Sickness Impact Profile (SIP) & (SIP-CP)
Bergner‚ Bobbitt‚ Carter‚ & Gilson‚ 1981
نیمرخ (نمایه) تاثیر بیماری
Sickness Impact Profile 136 (SIP136)
SR
1. I spend much of the day lying down in order to rest.
2. I sit during much of the day.
3. I am sleeping or dozing most of the time - day and night.
4. I lie down more often during the day in order to rest.
5. I sit around half-asleep.
6. I sleep less at night‚ for example‚ wake up too early‚ don't fall asleep for a long time‚ and awaken frequently.
7. I sleep or nap more during the day.
EB
1. I say how bad or useless I am‚ for example‚ that I am a burden to others.
2. I laugh or cry suddenly.
3. I often moan and groan in pain or discomfort.
4. I have attempted suicide.
5. I act nervous or restless.
6. I keep rubbing or holding areas of my body that hurt or are uncomfortable.
7. I act irritable and impatient with myself; for example‚ I talk badly about myself‚ swear at myself‚ and blame myself for things that happen.
8. I talk about the future in a hopeless way.
9. I get sudden frights
BCM
1. I make difficult moves with help‚ for example‚ getting into or out of cars‚ the bath.
2. I do not move in or out of a bed or chair by myself but am moved by another person or mechanical aid.
3. I stand only for short periods of time.
4. I do not maintain my balance.
5. I move my hands or fingers with some limitation or difficulty.
6. I stand up only with someone's help.
7. I kneel‚ stoop‚ or bend down only by holding on to something.
8. I am in a restricted position all of the time.
9. I am very clumsy in body movements.
10. I get in or out of bed or chairs by grasping something for support or by using a cane or walker.
11. I stay lying down most of the time.
12. I change positions frequently.
13. I hold on to something to move myself around in bed.
14. I do not bathe myself completely‚ for example‚ I require assistance with bathing.
15. I do not bathe myself‚ but am bathed by someone else.
16. I use a bedpan with assistance.
17. I have trouble getting shoes‚ socks‚ stocking on.
18. I do not have control of my bladder.
19. I do not fasten my clothing‚ for example‚ I require assistance with buttons‚ zippers‚ and shoelaces.
20. I spend most of my time partly undressed or in pajamas.
21. I do not have control of my bowels.
22. I dress myself‚ but do so very slowly.
23. I get dressed only with someone's help.
HM
1. I do work around the house only for short periods of time and rest often.
2. I am doing less of the regular daily work around the house than I would usually do.
3. I am not doing any of the regular daily work around the house than I would usually do.
4. I am not doing any of the maintenance or repair work that I would usually do in my home or garden.
5. I am not doing any of the shopping that I would usually do.
6. I am not doing any of the house cleaning that I would usually do.
7. I have difficulty doing handwork‚ for example‚ turning taps‚ using kitchen gadgets‚
1. sewing‚ carpentry.
8. I am not doing any of the clothes washing that I would usually do.
9. I am not doing heavy work around the house.
10. I have given up taking care of personal or household business affairs‚ for example‚ paying bills‚ banking‚ working on a budget.
M
1. I am getting around only within one building.
2. I stay within one room.
3. I am staying in bed more.
4. I am staying in bed most of the time.
5. I am not now using public transport.
6. I stay at home most of the time.
7. I am only going to places with toilets nearby.
8. I am not going in to town.
9. I stay away from home only for brief periods of time.
10. I do not get around in the dark or in unlit places without someone else to help me.
SI
1. I am going out less to visit people
2. I am not going out to visit people at all.
3. I show less interest in other people's problems‚ for example‚ I don't listen when they tell me about their problems‚ I don't offer to help.
