The instrument consists of 26 questions.
Responses: based on findings during the past 4 weeks
|
Response
|
Points if unable to function
|
Points if able to function
|
|
all days or always
|
4
|
0
|
|
most days or very often
|
3
|
1
|
|
some days or sometimes
|
2
|
2
|
|
few days or almost never
|
1
|
3
|
|
no days or never
|
0
|
4
|
total score =
= SUM(points for all 24 or 26 items)
Subscales:
(1) physical: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 24
(2) symptoms: 13, 14, 15
(3) affect: 16, 17, 18, 20
(4) social interaction: 19, 21, 22, 23
(5) role: 25 and 26
The scores can be rescaled to cover 0 (no impact perfect health) to 10 (maximum, worst health).
