PGA Adolescent PedsQL Module

In the past two weeks, how much of a problem has this been for you?

PAIN AND HURT (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
I ache and hurt in my joints and/or muscles	I ache and hurt in my joints and/or muscles: Never	I ache and hurt in my joints and/or muscles: Almost Never	I ache and hurt in my joints and/or muscles: Sometimes	I ache and hurt in my joints and/or muscles: Often	I ache and hurt in my joints and/or muscles: Almost Always
I hurt a lot	I hurt a lot: Never	I hurt a lot: Almost Never	I hurt a lot: Sometimes	I hurt a lot: Often	I hurt a lot: Almost Always

NAUSEA (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
I become sick to my stomach when I have medical treatments	I become sick to my stomach when I have medical treatments: Never	I become sick to my stomach when I have medical treatments: Almost Never	I become sick to my stomach when I have medical treatments: Sometimes	I become sick to my stomach when I have medical treatments: Often	I become sick to my stomach when I have medical treatments: Almost Always
Food does not taste very good to me	Food does not taste very good to me: Never	Food does not taste very good to me: Almost Never	Food does not taste very good to me: Sometimes	Food does not taste very good to me: Often	Food does not taste very good to me: Almost Always
I become sick to my stomach when I think about medical treatments	I become sick to my stomach when I think about medical treatments: Never	I become sick to my stomach when I think about medical treatments: Almost Never	I become sick to my stomach when I think about medical treatments: Sometimes	I become sick to my stomach when I think about medical treatments: Often	I become sick to my stomach when I think about medical treatments: Almost Always
I feel too sick to my stomach to eat	I feel too sick to my stomach to eat: Never	I feel too sick to my stomach to eat: Almost Never	I feel too sick to my stomach to eat: Sometimes	I feel too sick to my stomach to eat: Often	I feel too sick to my stomach to eat: Almost Always
Some foods and smells make me sick to my stomach	Some foods and smells make me sick to my stomach: Never	Some foods and smells make me sick to my stomach: Almost Never	Some foods and smells make me sick to my stomach: Sometimes	Some foods and smells make me sick to my stomach: Often	Some foods and smells make me sick to my stomach: Almost Always

PROCEDURAL ANXIETY (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
Needle sticks (i.e. injections, blood tests, IV's) hurt	Needle sticks (i.e. injections, blood tests, IV's) hurt: Never	Needle sticks (i.e. injections, blood tests, IV's) hurt: Almost Never	Needle sticks (i.e. injections, blood tests, IV's) hurt: Sometimes	Needle sticks (i.e. injections, blood tests, IV's) hurt: Often	Needle sticks (i.e. injections, blood tests, IV's) hurt: Almost Always
I get scared when I have to have blood tests	I get scared when I have to have blood tests: Never	I get scared when I have to have blood tests: Almost Never	I get scared when I have to have blood tests: Sometimes	I get scared when I have to have blood tests: Often	I get scared when I have to have blood tests: Almost Always
I get scared about having needle sticks (i.e. injections, blood tests, IV's)	I get scared about having needle sticks (i.e. injections, blood tests, IV's): Never	I get scared about having needle sticks (i.e. injections, blood tests, IV's): Almost Never	I get scared about having needle sticks (i.e. injections, blood tests, IV's): Sometimes	I get scared about having needle sticks (i.e. injections, blood tests, IV's): Often	I get scared 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
I get scared when I am waiting to see the doctor	I get scared when I am waiting to see the doctor: Never	I get scared when I am waiting to see the doctor: Almost Never	I get scared when I am waiting to see the doctor: Sometimes	I get scared when I am waiting to see the doctor: Often	I get scared when I am waiting to see the doctor: Almost Always
I get scared when I have to go to the doctor	I get scared when I have to go to the doctor: Never	I get scared when I have to go to the doctor: Almost Never	I get scared when I have to go to the doctor: Sometimes	I get scared when I have to go to the doctor: Often	I get scared when I have to go to the doctor: Almost Always
I get scared when I have to go to the hospital	I get scared when I have to go to the hospital: Never	I get scared when I have to go to the hospital: Almost Never	I get scared when I have to go to the hospital: Sometimes	I get scared when I have to go to the hospital: Often	I get scared when I have to go to the hospital: Almost Always

