PGA Parent PedsQL Module

In the last 2 weeks, how much of a problem has your child had with...

PAIN AND HURT (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
Aches in joints and/or muscles	Aches in joints and/or muscles: Never	Aches in joints and/or muscles: Almost Never	Aches in joints and/or muscles: Sometimes	Aches in joints and/or muscles: Often	Aches in joints and/or muscles: Almost Always
Having a lot of pain	Having a lot of pain: Never	Having a lot of pain: Almost Never	Having a lot of pain: Sometimes	Having a lot of pain: Often	Having a lot of pain: Almost Always

NAUSEA (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
Becoming nauseated during medical treatments	Becoming nauseated during medical treatments: Never	Becoming nauseated during medical treatments: Almost Never	Becoming nauseated during medical treatments: Sometimes	Becoming nauseated during medical treatments: Often	Becoming nauseated during medical treatments: Almost Always
Food not tasting very good to him/her	Food not tasting very good to him/her: Never	Food not tasting very good to him/her: Almost Never	Food not tasting very good to him/her: Sometimes	Food not tasting very good to him/her: Often	Food not tasting very good to him/her: Almost Always
Becoming nauseated while thinking about medical treatments	Becoming nauseated while thinking about medical treatments: Never	Becoming nauseated while thinking about medical treatments: Almost Never	Becoming nauseated while thinking about medical treatments: Sometimes	Becoming nauseated while thinking about medical treatments: Often	Becoming nauseated while thinking about medical treatments: Almost Always
Feeling too nauseous to eat	Feeling too nauseous to eat: Never	Feeling too nauseous to eat: Almost Never	Feeling too nauseous to eat: Sometimes	Feeling too nauseous to eat: Often	Feeling too nauseous to eat: Almost Always
Some foods and smells making him/her nauseous	Some foods and smells making him/her nauseous: Never	Some foods and smells making him/her nauseous: Almost Never	Some foods and smells making him/her nauseous: Sometimes	Some foods and smells making him/her nauseous: Often	Some foods and smells making him/her nauseous: Almost Always

PROCEDURAL ANXIETY (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
Needle sticks (i.e. injections, blood tests, IV's) causing him/her pain	Needle sticks (i.e. injections, blood tests, IV's) causing him/her pain: Never	Needle sticks (i.e. injections, blood tests, IV's) causing him/her pain: Almost Never	Needle sticks (i.e. injections, blood tests, IV's) causing him/her pain: Sometimes	Needle sticks (i.e. injections, blood tests, IV's) causing him/her pain: Often	Needle sticks (i.e. injections, blood tests, IV's) causing him/her pain: Almost Always
Getting anxious about having blood drawn	Getting anxious about having blood drawn: Never	Getting anxious about having blood drawn: Almost Never	Getting anxious about having blood drawn: Sometimes	Getting anxious about having blood drawn: Often	Getting anxious about having blood drawn: Almost Always
Getting anxious about having needle sticks (i.e. injections, blood tests, IV's)	Getting anxious about having needle sticks (i.e. injections, blood tests, IV's): Never	Getting anxious about having needle sticks (i.e. injections, blood tests, IV's): Almost Never	Getting anxious about having needle sticks (i.e. injections, blood tests, IV's): Sometimes	Getting anxious about having needle sticks (i.e. injections, blood tests, IV's): Often	Getting anxious about having needle sticks (i.e. injections, blood tests, IV's): Almost Always

TREATMENT ANXIETY (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
Getting anxious when waiting to see the doctor	Getting anxious when waiting to see the doctor: Never	Getting anxious when waiting to see the doctor: Almost Never	Getting anxious when waiting to see the doctor: Sometimes	Getting anxious when waiting to see the doctor: Often	Getting anxious when waiting to see the doctor: Almost Always
Getting anxious about going to the doctor	Getting anxious about going to the doctor: Never	Getting anxious about going to the doctor: Almost Never	Getting anxious about going to the doctor: Sometimes	Getting anxious about going to the doctor: Often	Getting anxious about going to the doctor: Almost Always
Getting anxious about going to the hospital	Getting anxious about going to the hospital: Never	Getting anxious about going to the hospital: Almost Never	Getting anxious about going to the hospital: Sometimes	Getting anxious about going to the hospital: Often	Getting anxious about going to the hospital: Almost Always

