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Four-Dimensional Symptom Questionnaire (4DSQ) in the Primary Healthcare Practice of Therapists

03 February 2013 | Questionnaires 2013 |

Klabbers G. A.
Keywords| 4SDQ| IJHH| primary healthcare practice


The importance of clinimetrics is ever-increasing. The government, health insurance companies and clients demand more and more visibility of the quality of healthcare. In the framework of the multidisciplinary consultation of (para)medical and psychological disciplines it is necessary to be able to communicate about this in a clear-cut manner. As a haptotherapist and a general physiotherapist I work with Marga Hoeksema (psychomotor therapist) and Christa van Meerten (psychosomatic physiotherapist) in our therapy center in Apeldoorn, the Netherlands.

During meetings it struck me that due to our different areas of expertise and different work methods we communicate with each other in a specific jargon. We also use a variety of measuring instruments, which is not always practical when exchanging client information. Sometimes it is practical, because clearly for instance the range of motion (ROM) of the knee joint is better measured with a goniometer than with a questionnaire, a person’s weight is measured with weighing scales and their height is measured with a height measure – all this is clear. However, when it comes to measuring psychological symptomatology there are several questionnaires available, and that diversity can be unpractical for communication.

As a supporting instrument for communication within the practice the Four-Dimensional Symptom Questionnaire (4DSQ) stands out for me, partly because the 4DSQ is used a lot by primary physicians and also because of the convenience with which in merely ten minutes one can gain an impression of Distress, Depression, Anxiety and Somatization. For a scientific comparison of the 4DSQ with other questionnaires I refer to the article “What does the Four-Dimensional Symptom Questionnaire Measure compared to other Measuring Instruments” (Terluin, 1998, in Dutch)

In this article “Four-Dimensional Symptom Questionnaire (4DSQ) in the Primary Healthcare Practice of Therapists” is more of a vision document that reports on the pilot “4DSQ Research Haptotherapy” ii and pleads for experimenting with the Four Dimensional Symptom Questionnaire as an instrument to measure the effect of therapeutic interventions.

  1. Terluin, B. (1998). Wat meet de Vierdimensionale Klachtenlijst in vergelijking met enkele bekende klachtenlijsten? Tijdschrift voor gezondheidswetenschappen, 76, 435-441
  2. Klabbers G.A. (2010), 4DKL onderzoek Haptotherapie, een pilot van tien (10) GZ-Haptotherapeuten die vanuit hun praktijk werkzaam zijn in de eerstelijns Gezondheidszorg in Nederland, Uitgeverij Haptotherapie Nederland, ISBN / EAN: 978-90-815247-1-1.
  3. COTAN: Evers, A., Braak, M.S.L., Frima, R.M., & Vliet-Mulder, J.C. van (2009). COTAN Documentatie. Amsterdam: Boom test uitgevers.
  4. Diagnostische Criteria van de DSM-IV-TR. ISBN: 90-265-1695-9 v M. van der Horst. Msc, Dr. R. Lindeboom, Dr. C. Lucas; De prognostische waarde van de Vierdimensionale Klachtenlijst (4DKL; Nederlands Tijdschrift voor Fysiotherapie 2005; 115(4): 102-107.
  5. Terluin, B. & Duijsens, I.J. (2002). Handleiding Vierdimensionale Klachtenlijst. Leiderdorp: DATEC. vii SCEGS = Somatisch-Cognitief-Emotioneel-Gedragsmatig-Sociaal
  6. Wijma, K., B. Wijma, and M., Zar. “Psychometric aspects of the W-DEQ: a new questionnaire for the measurement of fear of childbirth.” Journal of Psychosomatic Obstetrics and Gynecology, 1998: 19, 84-97.
  7. HADS Zigmond, A.S., and R.P. Snaith. “The hospital anxiety and depression scale.” Acta Psychiatrica Scandinavica, 1983: 67: 361.

Volume 1

No. 3
  • Publication date:
    February 3, 2013
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How to cite (apa)
Klabbers, G. A. (2013). Four-Dimensional Symptom Questionnaire (4DSQ) in the Primary Healthcare Practice of Therapists. In International Journal of Haptonomy and Haptotherapy (Vol. 1, Issue 3, pp. 9-24).
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