4. I often act irritable to those around me‚ for example‚ snap at people‚ give sharp answers‚ criticize easily.
5. I show less affection.
6. I am doing fewer social activities with groups of people.
7. I am cutting down on the length of visits with friends.
8. I am avoiding social visits from others.
9. My sexual activity is decreased.
10. I often express concern over what might be happening to my health.
11. I talk less with those around me.
12. I make many demands‚ for example‚ insist that people do things for me‚ tell them how to do things.
13. I stay alone much of the time.
14. I act disagreeable to family members‚ for example‚ I act spiteful‚ I am stubborn.
15. I have frequent outbursts of anger at family members‚ for example‚ strike at them‚ scream‚ or throw things at them.
16. I isolate myself as much as I can from the rest of the family.
17. I am paying less attention to the children.
18. I refuse contact with family members‚ for example‚ turn them away.
19. I am not doing the things that I usually do to take care of my children or family.
20. I am not joking with my family members as I usually do.
A
1. I walk shorter distances or stop often to rest.
2. I do not walk up or down hills.
3. I use stairs only with mechanical support‚ for example‚ handrails‚ stick‚ crutches.
4. I walk up or down stairs only with support from someone else.
5. I get around in a wheelchair.
6. I do not walk at all.
7. I walk by myself‚ but with some difficulty‚ for example‚ limp‚ wobble‚ stumble‚ have stiff legs.
8. I walk only with help from someone.
9. I go up and down stairs more slowly‚ for example‚ one step at a time‚ stop often.
10. I do not use stairs at all.
11. I get around only by using a walker‚ crutches‚ stick‚ walls‚ or furniture.
12. I walk more slowly.
AB
1. I am confused and start several actions at a time.
2. I have more minor accidents‚ for example‚ drop things‚ trip and fall‚ bump into things.
3. I react slowly to things that are said or done.
4. I do not finish things that I start.
5. I have difficulty reasoning and solving problems‚ for example‚ making plans‚ making decisions‚ learning new things.
6. I sometimes behave as if I were confused or disorientated in place or time‚ for example‚ where I am‚ who is around‚ directions‚ what day it is.
7. I forget a lot‚ for example‚ things that have happened recently‚ where I have put things‚ appointments.
8. I do not keep my attention on activities for long.
9. I make more mistakes than usual.
10. I have difficulty doing activities that involve concentration and thinking.
C
1. I am having trouble writing or typing.
2. I communicate mostly by gestures‚ for example‚ moving head‚ pointing‚ sign language.
3. My speech is understood by only a few people who know me well.
4. I often lose control of my voice when I talk; for example‚ my voice gets louder‚ or softer‚ trembles‚ changes unexpectedly
5. I don’t write except to sign my name.
6. I carry on a conversation only when very close to the other person or looking at them.
7. I have difficulty speaking‚ for example‚ get stuck‚ stutter‚ stammer‚ slur my words.
8. I am understood with difficulty.
9. I do not speak clearly when I am under stress.
Do you usually work other than managing your home? YES NO
IF YOU ANSWERED YES: GO TO THE NEXT PAGE
IF YOU ANSWERED NO: THEN PLEASE CONTINUE
Are you retired? YES NO
If you retired‚ was this due to your health? YES NO
If you are not retired‚ but are not working‚ is this related to your health? YES NO
w
1. I am not working at all. (If you ticked this item then please go to next page)
2. I am doing part of my job at home.
3. I am not accomplishing as much as usual at work.
4. I often act irritable toward my work associates‚ for example‚ snap at them‚ give sharp answers‚ criticize easily.
5. I am working shorter hours.
6. I am doing only light work.
7. I work only for short periods of time or take frequent rests.
8. I am working at my usual job but with some changes‚ for example‚ using different tools or special aids‚ trading some tasks with other workers.
9. I do not do my job as carefully and accurately as I usually do.
RP
1. I do my hobbies and recreation activities for shorter periods of time.
2. I am going out for entertainment less often.
3. I am cutting down on some of my usual inactive recreation and pastimes‚ for example‚ watching TV‚ playing cards‚ reading.
4. I am not doing any of my usual inactive recreation and pastimes‚ for example‚ watching TV‚ playing cards‚ reading.
5. I am doing more inactive pastimes in place of my usual activities.
6. I am doing fewer community activities.
7. I am cutting down on some of my usual physical recreation or activities.
8. I am not doing any of my usual physical recreation or activities.
E
1. I am eating much less than usual.
2. I feed myself but only by using specially prepared food or utensils.
3. I am eating special or different food‚ for example‚ soft food‚ bland diet‚ low-salt‚ low- fat‚ low-sugar.
4. I eat no food at all but I am drinking fluids.
5. I just pick or nibble at my food.
6. I am drinking less fluids.
7. I feed myself with help from someone else.
8. I do not feed myself at all‚ but must be fed.
9. I am eating no food at all; nutrition is taken through tubes or intravenous fluids.
Sickness Impact Profile 68 (SIP68)
