SF36健康自测量表Word文档格式.docx

1、RAND 36-Item Health Survey 1.0 Questionnaire ItemsSF-36 Resources Terms and Conditions for Using the SF-36 MOS 36-Item Short Form Survey Instrument （SF-36）（English PDF） MOS 36-Item Short Form Survey Instrument （SF-36）（Arabic PDF） Scoring Instructions for MOS 36-Item Short Form Survey Instrument （SF-

2、36）Choose one option for each questionnaire item.1. In general, would you say your health is:1 - Excellent2 - Very good3 - Good4 - Fair5 - Poor2.Compared to one year ago, how would you rate your health in generalnow?1 - Much better now than one year ago2 - Somewhat better now than one year ago3 - Ab

3、out the same4 - Somewhat worse now than one year ago5 - Much worse now than one year agoThe following items are about activities you might do during a typical day. Doesyour health now limit youin these activities? If so, how much?Yes, limited a lotYes, limited a littleNo, not limited at all3.Vigorou

4、s activities, such as running, lifting heavy objects, participating in strenuous sports1234.Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf5. Lifting or carrying groceries6. Climbingseveralflights of stairs7. Climbingoneflight of stairs8. Bending, knee

5、ling, or stooping9. Walkingmore than a mile10. Walkingseveral blocks11. Walkingone block12. Bathing or dressing yourselfDuring thepast 4 weeks, have you had any of the following problems with your work or other regular daily activitiesas a result of your physical health?YesNo13. Cut down theamount o

6、f timeyou spent on work or other activities14.Accomplished lessthan you would like15. Were limited in thekindof work or other activities16. Haddifficultyperforming the work or other activities （for example, it took extra effort）as a result of any emotional problems（such as feeling depressed or anxio

7、us）?17. Cut down the18.19. Didnt do work or other activities ascarefullyas usual20. During thepast 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbors, or groups?1 - Not at all2 - Slightly3 - Moderately4

8、 - Quite a bit5 - Extremely21. How muchbodilypain have you had during thepast 4 weeks?1 - None2 - Very mild3 - Mild4 - Moderate5 - Severe6 - Very severe22. During thepast 4 weeks, how much didpaininterfere with your normal work （including both work outside the home and housework）?2 - A little bitThe

9、se questions are about how you feel and how things have been with youduring the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling.How much of the time during thepast 4 weeks.All of the timeMost of the timeA good bit of the timeSome of the timeA little of the timeNone of the time23. Did you feel full of pep?45624. Have you been a very nervous person?25. Have you felt so down in the dumps that nothing could cheer you up?