Australian Pelvic Floor Questionnaire

This short screening tool is designed for women to check if at risk of pelvic floor problems. 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. 0 up to 7 1 between 8 10 2 between 11 15 3 more than 15 2.

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Please mark x in the box that best describes your symptoms in the last month.

Australian pelvic floor questionnaire.

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. For example the australian pelvic floor questionnaire as used by behnia et al 15 was tested and validated in a population of women with varying pelvic floor disorders. The australian pelvic floor questionaire please circle your most applicable answer. All information is strictly confidential.

The following is a questionnaire about your pelvic health. 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. How many times do you pass urine in the day. Do you experience urine leakage incontinence related to physical activity such as.

Bladder section q 1 14 score 42 urinary frequency how many times do you pass urine in the day. How many times to you get up at night to pass urine. Takes 5 minutes to complete. Once completed you can compare your scores to that of healthy volunteers and those referred for treatment.

Consider your experiences during the last month. Queensland female pelvic floor questionnaire 1 patient. 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. It has recently been validated in pregnant and postpartum women and designed to facilitate clinical assessment of pelvic.

Erience during the last month. 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. Date of birth. Pelvic floor bother questionnaire.

Page 1 of 2 australian pelvic floor questionnaire please circle your most applicable answer. It also advises women to ensure their exercise program is pelvic floor friendly. 0 0 1 1 2 2 3. Consider your exp patient s name.