Somatic Autonomy
1. I get around in a wheelchair.
2. I get dressed only with someone’s help.
3. I do not move into or out of bed by myself‚ but am moved by a person or mechanical aid.
4. I stand up only with someone’s help.
5. I do not fasten my clothing‚ for example‚ require assistance with buttons‚ zippers‚ shoelaces.
6. I do not walk at all.
7. I do not use stairs at all.
8. I make difficult moves with help‚ for example‚ require assistance with bathing.
9. I do not bathe myself completely‚ for example‚ require assistance with bathing.
10. I do not bathe myself at all‚ but am bathed by someone else.
11. I do not have control of my bladder.
12. I am very clumsy in body movements.
13. I do not have control of my bowels.
14. I feed myself with help from someone else.
15. I do not maintain balance.
16. I use a bedpan with assistance.
17. I am in a restricted position all the time
Mobility Control
1. I go up and down stairs more slowly‚ for example‚ one step in a time‚ stop often.
2. I walk shorter distances or stop to rest often.
3. I walk more slowly.
4. I use stairs only with mechanical support‚ for example‚ handrail‚ cane‚ crutches.
5. I walk by myself with some difficulty‚ for example‚ limp‚ wobble‚ stumble‚ have stiff legs.
6. I kneel‚ stoop‚ or bend down only by holding on to something.
7. I do not walk up or down hills.
8. I get in and out of bed or chairs by grasping something for support‚ or using a cane or walker.
9. I stand only for short periods of time.
10. I dress myself‚ but do so very slowly.
11. I have difficulty doing handwork‚ for example‚ turning faucets‚ using kitchen gadgets‚ sewing‚ carpentry.
12. I move my hands or fingers with some limitation or difficulty.
Psychological Autonomy & Communication
1. I have difficulty reasoning and solving problems‚ for example‚ making plans‚ making decisions‚ learning new things.
2. I have difficulty doing activities involving concentration and thinking.
3. I react slowly to things that are said or done.
4. I make more mistakes than usual.
5. I do not keep my attention on any activity for long.
6. I forget a lot‚ for example‚ things that happened recently‚ where I put things‚ appointments.
7. I am confused and start several actions at a time.
8. I do not speak clearly when I am under stress.
9. I have difficulty speaking‚ for example‚ get stuck‚ stutter‚ stammer‚ slur my words.
10. I do not finish things I start.
11. I am having trouble writing or typing.
Social Behavior
1. My sexual activity is decreased.
2. I am cutting down the length of visits with friends.
3. I am drinking less fluids.
4. I am doing fewer community activities.
5. I am doing fewer social activities with groups of people.
6. I am going out for entertainment less often.
7. I stay away from home only for brief periods of time.
8. I am eating much less than usual.
9. I am not doing heavy work around the house.
10. I do my hobbies and recreation for shorter periods of time.
11. I am doing less of the regular daily work around the house than I would usually do.
12. I am cutting down on some of my usual inactive recreation and pastime‚ for example‚ watching TV‚ playing cards‚ reading.
Emotional Stability
1. I often act irritable toward those around me‚ for example‚ snap at people‚ give sharp answers‚ criticize easily.
2. I act disagreeable to family members‚ for example‚ I act spiteful‚ I am stubborn.
3. I have frequent outbursts of anger at family members‚ for example‚ strike at them‚ scream‚ throw things at them.
4. I act irritable and impatient with myself‚ for example‚ talk badly about myself‚ swear at myself‚ blame myself for things that happen.
5. I am not joking with family members as I usually do.
6. I talk less with those around me.
Mobility Range
1. I am not doing any of the shopping that I would usually do.
2. I am not going into town.
3. I am not doing any of the house cleaning that I would usually do.
4. I am not doing any of the regular work around the house that I would usually do.
5. I stay home most of the time.
6. I am not doing any of the clothes washing that I would usually do.
7. I am not going out to visit people at all.
8. I am getting around only within one building.
9. I have given up taking care of personal or household business affairs‚ for example‚ paying bills‚ banking‚ working on a budget.
10 I do not get around in the dark or in unlit places without someone’s help.
Sickness Impact Profile for Chronic Pain (SIP-CP)
EB
1. I say how bad or useless I am‚ for example‚ that I am a burden to others.
2. I laugh or cry suddenly.
3. I often moan and groan in pain or discomfort.
5. I act nervous or restless.
7. I act irritable and impatient with myself; for example‚ I talk badly about myself‚ swear at myself‚ and blame myself for things that happen.
