people severely affected by diseases such as cancer, respiratory, heart, renal or liver failure, and neurological diseases.
Kansas City Cardiomyopathy Questionnaire (KCCQ)
The Kansas City Cardiomyopathy Questionnaire (KCCQ), is a patient-reported outcome instrument, provides a measure of symptoms and physical limitations associated with heart failure
Knee injury and Osteoarthritis Outcome (KOOS)
The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a knee-specific instrument, developed to assess the patients' opinion about their knee and associated problems.
Oxford Hip Score
Oxford hip score mobility and pain questionnaire.
Oxford Knee Score
Oxford knee score mobility and pain questionnaire.
Partners in Health (PIH) Scale
Partners in Health (PIH) survey, available for ad-hoc use in clinical programs where chronic disease management and self-management information forms part of shared decision making.
This survey is used broadly across NSW in integrated models of care.
Patient Reported Outcome Measures Information System (PROMIS-29)
The questionnaire is intended to be used in adult population to measure the level of concern and their overall wellbeing.
Patient Health Questionnaire-4 (PHQ-4) (PROM)
The Patient Health Questionnaire-4 is a short, four-question tool to assess a patient’s mood – specifically, symptoms of anxiety and depression. Patients in rehabilitation have often experienced life-altering, sometimes traumatic events, hence mood disturbance is common.
Post COVID-19 Functional Status (PCFS) Scale
An ordinal outcome measure that can be used to track functional status over time.
Problem Areas In Diabetes (PAID) Scale
The Problem Areas In Diabetes (PAID) scale is a well-validated, psychometrically robust questionnaire with 20 items.
St George Respiratory (SGR) Questionnaire
This questionnaire is designed to help us learn much more about how your breathing is troubling you and how it affects your life. We are using it to find out which aspects of your illness cause you most problems, rather than what the doctors and nurses think your problems are.
WOUND-Q©
Three scales; Assessment, Drainage and Smell. WOUND-Q© is validated for patients with all types of chronic wounds in any anatomic location.