All-Europe Pain Patients’ Survey

INTRODUCTION:

The charity members of Pain Alliance Europe (PAE) are inviting people with chronic pain or their carers to fill in this short survey on the cause of their pain and its severity – and the various places where they have received or are receiving their treatment.

PAE will then create a report comparing the pain patients’ experiences in different countries that can help make politicians and policy makes be more aware of the important issue of chronic pain.

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* 1. Country

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* 2. Gender

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* 3. Age

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* 4. How long was it between your first visit to a healthcare professional about your condition and getting a diagnosis?

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* 5. Do you have co-morbidities (other conditions for which you are having treatment)?

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* 6. What caused your chronic pain (underlying condition)? Choose one that best describes your problem:

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* 7. How long has your pain lasted? 

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* 8. On a scale from one to 10, 10 being the worst possible pain, how do you rate your average daily pain level?

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* 9. Questions about your treatment:
Is your treatment as good as you expected?

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* 10. Has your family doctor given you a referral to additional therapy?

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* 11. If yes, how many months were you treated by your family doctor, before you were referred to special care/pain clinic? 

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* 12. If yes, how many visits were you able get at the pain clinic?

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* 13. If yes, when was the last time you received additional therapy?

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* 14. If yes, how frequent is your additional therapy?

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* 15. Where are you currently receiving your pain management from? (Tick all applicable)

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* 16. Have you attended a local health care centre’s/hospital's pain management group (groups of patients) led by a professional?

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* 17. Have you attended any patient group meetings for your condition?

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* 18. Have you participated in a patient association's forum on the web?

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* 19. Do you think this kind of all-European survey would get more visibility for chronic pain ?

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* 20. Do you thing this survey will help politicians and decision-makers to see the large scale problem of chronic pain?

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* 21. Do you want to receive the results of this questionnaire?

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* 22. Do you want to receive the Pain Alliance Europe newsletter?

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* 23. Do you want to participate in future questionnaires?

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* 24. If you have said ‘yes’ to any of the last three questions, please type in your email address. Your e-mail address will only be used for the purpose you have selected. It will not be given to third parties.

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* 25. Extra questions for the Maltese survey:
What is currently your employment status?

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* 26. 2) If you are employed, in the past six months, how many days in total have you lost from work because of your pain?

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* 27. Does your current employment status or the hours you work have anything to do with the pain that you experience?

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* 28. Have any of the following ever happened as a result of your pain ... ?

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* 29. What is your legal marital status?

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* 30. Do you believe that your pain condition may affect your marital status?

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* 31. Have you been treated for pain or seen a doctor for pain in another country?

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* 32. If you answered “Yes”, for what reasons?

THANK YOU FOR YOUR PARTICIPATION

This survey was sent to you by No Pain Foundation, Malta.  You can email them at info@nopainfoundation.org if you would like to know more about these organisations.

You can visit http://www.pae-eu.eu/ to find out more about the Pain Alliance Europe.

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