Tasks:
(1) standing for long periods
(2) taking care of household resoonsibilities
(3) learning a new task
(4) problem joining community activities
(5) emotional impact of health problems
(6) concentrating on doing something for 10 minutes
(7) walking a long distance
(8) washing your whole body
(9) getting dressed
(10) dealing with people you do not know
(11) maintaining friendships
(12) day-to-day work or school
|
Difficulty
|
Points
|
|
none
|
0
|
|
mild
|
1
|
|
moderate
|
2
|
|
severe
|
3
|
|
extremely difficult or cannot do
|
4
|
total score =
= SUM(points for all 12 tasks)
score as percent of maximum =
= (score) / 48 * 100%
Interpretation:
• minimum score: 0
• maximum score: 48
Additional questions:
(1) number of days in past 30 when difficulties were present
(2) number of days in the past 30 that totally unable to carry out usual activities
(3) number of days in the past 30 that activities were cut back or reduced (excluding days totally incapacitated)
