Table 2 GERD-specific work productivity and activity impairment questionnaire (WPAI-GERD)
From: The impact of illness in patients with moderate to severe gastro-esophageal reflux disease
1. Are you currently employed? |
2. During the past 7 days, how many days did you work? |
3. How many of those days did you have reflux symptoms while working? |
4. During the past 7 days, how many hours were you absent from work because of problems associated with your reflux symptoms? |
5. During the past 7 days, how many hours were you absent from work for any other reason than problems associated with your reflux symptoms? |
6. During the past 7 days, how many hours did you actually work? |
7. During the past 7 days, how much did your reflux symptoms on average affect your normal productivity while you were working? |
8. During the past 7 days, how much did your reflux symptoms on average affect your normal productivity while you were doing your regular activities, other than working? |