9. I get sudden frights.
BCM
1. I make difficult moves with help‚ for example‚ getting into or out of cars‚ the bath.
2. I do not move in or out of a bed or chair by myself but am moved by another person or mechanical aid.
6. I stand up only with someone's help.
14. I do not bathe myself completely‚ for example‚ I require assistance with bathing
17. I have trouble getting shoes‚ socks‚ stocking on.
19. I do not fasten my clothing‚ for example‚ I require assistance with buttons‚ zippers‚ and shoelaces.
23 I get dressed only with someone's help.
M
1. I am getting around only within one building.
2. I stay within one room.
4. I am staying in bed most of the time.
6. I stay at home most of the time.
8. I am not going in to town.
SI
3. I show less interest in other people's problems‚ for example‚ I don't listen when they tell me about their problems‚ I don't offer to help.
4. I often act irritable to those around me‚ for example‚ snap at people‚ give sharp answers‚ criticize easily.
5. I show less affection.
9. My sexual activity is decreased.
12. I make many demands‚ for example‚ insist that people do things for me‚ tell them how to do things.
15. I have frequent outbursts of anger at family members‚ for example‚ strike at them‚ scream‚ or throw things at them.
20. I am not joking with my family members as I usually do.
A
2. I do not walk up or down hills.
3. I use stairs only with mechanical support‚ for example‚ handrails‚ stick‚ crutches.
7. I walk by myself‚ but with some difficulty‚ for example‚ limp‚ wobble‚ stumble‚ have stiff legs.
11. I get around only by using a walker‚ crutches‚ stick‚ walls‚ or furniture.
AB
1. I am confused and start several actions at a time.
3. I react slowly to things that are said or done.
4. I do not finish things that I start.
5. I have difficulty reasoning and solving problems‚ for example‚ making plans‚ making decisions‚ learning new things.
8. do not keep my attention on activities for long.
9. I make more mistakes than usual.
10. I have difficulty doing activities that involve concentration and thinking.
C
1. I am having trouble writing or typing.
2. I communicate mostly by gestures‚ for example‚ moving head‚ pointing‚ sign language.
4. I often lose control of my voice when I talk; for example‚ my voice gets louder‚ or softer‚ trembles‚ changes unexpectedly
7. I have difficulty speaking‚ for example‚ get stuck‚ stutter‚ stammer‚ slur my words.
8. I am understood with difficulty.
9. I do not speak clearly when I am under stress.
Narcolepsy and the Sickness Impact Profile
Adopted by Tona et al‚ 2014
حمله خواب و نمایه تأثیر بیماری
• I sleep or nap more during the day
• I am going out for entertainment less often
• I am doing less of the regular daily work around the house than I would usually do
• My sexual activity is decreased
• I do my hobbies and recreation for shorter periods of time
• I am doing fewer social activities with groups of people
• I do not finish things I start
• I forget a lot‚ for example‚ things that happened recently‚ where I put things‚ appointments
• I sleep less at night‚ for example‚ wakeup too early‚ don’t fall asleep for a long time‚ awaken frequently
• I do work around the house only for short periods of time or rest often
• I sit around half-asleep
• I sit during much of the day
• I am going out less to visit people
• I walk shorter distances or stop to rest often
• I have difficulty doing activities involving concentration and thinking
• I am cutting down on some of my usual physical recreation or activities
• I lie down more often during the day in order to rest
• I am doing fewer community activities
• I do not keep my attention on any activity for long
• I change position frequently
• I have more minor accidents‚ for example‚ drop things‚ trip and fall‚ bump into things
شرح سایت روان سنجی: نیمرخ تاثیر بیماری یکی از تثبیت شده ترین معیارهای کلی کیفیت زتدگی مرتبط با سلامت است .این ابزار برای ارزیابی تاثیر طیف گسترده ای از بیماری ها بر فعالیت روزانه در زمینه های جسمی، روانی و اجتماعی است.
Physical‚ Psychosocial‚ and Independence/Other disability‚ and 12 subscale scores (Sleep & Rest‚ Emotional Behavior‚ Body Care & Movement‚ Household Management‚ Mobility‚ Social Interaction‚ Ambulation‚ Alertness Behavior‚ Communication‚ Work‚ Recreation & Pastimes‚ and Eating).
