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1 This is a Sample version of the McGill Pain Questionnaire Long Form & Short Form (MPQ-LF & SF) The full version of MPQ-LF & SF comes without sample watermark.. The full complete 23 page version includes MPQ-LF & SF Overview information MPQ-LF & SF Scoring/ Administration instructions MPQ-LF Complete 78 item questionnaire MPQ-Short Form complete quick questionnaire. - MPQ Clinical Validity Buy full version here - for $7.00 Clicking the above buy now button will take you to the PayPal payment service website in which you can pay via credit card or your optional PayPal account. Once you have paid for your item you will receive a direct link to download your full complete e-book instantly. You will also receive an with a link to download your e-book. Each purchased product you order is available to download for 24 hours from time of purchase. Should you have any problems or enquiries please contact - info@agedcaretests.com

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3 This is the end of the SAMPLE MPQ clinical validity.

4 habilitation Measures Database McGill Pain Questionnaire Title of Assessment Acronym Instrument Reviewer(s) McGill Pain Questionnaire MPQ Jason H. Raad Summary Date 8/2/2013 Purpose Description A self-report measure of pain The MPQ is a self-report measure of pain studied with a number of diagnoses. The MPQ assesses both the quality and intensity of subjective pain. The MPQ is composed of 78 words, of which respondents choose those that best describe their experience of pain. Seven words are selected from the following categories: dimension 1 to 10 (pain descriptors), three words; dimensions 11 to 15 (affective components of pain), dimension 16 (evaluation of pain) one word, and dimension 17 to 20 (miscellaneous) one word. Scores are tabulated by summing values associated with each word; scores range from 0 (no pain) to 78 (severe pain). Qualitative differences in pain may be reflected in respondent s word choice (Melzack, 1975). Area of Assessment Body Part ICF Domain Domain Assessment Type Length of Test Time to Administer MPQ Dimensions Sensory: 1 Flickering/beating 2 Jumping/shooting 3 Pricking/lancinating 4 Sharp/lacerating 5 Pinching/crushing 6 Tugging/wrenching 7 Hot/searing 8 Tingling/stinging 9 Dull/heavy 10 Tender/splitting Affective: 11 Tiring/exhausting 12 Sickening/suffocating 13 Fearful/terrifying 14 Punishing/killing 15 Wretched/blinding Evaluative: 16 Annoying/unbearable Miscellaneous: 17 Spreading/piercing 18 Tight/tearing 19 Cold/freezing 20 Nagging/torturing Pain Not Applicable Body Function Sensory Patient Reported Outcomes 06 to 30 Minutes The MPQ long version may take as long as 30 minutes to complete, short forms of the measure are available. This is the end of the SAMPLE MPQ overview info.

5 The McGill Pain Questionnaire- Long form Scoring Instructions Overview: The McGill Pain Questionnaire can be used to evaluate a person experiencing significant pain. It can be used to monitor the pain over time and to determine the effectiveness of any intervention. Sections: (1) What Does Your Pain Feel Like? (2) How Does Your Pain Change with Time? (3) How Strong is Your Pain? Interpretation: (The MPQ long version may take as long as 30 minutes to complete) minimum pain score: 0 (would not be seen in a person with true pain) maximum pain score: 78 The higher the pain score the greater the pain.. This is the end of the SAMPLE MPQ-LF Scoring Instructions.

6 The McGill Pain Questionnaire-Long form Sections: (1) What Does Your Pain Feel Like? (2) How Does Your Pain Change with Time? (3) How Strong is Your Pain? What Does Your Pain Feel Like? Statement: Some of the following words below describe your present pain. Circle ONLY those words that best describe it. Leave out any category that is not suitable. Use only a single word in each appropriate category - the one that applies best. Group Descriptor Points 1 (temporal) flickering 1 quivering 2 pulsing 3 throbbing 4 beating 5 pounding 6 2 (spatial) jumping 1 flashing 2 shooting 3 3 (punctate pressure) pricking 1 boring 2 drilling 3 stabbing 4 lancinating 5 4 (incisive pressure) sharp 1 cutting 2 lacerating 3 This is the end of the SAMPLE MPQ-LF questionnaire.

7 Instructions to patients: Short-Form McGill Pain Questionnaire Instructions to patients and scoring procedures Ronald Melzack, 1984 This questionnaire provides you with a list of words that describe some of the different qualities of pain. Please check ( ) those words that best describe the pain you feel currently*, and indicate their intensity as mild, moderate, or severe. Check 0 if the word does not describe your pain. Another way to indicate your pain s intensity is the visual analogue scale (VAS), which is a horizontal line from no pain to worst pain. Make a small vertical line at the intensity level you think best describes your current pain. Finally, make a check ( ) beside the word in the vertical list of words that best describes your present pain intensity (PPI) from mild to excruciating. * currently, to most people, refers to the past few hours, days, or as long as a week; investigators may wish to be explicit and, for example, state your pain during the last week, presently, or other period of time. However, do not ask patients for an average; studies show that people have excellent recall of a specific pain episode, using the MPQ, many days after it occurred. Please me if you wish to discuss this issue. Scoring procedures: 1. SF-MPQ This is the end of the SAMPLE MPQ-SF scoring instructions.

8 Check the column to indicate the level of your pain for each word, or leave blank if it does not apply to you. SHORT FORM McGILL PAIN QUESTIONNAIRE and PAIN DIAGRAM (Reproduced with permission of author Dr. Ron Melzack, for publication and distribution) Date: Name: Mild Moderate Severe 1 Throbbing 2 Shooting 3 Stabbing 4 Sharp 5 Cramping 6 Gnawing 7 Hot-burning 8 Aching 9 Heavy 10 Tender 11 Splitting 12 Tiring-Exhausting 13 Sickening 14 Fearful 15 Cruel-Punishing This is the end of the SAMPLE MPQ-SF questionnaire.