PatientHealthQuestionnaire(PHQ-9)患者健康问卷介绍.PDF

MSU Olin Student Health Center 密歇根州立大学Olin 学生健康中心 Patient Health Questionnaire (PHQ-9) 患者健康问卷 □ Initial Screening 首次检测□ Follow Up 跟踪检测□ Annual Screening 年度检测 Name 姓名_______________ Student # 学生证号____________ Date 日期__________ This questionnaire will help your health provider to improve your treatment. Simply circle your answer to the questions below. Please give your completed form to a health professional. 这份问卷将帮助您的医疗服务人员改善对您的医疗方案。请圈出您对于以下问题的答案，并且将完成的 问卷提交给专业医疗人士。 Over the last two weeks, how often have you been bothered by any of the following problems? 在过去的两周里，您感觉自己被以下症状所困扰的频率是？ Not At All Several days More than half Nearly every 完全没有 有过几天 the days day 超过一半天数 几乎每天 1. Little interest or pleasure in doing things 0 1 2 3 对任何事情都提不起兴趣/感受不到兴趣 2. Feeling down, depressed, or hopeless 感觉沮丧的，忧郁的，或绝望的 0 1 2 3 Scores (add columns) 分数(每列分数累加) ___________ + _____________ + _____________ + ___________ Front Total Score 总分1 If your total score is greater than or equal to three, please continue with questions 3-10 on the back. 如果您的总分等于或大于3，请翻页回答第3 至第10 题。 Provider Signature 答卷人签名__________________________ Date 日期_________________ *NOTE: This document will be scanned into your medical record. Name姓名______________________ Student #学生证号 ________________ Date 日期___________ Over the last two week