SF-36
3
8. During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and
housework)?
q
Not at all
q
Slightly
q
Moderately
q
Quite a bit
q
Extremely
9. These questions are about how you feel and how things have been with you during 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 the past 4
weeks.
a. did you feel full of pep?
q
All of the time
q
Most of the time
q
A good bit of the time
q
Some of the time
q
A little of the time
q
None of the time
b. have you been a very nervous person?
q
All of the time
q
Most of the time
q
A good bit of the time
q
Some of the time
q
A little of the time
q
None of the time
c. have you felt so down in the dumps nothing could cheer you up?
q
All of the time
q
Most of the time
q
A good bit of the time
q
Some of the time
q
A little of the time
q
None of the time
d. have you felt calm and peaceful?
q
All of the time
q
Most of the time
q
A good bit of the time
q
Some of the time
q
A little of the time
q
None of the time
e. did you have a lot of energy?
q
All of the time
q
Most of the time
q
A good bit of the time
q
Some of the time
q
A little of the time
q
None of the time
f. have you felt downhearted and blue?
q
All of the time
q
Most of the time
q
A good bit of the time
q
Some of the time
q
A little of the time
q
None of the time