NORFOLK

The Norfolk Quality of Life‐Diabetic Neuropathy (QOL‐DN ) questionnaire is an instrument to assess QOL in diabetic polyneuropathy.

An observational, cross‐sectional study in 61 patients with V30M transthyretin familial amyloid polyneuropathy (TTR‐FAP ) and 16 healthy volunteers was conducted with the objective to validate the Norfolk QOL‐DN for assessment of QOL in TTR‐FAP .

Comparisons were conducted to identify the best items to discriminate disease stages and assess which individual Norfolk domains (symptoms, large fiber, small fiber, autonomic, and activities of daily living) would be most affected by disease stage. Analysis of individual items revealed a significant pattern of discrimination among disease stages (p < 0.001).

Total QOL scores increased (indicating worsening) with duration of symptoms, with a steeper increase observed earlier in the course of disease. Significant correlations were observed between each Norfolk domain and other measures of neurological function.

These results suggest the Norfolk QOL‐DN is a reliable indicator of the impact of disease severity on QOL in patients with TTR‐FAP .[1]

[1] Vinik et al. J Peripher Nerv Syst 2014;19:104–14

Part I: Symptoms

Have you had any of the following symptoms in the past 4 weeks? Please Check all that apply.

Feet

Legs

Hands

Arms

None
1. Numbness
2. Tingling, Pins and Needles
3. Electric Shocks
4. Other Unusual Sensations
5. Superficial Pain
6. Deep Pain
7. Weakness

 

Part II: Activities of Daily Life

Answer these questions according to the following scale:

0 Not a problem / 1 Very mild problem / 2 Mild problem / 3 Moderate problem / 4 Severe problem

8. In the past 4 weeks, has pain kept you awake or woken you at night?
9. In the past 4 weeks, has the touch of bed sheets, clothes, or wearing shoes bothered you?
10. In the past 4 weeks, have you burned or injured yourself and been unable to feel it?
11. In the past 4 weeks, have any symptoms kept you from doing your usual activities during the day?
12. In the past 4 weeks, have you had difficulty doing fine movements with your fingers, like buttoning your clothes, turning pages in a book, picking up coins from a table?
13. In the past 4 weeks, have you felt unsteady on your feet when you walk?
14. In the past 4 weeks, have you had any problem getting out of a chair without pushing with your hands?
15. In the past 4 weeks, have you had a problem walking down stairs?
16. In the past 4 weeks, have you been unable to feel your feet when walking?
17. In the past 4 weeks, have you been unable to tell hot from cold water with your hands?
18. In the past 4 weeks, have you been unable to tell hot from cold water with your feet?
19. In the past 4 weeks, have you had a problem with vomiting, particularly after meals (but not due to flu or other illness)?
20. In the past 4 weeks, have you had a problem with diarrhea and/or loss of bowel control?
21. In the past 4 weeks, have you had a problem with fainting or dizziness when you stand?
In the past 4 weeks, how much difficulty have you had performing the following activities:
22. Bathing/Showering?
23. Dressing?
24. Walking?
25. Getting on or off the toilet?
26. Using eating utensils?

 

Answer these questions according to the following scale:

0 Not at all / 1 A little / 2 Somewhat / 3 Moderately / 4 Severely

In the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical or emotional health?
27. Cut down on the amount of time you spent on work or other activities?
28. Accomplished less than you would like?
29. Were limited in the kind of work or other activities you could perform?
30. Had difficulty performing the work/other activities (it took extra effort)?
31. In general, would you say your health now is:
32. Compared with 3 months ago, how would you rate your health in general now?
33. In the past 4 weeks, to what extent has your physical health interfered with your normal social activities with family, friends, neighbors, or groups?
34. In the past 4 weeks, how much did pain interfere with your normal work (including work both outside the home and housework)?
35. In the past 4 weeks, how much did weakness or shakiness interfere with your normal work (including work both outside the home and housework)?

Vinik EJ, Hayes RP, Oglesby A, Bastyr E, Barlow P, Ford-Molvik SL, Vinik AI. The development and validation of the Norfolk QOL-DN, a new measure of patients’ perception of the effects of diabetes and diabetic neuropathy. Diabetes Technol Ther. 2005 Jun;7(3):497-508 (PubMed abstract)