Health Status Questionnaire 36

developed at RAND as part of the Medical Outcomes Study
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    3a Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports.
    3b. Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf?
    3c. Lifting or carrying groceries.
    3d. Climbing several flights of stairs
    3e. Climbing one flight of stairs.
    3f. Bending, kneeling or stooping
    3g. Walking more than one mile.
    3h. Walking several blocks
    3i. Walking one block.
    3j. Bathing or dressing yourself.
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    4a. Cut down the amount of time you spent on work or other activities?
    4b. Accomplished less than you would like?
    4c. Were limited in the kind of work or other activities
    4d. Had difficulty performing the work or other activities (for example, it took extra time)
    Please enter one response per row
    5a. Cut down the amount of time you spent on work or other activities?
    5b. Accomplished less than you would like
    5c. Didn't do work or other activities as carefully as usual
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    9a. did you feel full of pep?
    9b. have you been a very nervous person?
    9c. have you felt so down in the dumps nothing could cheer you up?
    9d. have you felt calm and peaceful?
    9e. did you have a lot of energy?
    9f. have you felt downhearted and blue?
    9g. did you feel worn out?
    9h. have you been a happy person?
    9i. did you feel tired?
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    11a. I seem to get sick a little easier than other people
    11b. I am as healthy as anybody I know
    11c. I expect my health to get worse
    11d. My health is excellent
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