Hernia Surgery Post-Op QPROM

Thank you for having your hernia surgery at Kinvara Private Hospital. Please complete this short questionnaire (known as a Quality Patient-Reported Outcome Measure – QPROM).

The questionnaire should only be completed by patients that have had hernia surgery and will only take a few minutes.

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Name
Date of birth
When did your hernia surgery take place?
1. Is anyone helping you fill in this questionnaire?
2. Which statement best describes your living arrangements?
3. Did you experience any of the following problems after your operation?
4. Have you been readmitted to hospital since your hernia operation?
5. Have you had another operation on your groin areas?
6. In general, how would you rate your general health?
7. Overall, how are your hernia problems now, compared to before your operation?

By placing a tick in one box in each group below, please indicate which statements best describe your own health state today.

8. Mobility
9. Self-care
9. Usual activities (e.g. work, study, housework, family)
10. Pain / discomfort
11. Anxiety / depression