Physical health
|
Stair Climbing
|
1. I had no difficulty climbing stairs. |
2. I had some difficulty climbing stairs. |
3. I had a lot of difficulty climbing stairs. |
4. I couldn’t climb stairs. |
Pain
|
1. I had no pain. |
2. I had mild pain. |
3. I had severe pain. |
4. I had intense pain. |
Vitality
|
1. I always had energy. |
2. I often had energy. |
3. I sometimes had energy. |
4. I had no energy at all. |
Social health
|
Working
|
1. I had no difficulty working. |
2. I had some difficulty working. |
3. I had a lot of difficulty working. |
4. I couldn’t work. |
Mental health
|
Depression
|
1. I was not depressed at all. |
2. I was occasionally depressed. |
3. I was frequently depressed. |
4. I was always depressed. |
Memory
|
1. I had no difficulty remembering. |
2. I had some difficulty remembering. |
3. I had a lot of difficulty remembering. |
4. I couldn’t remember at all. |
Sleep
|
1. I had no difficulty sleeping. |
2. I had some difficulty sleeping. |
3. I had a lot of difficulty sleeping. |
4. I couldn’t sleep well. |
Positive health
|
Happiness
|
1. I was always happy. |
2. I was often happy. |
3. I was occasionally happy. |
4. I was not happy at all. |