| Overall, my health is poor | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | Overall, my health is good |
| Feeling Down | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | Feeling great |
| Feeling Stressed | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | Relaxed |
| I have no friends or others who provide support to me | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | I have friends or others who provide support |
| I find it difficult to look after my child | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | I enjoy looking after my child |
| I find it hard to manage the day-to-day tasks of running a home | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | I can manage the day-to-day tasks of running a home |
| I spend most of my time in the house | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | I get out and about when I want to |
| Overall my quality of life is poor | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | Overall my quality of life is good |
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