WORRY (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
I worry about side effects from medical treatments	I worry about side effects from medical treatments: Never	I worry about side effects from medical treatments: Almost Never	I worry about side effects from medical treatments: Sometimes	I worry about side effects from medical treatments: Often	I worry about side effects from medical treatments: Almost Always
I worry about whether or not my medical treatments are working	I worry about whether or not my medical treatments are working: Never	I worry about whether or not my medical treatments are working: Almost Never	I worry about whether or not my medical treatments are working: Sometimes	I worry about whether or not my medical treatments are working: Often	I worry about whether or not my medical treatments are working: Almost Always
I worry that my cancer will come back or relapse	I worry that my cancer will come back or relapse: Never	I worry that my cancer will come back or relapse: Almost Never	I worry that my cancer will come back or relapse: Sometimes	I worry that my cancer will come back or relapse: Often	I worry that my cancer will come back or relapse: Almost Always

COGNITIVE PROBLEMS (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
It is hard for me to figure out what to do when something bothers me	It is hard for me to figure out what to do when something bothers me: Never	It is hard for me to figure out what to do when something bothers me: Almost Never	It is hard for me to figure out what to do when something bothers me: Sometimes	It is hard for me to figure out what to do when something bothers me: Often	It is hard for me to figure out what to do when something bothers me: Almost Always
I have trouble solving math problems	I have trouble solving math problems: Never	I have trouble solving math problems: Almost Never	I have trouble solving math problems: Sometimes	I have trouble solving math problems: Often	I have trouble solving math problems: Almost Always
I have trouble writing school papers or reports	I have trouble writing school papers or reports: Never	I have trouble writing school papers or reports: Almost Never	I have trouble writing school papers or reports: Sometimes	I have trouble writing school papers or reports: Often	I have trouble writing school papers or reports: Almost Always
It is hard for me to pay attention to things	It is hard for me to pay attention to things: Never	It is hard for me to pay attention to things: Almost Never	It is hard for me to pay attention to things: Sometimes	It is hard for me to pay attention to things: Often	It is hard for me to pay attention to things: Almost Always
It is hard for me to remember what I read	It is hard for me to remember what I read: Never	It is hard for me to remember what I read: Almost Never	It is hard for me to remember what I read: Sometimes	It is hard for me to remember what I read: Often	It is hard for me to remember what I read: Almost Always

PERCEIVED PHYSICAL APPEARANCE (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
I feel I am not good looking	I feel I am not good looking: Never	I feel I am not good looking: Almost Never	I feel I am not good looking: Sometimes	I feel I am not good looking: Often	I feel I am not good looking: Almost Always
I don't like other people to see my scars	I don't like other people to see my scars: Never	I don't like other people to see my scars: Almost Never	I don't like other people to see my scars: Sometimes	I don't like other people to see my scars: Often	I don't like other people to see my scars: Almost Always
I am embarrassed when others see my body	I am embarrassed when others see my body: Never	I am embarrassed when others see my body: Almost Never	I am embarrassed when others see my body: Sometimes	I am embarrassed when others see my body: Often	I am embarrassed when others see my body: Almost Always

COMMUNICATION (problems with...)

Space Cell	Never	Almost Never	Sometimes	Often	Almost Always
It is hard for me to tell the doctors and nurses how I feel	It is hard for me to tell the doctors and nurses how I feel: Never	It is hard for me to tell the doctors and nurses how I feel: Almost Never	It is hard for me to tell the doctors and nurses how I feel: Sometimes	It is hard for me to tell the doctors and nurses how I feel: Often	It is hard for me to tell the doctors and nurses how I feel: Almost Always
It is hard for me to ask the doctors and nurses questions	It is hard for me to ask the doctors and nurses questions: Never	It is hard for me to ask the doctors and nurses questions: Almost Never	It is hard for me to ask the doctors and nurses questions: Sometimes	It is hard for me to ask the doctors and nurses questions: Often	It is hard for me to ask the doctors and nurses questions: Almost Always
It is hard for me to explain my illness to other people	It is hard for me to explain my illness to other people: Never	It is hard for me to explain my illness to other people: Almost Never	It is hard for me to explain my illness to other people: Sometimes	It is hard for me to explain my illness to other people: Often	It is hard for me to explain my illness to other people: Almost Always