pain scales welsh

PAIN RATING SCALE (Welsh) Teitl: .......................................................... Enw Cyntaf::.............................................. Cyfenw: .....................................................

Dyddiad: ................................................ Rhif y Claf::............................................. Clinig: ......................................................

Marciwch y raddfa islaw i ddangos pa mor ddrwg yw eich poen, os gwelwch yn dda. Mae dim (0) yn golygu dim poen, ac mae deg (10) yn golygu dirboen. Pa mor ddwys yw eich poen nawr? I

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0 1 dim poen

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9 10 poen dirfawr

Pa mor ddwys oedd eich poen ar gyfartaledd yr wythnos ddiwethaf? I

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9 10 poen dirfawr

Nawr, defnyddiwch yr un drefn i ddisgrifio pa mor ofidus yw eich poen, os gwelwch yn dda. Pa mor ofidus yw eich poen nawr? I

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0 1 dim yn ofidus o gwbl

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10 yn ofidus dros ben

Pa mor ofidus oedd eich poen ar gyfartaledd yr wythnos ddiwethaf? I

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10 yn ofidus dros ben

Nawr, defnyddiwch yr un drefn i ddisgrifio faint mae eich poen yn effeitho ar eich gweithgareddau arferol bob dydd, os gwelwch yn dda. I

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0 dim effaith

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9 10 yn effeithio yn llwyr

Os ydych wedi cael triniaeth at eich poen, pa faint mae hyn wedi esmwytho (wedi gwaredu) y poen? 0% 10% Dim Esmwythhad

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90% 100% esmwythhad llwyr

The Pain Society An alliance of professionals advancing the understanding and management of pain for the benefit of patients

©ThePainSociety2003

www.painsociety.org

Charity no. 278685

PAIN RATING SCALE (English) Title: .......................................................... First Name:................................................ Surname:...................................................

Date:........................................................ Patient number:....................................... Clinic: ......................................................

Please mark the scale below to show how intense your pain is. A zero (0) means no pain, and ten (10) means extreme pain. How intense is your pain now? I

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0 1 no pain

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9 10 extreme pain

How intense was your pain on average last week? I

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0 1 no pain

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9 10 extreme pain

Now please use the same method to describe how distressing your pain is. How distressing is your pain now? I

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0 1 not at all distressing

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10 extremely distressing

How distressing was your pain on average last week? I

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Now please use the same method to describe how much your pain interferes with your normal everyday activities. I

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10 interferes completely

If you have had treatment for your pain, how much has this relieved (taken away) the pain? 0% 10% no relief

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90% 100% complete relief

The Pain Society An alliance of professionals advancing the understanding and management of pain for the benefit of patients

©ThePainSociety2003

www.painsociety.org

Charity no. 278685