WORRY (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
Worrying about side effects from medical treatments	Worrying about side effects from medical treatments: Never	Worrying about side effects from medical treatments: Almost Never	Worrying about side effects from medical treatments: Sometimes	Worrying about side effects from medical treatments: Often	Worrying about side effects from medical treatments: Almost Always
Worrying about whether or not his/her treatments are working	Worrying about whether or not his/her treatments are working: Never	Worrying about whether or not his/her treatments are working: Almost Never	Worrying about whether or not his/her treatments are working: Sometimes	Worrying about whether or not his/her treatments are working: Often	Worrying about whether or not his/her treatments are working: Almost Always
Worrying that the cancer will reoccur or relapse	Worrying that the cancer will reoccur or relapse: Never	Worrying that the cancer will reoccur or relapse: Almost Never	Worrying that the cancer will reoccur or relapse: Sometimes	Worrying that the cancer will reoccur or relapse: Often	Worrying that the cancer will reoccur or relapse: Almost Always

COGNITIVE PROBLEMS (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
Difficulty figuring out what to do when something bothers him/her	Difficulty figuring out what to do when something bothers him/her: Never	Difficulty figuring out what to do when something bothers him/her: Almost Never	Difficulty figuring out what to do when something bothers him/her: Sometimes	Difficulty figuring out what to do when something bothers him/her: Often	Difficulty figuring out what to do when something bothers him/her: Almost Always
Difficulty working with numbers or doing math	Difficulty working with numbers or doing math: Never	Difficulty working with numbers or doing math: Almost Never	Difficulty working with numbers or doing math: Sometimes	Difficulty working with numbers or doing math: Often	Difficulty working with numbers or doing math: Almost Always
Difficulty paying attention to things	Difficulty paying attention to things: Never	Difficulty paying attention to things: Almost Never	Difficulty paying attention to things: Sometimes	Difficulty paying attention to things: Often	Difficulty paying attention to things: Almost Always
Difficulty remembering what is read to him/her	Difficulty remembering what is read to him/her: Never	Difficulty remembering what is read to him/her: Almost Never	Difficulty remembering what is read to him/her: Sometimes	Difficulty remembering what is read to him/her: Often	Difficulty remembering what is read to him/her: Almost Always

PERCEIVED PHYSICAL APPEARANCE (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
Feeling that he/she is not good looking	Feeling that he/she is not good looking: Never	Feeling that he/she is not good looking: Almost Never	Feeling that he/she is not good looking: Sometimes	Feeling that he/she is not good looking: Often	Feeling that he/she is not good looking: Almost Always
Not liking other people to see his/her scars	Not liking other people to see his/her scars: Never	Not liking other people to see his/her scars: Almost Never	Not liking other people to see his/her scars: Sometimes	Not liking other people to see his/her scars: Often	Not liking other people to see his/her scars: Almost Always
Being embarrassed about others seeing his/her body	Being embarrassed about others seeing his/her body: Never	Being embarrassed about others seeing his/her body: Almost Never	Being embarrassed about others seeing his/her body: Sometimes	Being embarrassed about others seeing his/her body: Often	Being embarrassed about others seeing his/her body: Almost Always

COMMUNICATION (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
Difficulty telling the doctors and nurses how he/she feels	Difficulty telling the doctors and nurses how he/she feels: Never	Difficulty telling the doctors and nurses how he/she feels: Almost Never	Difficulty telling the doctors and nurses how he/she feels: Sometimes	Difficulty telling the doctors and nurses how he/she feels: Often	Difficulty telling the doctors and nurses how he/she feels: Almost Always
Difficulty asking the doctors or nurses questions	Difficulty asking the doctors or nurses questions: Never	Difficulty asking the doctors or nurses questions: Almost Never	Difficulty asking the doctors or nurses questions: Sometimes	Difficulty asking the doctors or nurses questions: Often	Difficulty asking the doctors or nurses questions: Almost Always
Difficulty explaining his/her illness to other people	Difficulty explaining his/her illness to other people: Never	Difficulty explaining his/her illness to other people: Almost Never	Difficulty explaining his/her illness to other people: Sometimes	Difficulty explaining his/her illness to other people: Often	Difficulty explaining his/her illness to other people: Almost Always