Table 1 The Assessment of Burden of COPD scale
Never | Hardly ever | A few times | Several times | Many times | A great many times | Almost all the time | |
|---|---|---|---|---|---|---|---|
On average, during the past week, how often did you feel: | |||||||
1. Short of breath at rest? | □ | □ | □ | □ | □ | □ | □ |
2. Short of breath doing physical activities? | □ | □ | □ | □ | □ | □ | □ |
3. Concerned about getting a cold or your breathing getting worse? | □ | □ | □ | □ | □ | □ | □ |
4. Depressed (down) because of your breathing problems? | □ | □ | □ | □ | □ | □ | □ |
In general, during the past week, how much of the time: | |||||||
5. Did you cough? | □ | □ | □ | □ | □ | □ | □ |
6. Did you produce phlegm? | □ | □ | □ | □ | □ | □ | □ |
Not limited at all | Very slightly limited | Slightly limited | Moderately limited | Very limited | Extremely limited | Totally limited/ or unable to do | |
On average, during the past week, how limited were you in these activities because of your breathing problems: | |||||||
7. Strenuous physical activities (such as climbing stairs, hurrying, doing sports)? | □ | □ | □ | □ | □ | □ | □ |
8. Moderate physical activities (such as walking, house work, carrying things)? | □ | □ | □ | □ | □ | □ | □ |
9. Daily activities at home (such as dressing, washing yourself)? | □ | □ | □ | □ | □ | □ | □ |
10. Social activities (such as talking, being with children, visiting friends/relatives)? | □ | □ | □ | □ | □ | □ | □ |
Never | Hardly ever | A few times | Several times | Many times | A great many times | Almost all the time | |
How often in the past week did you suffer from: | |||||||
11. Worry? | □ | □ | □ | □ | □ | □ | □ |
12. Listlessness? | □ | □ | □ | □ | □ | □ | □ |
13. A tense feeling? | □ | □ | □ | □ | □ | □ | □ |
14. Fatigue? | □ | □ | □ | □ | □ | □ | □ |
