A Three-Item Scale Assessing Pain Intensity And Interference Screening Checklist Template
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1PEG: A Three-Item Scale Assessing Pain Intensity and Interference
1. What number best describes your pain on average in the past week?
0
1
2
3
4
5
6
7
8
9
10
No pain
Pain as bad as
you can imagine
2. What number best describes how, during the past week, pain has interfered
with your enjoyment of life?
0
1
2
3
4
5
6
7
8
9
10
No pain
Pain as bad as
you can imagine
3. What number best describes how, during the past week, pain has interfered
with your general activity?
0
1
2
3
4
5
6
7
8
9
10
No pain
Pain as bad as
you can imagine
From Krebs et al., 2009.
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0 votes
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Parent category: Life