Generic Quality of Life Measure: Health Status Questionnaire (SF-36)
Stewart‚ Hayes and Ware (1988)
پرسشنامه شرایط سلامتی
1. In general‚ would you say your health is: 1=Excellent‚ 2=Very Good‚ 3=Good‚ 4=Fair‚ 5=Poor
2. For each statement please circle the one number that indicates how true or false that statement is for you.
1=Definitely True‚ 2=Mostly True‚ 3=Not Sure‚ 4=Mostly False‚ 5= Definitely False
a. I seem to get sick a little easier than other people.
b. I am as healthy as anybody I know.
c. I expect my health to get worse.
d. My health is excellent.
3. Compared to one year ago‚ how would you rate your health in general now? 1=Much Better‚ 2=Somewhat Better‚ 3= Same‚ 4=Somewhat Worse‚ 5=Much Worse
4. Now‚ think about the activities you might do on a typical day. Does your health limit you in these activities? If so‚ how much? Please circle 1‚ 2 or 3 for each item to indicate how much your health limits you.
1=Yes‚ Limited A Lot‚ 2=Yes‚ Limited A Little‚ 3= No‚ Not Limited At All
a. Vigorous activities‚ such as running‚ lifting heavy objects‚ participating in strenuous sports
b. Moderate activities‚ such as moving a table‚ pushing a vacuum cleaner or bowling‚ or playing golf
c. Lifting or carrying groceries
d. Climbing several flights of stairs
e. Climbing one flight of stairs
f. Bending‚ kneeling‚ or stooping
g. Walking more than a mile
h. Walking several blocks
i. Walking one block
j. Bathing and dressing yourself
5. During 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 health? Please circle "1" (Yes) or "2" (No) for each item.
a. Cut down on the amount of time you spent on work or other activities
b. Accomplished less than you would like
c. Were limited in the kind of work or other activities
d. d) Had difficulty performing the work or other activities (for example‚ it took extra effort)
6. How much bodily pain have you had during the past 4 weeks?
1=None‚ 2=Very mild‚ 3=Mild‚ 4=Moderate‚ 5=Severe‚ 6=Very severe
7. During the past 4 weeks‚ how much did pain interfere with your normal work (including work both outside the home and housework)?
1=Not at all‚ 2=A little bit‚ 3=Moderately‚ 4=Quite a bit‚ 5=Extremely
8. During the past 4 weeks‚ have you had the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)? Please circle "1" (Yes) or "2" (No) for each item.
a. Cut down on the amount of time you spent on work or other activities
b. b) Accomplished less than you would like
c. c) Did do work or other activities less carefully than usual
9. 9. During the past 4 weeks‚ to what extent have your physical health or emotional problems interfered with your normal social activities with family‚ friends‚ neighbors‚ or groups?
1=Not at all‚ 2=Slightly‚ 3=Moderately‚ 4=Quite a bit‚ 5=Extremely
10.The next set of questions is about how you feel and how things have been with you during the past 4 weeks. For each question‚ please circle the one number for the answer that comes closest to the way you have been feeling.
How much of the time during the past 4 weeks...
1=All of the Time‚ 2=Most of the Time‚ 3=A Good Bit of the Time‚ 4=Some of the Time‚ 5=A Little of the Time‚ 6=None of the Time
a. did you feel full of pep?
b. have you been a very nervous person
c. have you felt so down in the dumps nothing could cheer you up?
d. have you felt calm and peaceful?
e. did you have a lot of energy?
f. have you felt down hearted and blue?
g. did you feel worn out?
h. have you been a happy person?
i. did you feel tired?
11.Finally‚ during the past 4 weeks‚ how much of the time has your physical health or emotional problems intefered with your social activities (like visiting with friends‚ relatives‚ etc.)?
1=All of the time‚ 2=Most of the time‚ 3=Some of the time‚ 4=A little of the time‚ 5= None of the time
شرح سایت روان سنجی: پرسشنامه های SF-36 و SF-36v2 و RAND 36 هر سه برگرفته از مطالعه پیامدهای پزشکی Medical Outcomes Study هستند. نمره گذاری سلامت عمومی و مقیاس درد بین این نسخه ها تفاوت دارد. شرح کامل تر را می توانید در ویکی پدیا ملاحظه کنید. این پرسشنامه هشت زمینه را پوشش می دهد: 1) عملکرد فیزیکی، 2) نقش فیزیکی، 3) نقش هیجانی (نقش عملکرد هیجانی در زندگی روزمره)، 4) درد جسمی، 5) سلامت عمومی، 6) سرزندگی ، 7) عملکرد اجتماعی و 8) بهداشت روانی (اضطراب و افسردگی)
شرح سایت روان سنجی: این ابزار بخشی از مجموعه ابزارها با عنوان MSQLI است.
Multiple Sclerosis Quality of Life Inventory (MSQLI)
· Health Status Questionnaire (SF-36)
· Modified Fatigue Impact Scale (MFIS)
· MOS Pain Effects Scale (PES)
· Sexual Satisfaction Scale (SSS)
· Bladder Control Scale (BLCS)
· Bowel Control Scale (BWCS)
· Impact of Visual Impairment Scale (IVIS)
· Perceived Deficits Questionnaire (PDQ)
· Mental Health Inventory (MHI)
· MOS Modified Social Support Survey (MSSS)
این پرسشنامه توسط منتظری . علی، گشتاسبی. آزیتا و سادات وحدانی نيا. مریم. (1384) به فارسی برگردان شده است.
این ابزار دارای دو نسخه 8 و 12 گویه ای نیز هست.
Physical Functioning (Cronbach’s alpha=.94)‚ Role-Physical (Cronbach’s alpha=.80)‚ Bodily Pain (Cronbach’s alpha=.91)‚ General Health (Cronbach’s alpha= .77)‚ Vitality (Cronbach’s alpha= .85)‚ Social Functioning (Cronbach’s alpha=.67)‚ Role-Emotional (Cronbach’s alpha=.75)‚ Mental Health (Cronbach’s alpha=.82)‚ Physical Component Summary Score (Cronbach’s alpha= 0.92)‚ Mental Component Summary Score (Cronbach’s alpha=.71).
چگونگی دستیابی
نمره گذاری به نشانی بخش چگونگی دستیابی مراجعه کنید.
منبع
Stewart‚ A.L.‚ Hays‚ R.‚ Ware‚ J. (1988). Communication: The MOS Short-form General Health Survey - reliability and validity in a patient population. Medical Care‚ 26‚ 7.
Stewart‚ A.L.‚ Greenfield‚ S.‚ Hays‚ R.D.‚ Wells‚ K.‚ Rogers‚ W.H.‚ Berry‚ S.D.‚ McGlynn‚ E.A. & Ware‚ Jr.‚ J. (1989). Functional status and well-being of patients with chronic conditions: Results from the Medical Outcomes Study. Journal of the American Medical Association‚ 262‚ 907-913.
Stewart‚ A.L.‚ Hays‚ R.D.‚ & Ware.‚ J.E. (1988). The MOS Short-Form General Health Survey: reliability and validity in a patient population. Medical Care‚ 26‚ 724-735.
Stewart‚ A.L.‚ & Ware‚ J.E. (1992). Measuring functioning and well-being: The Medical Outcomes Study approach. Durham‚ NC: Duke University Press.