Australian Pelvic Floor Questionnaire

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The following is a questionnaire about your pelvic health.

Australian pelvic floor questionnaire.

This short screening tool is designed for women to check if at risk of pelvic floor problems. 0 up to 7 1 between 8 10 2 between 11 15 3 more than 15 nocturia how many times do you get up at night to pass urine. The self administered australian pelvic floor questionnaire apfq comprehensively integrates four domains to assess bladder bowel prolapse and sexual symptoms their severity their bother and impact on quality of life. Bladder section q 1 14 score 42 urinary frequency how many times do you pass urine in the day.

The australian pelvic floor questionnaire apfq is a validated multi lingual self completed questionnaire that evaluates and scores all four areas of female pelvic floor dysfunction. Consider your experiences during the last month. Erience during the last month. Takes 5 minutes to complete.

0 0 1 1 2 2 3. All information is strictly confidential. Please mark x in the box that best describes your symptoms in the last month. 0 up to 7 1 between 8 10 2 between 11 15 3 more than 15 2.

It also advises women to ensure their exercise program is pelvic floor friendly. The australian pelvic floor questionnaire apfq is a validated multi lingual self completed questionnaire that evaluates and scores all four areas of female pelvic floor dysfunction. The australian pelvic floor questionnaire bladder and bowel domain scores demonstrated moderate positive correlations with the international consultation on incontinence questionnaire short form questionnaire for urinary incontinence r 0 74 p 0 01 and the international consultation on incontinence questionnaire bowel module r 0 69. Consider your exp patient s name.

Queensland female pelvic floor questionnaire 1 patient. It has recently been validated in pregnant and postpartum women and designed to facilitate clinical assessment of pelvic. Once completed you can compare your scores to that of healthy volunteers and those referred for treatment. Pelvic floor bother questionnaire.

Page 1 of 2 australian pelvic floor questionnaire please circle your most applicable answer. Do you experience urine leakage incontinence related to physical activity such as. How many times to you get up at night to pass urine. Date of birth.

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