SF-12评分标准.doc

1. 64In general, would you say your health is:Excellent .1Very Good.2Good.3Fair.4Poor .52. 65Does your health now limit you in Moderate activities, such as moving a table,pushing a vacuum cleaner, bowling, or playing golf? If so, how much?Yes, limited a lot. .1Yes, limited a little .2No, not limited at all.33. 66Does your health now limit you in Climbing several flights of stairs? If so, how much?Yes, limited a lot. .1Yes, limited a little .2No, not limited at all.34. 67During the PAST FOUR WEEKS, how much of the time have you accomplished less than you would like with your work or other regular daily activities as a result of your physical healthAll of the time .1 Most of the time.2 Some of the time.3 A little of the time.4 None of the time.55. 68During the PAST FOUR WEEKS, how much of the time have you not done work or other activities as carefully as usual as a result of your physical healthAll of the time .1Most of the time.2Some of the time.3A little of the time.4None of the time.56. 69During the PAST FOUR WEEKS, how much of the time have you accomplished less than you would like with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?All of the time .1Most of the time.2Some of the time.3A little of the time.4None of the time.57. 70During the PAST FOUR WEEKS, how much of the time have you not done work or other activities as carefully as usual as a result of any emotional problems (such as feeling depressed or anxious)?All of the time .1Most of the time.2Some of the time.3A little of the time.4None of the time.58. 71During the PAST FOUR WEEKS, how much did pain interfere with your normal work (including both work outside the home andhousework)?Not at all.1A little bit .2Moderately.3Quite a bit.4Extremely.59. 72How much of the time during the PAST FOUR WEEKS have you felt calm and peaceful?All of the time.1Most of the time.2Some of the time.3A little of the time.4None of the time.510. 73How much of the time during the PAST FOUR WEEKS did you have alot of energy?All of the time.1Most of the time.2Some of the time.3A little of the time.4None of the time.511. 74How much of the time during the PAST FOUR WEEKS have you felt downhearted and depressed?All of the time.1Most of the time.2Some of the time.3A little of the time.4None of the time.512. 75During the PAST FOUR WEEKS, how much of the time has yourphysical health or emotional problems interfered with your social activities (like visi