CONFIRMATION
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Assessment
The pre-operative assessment is an opportunity to identify co-morbidities that may lead to patient complications during the anaesthetic,
Over the past 2 weeks, how often have you been bothered by any of the following problems?
Not at All
Several Days
More Than Half the Days
Nearly Every Day
Little interest or pleasure in doing things
0
1
2
3
Feeling down, depressed, or hopeless
0
1
2
3
Trouble falling asleep, staying asleep, or sleeping too much
0
1
2
3
Feeling tired or having little energy
0
1
2
3
Poor appetite or overeating
0
1
2
3
Feeling bad about yourself - or that you're a failure or have let yourself or your family down
0
1
2
3
Trouble concentrating on things, such as reading the newspaper or watching television
0
1
2
3
Moving or speaking so slowly that other people could have noticed. Or, the opposite - being so fidgety or restless that you have been moving around a lot more than usual
0
1
2
3
Thoughts that you would be better off dead or hurting yourself in some way
0
1
2
3
Column Totals
0
+
0
+
0
Total
0
If you checked off any problems, how difficult have those problems made it for you to do your work? take care of things at home, or get along with other people?
Total Score
Depression Severity
Total Score
Depression Severity
1-4
Minimal depression
15-19
Moderately severe depression
5-9
Mild depression
20-27
Severe depression
10-14
Moderate depression