Subdomain |
|
RF |
|
Question stem |
“During the past 4 weeks, how much of the time have you had any of the following problems with your work or other regular activities as a result of your physical health?” |
Question 1 for stem |
“Accomplished less than you would like” |
Question 2 for stem |
“Did work or other activities less carefully than usual” |
PF |
|
Question stem |
“Does your health now limit you in these activities? If so, how much?” |
Question 1 for stem |
“Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf |
Question 2 for stem |
“Climbing several flights of stairs” |
BP |
|
Question 1 |
“During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)? ” |
General overall health perceptions (GH) |
|
Question 1 |
“In general, would you say your health is:” with the answer options being “Excellent, Very Good, Good, Fair, and Poor. ” |
RE |
|
Question stem |
“During the past 4 weeks, how much of the time have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?” |
Question 1 for stem |
“Accomplished less than you would like” |
Question 2 for stem |
“Did work or other activities less carefully than usual” |
SF |
|
Question 1 |
“During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (such as visiting friends, relatives, etc.)?” |
VT |
|
Question 1 |
“How much of the time during the past 4 weeks did you have a lot of energy?” |
MH |
|
Question stem |
“How much of the time during the past 4 weeks...” |
Question 1 for stem |
“Have you felt calm and peaceful?” |
Question 2 for stem |
“Have you felt downhearted and depressed?” |