间质性膀胱炎评分表

间质性膀胱炎的评分问卷表 The O’Leary-Sant IC Indices4 Problem Index During the past month, how much has each of the following been a problem for you: Q1: Frequent urination during the day? Q2: Getting up at night to urinate? Q3: Need to urinate with little warning? Q4: Burning, pain, discomfort or pressure in your bladder? ____ no problem = 0 ____ very small problem = 1 ____ small problem = 2 ____ medium problem = 3 ____ big problem = 4 Total score: ____/16 Symptom Index During the past month, how much has each of the following been a problem for you: Q1: Felt a strong need to urinate with little or no warning? ____ not at all = 0 ____ less than 1 time in 5 = 1 ____ less than half the time = 2 ____ about half the time = 3 ____ more than half the time = 4 ____ almost always = 5 Q2: Urinate less than 2 hours after urinating? ____ not at all = 0 ____ less than 1 time in 5 = 1 ____ less than half the time = 2 ____ about half the time = 3 ____ more than half the time = 4 ____ almost always = 5 Q3: Get up at night to urinate? ____ not at all = 0 ____ 1 time = 1 ____ 2 times = 2 ____ 3 times = 3 ____ 4 times = 4 ____ 5 times = 5 Q4: Experienced pain or burning in your bladder? ____ not at all = 0 ____ a few times = 1 ____ fairly often = 2 ____ almost always = 3 ____ always = 4 Total score: ____/19