Table 1.
SF-12 Scale Items
Question | Answer Choices | Physical or Mental Health Scale |
---|---|---|
In general, would you say your health is: | Excellent, Very Good, Good, Fair, Poor | Physical |
Does your health now limit you in moderate activities—such as moving a table or playing basketball—a lot, a little, or not at all? | A lot, A little, Not at all | Physical |
Does your health now limit you a lot, a little, or not at all when climbing several flights of stairs? | A lot, A little, Not at all | Physical |
During the past 30 days, have you accomplished less than you would like to have accomplished as a result of your physical health? | Yes, No | Physical |
During the past 30 days, were you limited in the kind of work or other regular activities you do as a result of your physical health? | Yes, No | Physical |
During the past 30 days, how much did pain interfere with your normal work? | Not at all, Slightly, Moderately, Quite a bit, Extremely | Physical |
During the past 30 days, have you accomplished less than you would like to have accomplished as a result of any emotional problems, such as feeling depressed or anxious? | Yes, No | Mental |
During the past 30 days, did you not do work or other regular activities as carefully as usual as a result of any emotional problems, such as feeling depressed or anxious? | Yes, No | Mental |
How much time during the past 30 days have you felt calm and peaceful? | All of the time, Most of the time, A good bit of the time, Some of the time, A little of the time, None of the time | Mental |
How much time during the past 30 days did you have a lot of energy? | All of the time, Most of the time, A good bit of the time, Some of the time, A little of the time, None of the time | Mental |
How much time during the past 30 days have you felt down? | All of the time, Most of the time, A good bit of the time, Some of the time, A little of the time, None of the time | Mental |
During the past 30 days, how much of the time has your physical health or emotional problems interfered with your social activities like visiting with friends, relatives, etc.? | All of the time, Most of the time, A good bit of the time, Some of the time, A little of the time, None of the time | Mental |