明尼苏达心力衰竭生活质量调查表.docVIP

明尼苏达心力衰竭生活质量调查表（明尼苏达大学，1986年） 在最近的一个月内，您的心力衰竭对您的生活的影响 Did your heart failure prevent you from living as you wanted during the last month by 无NO 很少Very Little ? ? ? 很多Very Much 1. 您的踝关节或腿出现肿胀？ causing swelling in your ankles or legs, etc.? 0 1 2 3 4 5 2. 使您在白天被迫坐下或躺下休息？ making you sit or lie down to rest during the day??????? 0 1 2 3 4 5 3. 使您在步行或上楼梯困难？ making your walking about or climbing? stairs difficult? 0 1 2 3 4 5 4. 使您在家中或院子里工作困难？ making your working around the house or yard difficult???? 0 1 2 3 4 5 5. 使您离开家出门困难？ making your going places away from home difficult? 0 1 2 3 4 5 6. 使您晚上睡眠状况困难？ making your sleeping well at night difficult? 0 1 2 3 4 5 7. 使您和您的朋友或家人一起做事困难？ making your relating to or doing things with your friends or family difficult? 0 1 2 3 4 5 8. 使您做获得收入的工作困难？ making your working to earn a living difficult???? 0 1 2 3 4 5 9. 使您的做娱乐、体育活动或喜好的事情困难？ making your recreational pastimes, sports or hobbies difficult? 0 1 2 3 4 5 10. 使您的性生活困难? making your sexual activities difficult? 0 1 2 3 4 5 11. 使您对您喜欢的食物也吃的很少？ making you eat less of the foods you like? 0 1 2 3 4 5 12. 使你有呼困难？ making you short of breath?? 0 1 2 3 4 5 13. 使您疲劳、乏力、或没有精力？ making you tired, fatigued, or low on energy? 0 1 2 3 4 5 14. 使您在医院住院？ making you stay in a hospital? 0 1 2 3 4 5 15. 使您因就医花钱？ costing you money for medical care? 0 1 2 3 4 5 16. 使您因为治疗出现了副作用？ giving you side effects from treatments? 0 1 2 3 4 5 17. 使您觉得自己是家人或朋友的负担？ making you feel you are a burden to your family or friends? 0 1 2 3 4 5 18. 使您觉得不能控制自己的生活？ making you feel a loss of self-control in your life? 0 1 2 3 4 5 19. 使得您焦虑？ making you worry??????? 0 1 2 3 4 5 20. 使您不能集中注意力或记忆力下降？ making it difficult for you to concentrate or remember things? 0 1 2 3 4 5 21. 使您情绪低落？ making you feel depressed?????????? 0 1 2 3 4 5