شواهد روان سنجی: اعتبار درونی برای SIP و SIP-CP
Total disability score [SIP and SIP-CP] .936 .883
Physical dimension .884 .810
Ambulation .673 .620
Mobility .696 .597
Body care & movement .813 .775
Psychosocial dimension .900 .858
Communication .630 .616
Alertness behavior .843 .825
Emotional behavior .669 .637
Social interaction .815 .677
Independence/Other dimension .705 .475
Sleep & rest .251 .145
Eating .355 .429
Work .515 ---
Home management .620 ---
Recreation & pastimes .484 .543
نمره گذاری: پاسخ دهنده درکنار گزاره "تیک" می زند.
چگونگی دستیابی
This instrument can be found at: https://digitalrepository.unm.edu/cgi/viewcontent.cgi?article=1092&context=psy_etds & https://www.researchgate.net/publication/270970803_Narcolepsy_and_the_Sickness_Impact_Profile_A_general_health_status_measure
منبع برای آگاهی بیشتر
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Bergner‚ M.‚ Bobbitt‚ R.A.‚ Pollard‚ W.E.‚ Martin‚ D.P.‚ & Gilson‚ B.S. (1976). The Sickness Impact Profile: Validation of a health status measure. Medical Care‚ 14‚ 57-67.
Bergner‚ M.‚ Bobbitt‚ R.A.‚ Kressel‚ S.‚ Pollard‚ W.E.‚ Gilson‚ B.S.‚ & Morris‚ J.R. (1976). The Sickness Impact Profile: Conceptual formulation and methodology for the development of a health status measure. International Journal of Health Services‚ 6‚ 393-415.
Pollard‚ W.E.‚ Bobbitt‚ R.A.‚ Bergner‚ M.‚ Martin‚ D.P.‚ & Gilson‚ B.S. (1976). The Sickness Impact Profile: Reliability of a health status measure. Medical Care‚ 14‚ 146-155.
Bergner‚ M.‚ Bobbitt‚ R.A.‚ Carter‚ W.B.‚ & Gilson‚ B.S. (1981). The Sickness Impact Profile: Development and final revision of a health status measure. Medical Care‚ 19‚ 787-805.
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Follick‚ M.J.‚ Smith‚ T.W.‚ & Ahern‚ D.K. (1985). The Sickness Impact Profile: A global measure of disability in chronic low back pain. Pain‚ 21‚ 67-76.
De Bruin‚ A.‚ De Witte‚ L.‚ Stevens‚ F.‚ & Diederiks‚ J. (1992). Sickness Impact Profile: The state of the art of a generic functional status measure. Social Science & Medicine‚ 35‚ 1003-1014.
Bergner‚ M. (1993). Development‚ testing‚ and use of the Sickness Impact Profile. In S. R. Walker & R. M. Rosser (Eds.)‚ Quality of life assessment: Key issues in the 1990s (2nd ed.‚ pp. 95-111). New York‚ NY: Springer.
De Bruin‚ A.‚ Buys‚ M.‚ De Witte‚ L.‚ & Diederiks‚ J. (1994). The Sickness Impact Profile: SIP68‚ a short generic version. First evaluation of the reliability and reproducibility. Journal of Clinical Epidemiology‚ 47‚ 863-871.
De Bruin‚ A.‚ Diederiks‚ J.‚ De Witte‚ L.‚ Stevens‚ F.‚ & Philipsen‚ H. (1994). The development of a short generic version of the Sickness Impact Profile. Journal of Clinical Epidemiology‚ 47‚ 407-418.
Damiano‚ A.M. (1996). The Sickness Impact Profile. In B. Spilker (Ed.)‚ Quality of life and pharmacoeconomics in clinical trials (2nd ed.‚ pp. 347-354). Philadelphia‚ PA: Lippincott-Raven.
De Bruin‚ A.‚ Diederiks‚ J.‚ De Witte‚ L.‚ Stevens‚ F.‚ & Philipsen‚ H. (1997). Assessing the responsiveness of a functional status measure: The Sickness Impact Profile versus the SIP68. Journal of Clinical Epidemiology‚ 50‚ 529-540.
McEntee‚ Mindy. (2014)‚ "Measuring disability in chronic pain: Factor structure and revision of the Sickness Impact Profile.". https://digitalrepository.unm.edu/psy_etds/93
Tona‚ Thanh G.N.‚ Watson‚ Nathaniel F.‚ Koepsell‚ Thomas‚D.‚ Longstrethe‚ William T.(2014). Narcolepsy and the Sickness Impact Profile: A general health status measure. Sleep Science‚7; 5–12