PHI stands for "Protected Health Information" (Y = Yes, N = No)
| Display | Field | Phi | Field type | Condition choices | Field note | Header | |
|---|---|---|---|---|---|---|---|
| 1. In general, would you say your health is: | sf12_1 | N | radio | 1, 1- Excellent | 2, 2- Very Good | 3, 3- Good | 4, 4- Fair | 5, 5- Poor | - | - | |
| 2. Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf. | sf12_2 | N | radio | 1, 1- Yes, limited a lot | 2, 2- Yes, limited a little | 3, 3- No, not limited at all | - | The following items are about activities you might do during a typical day. Does your health now limit you in these activities? And if so, how much? | |
| 3. Climbing several flights of stairs | sf12_3 | N | radio | 1, 1- Yes, limited a lot | 2, 2- Yes, limited a little | 3, 3- No, not limited at all | - | - | |
| 4. Accomplished less than you would like | sf12_4 | N | yesno | - | - | During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health? | |
| 5. Were limited in the kind of work or other activites | sf12_5 | N | yesno | - | - | - | |
| 6. Accomplished less than you would like | sf12_6 | N | yesno | - | - | During the past 4 weeks have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)? | |
| 7. Didn't do work or other activities as carefully as usual | sf12_7 | N | yesno | - | - | - | |
| 8. During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)? | sf12_8 | N | radio | 1, 1 - Not at all | 2, 2 - A little bit | 3, 3 - Moderately | 4, 4 - Quite a bit | 5, 5 - Extremely | - | - | |
| 9. Have you felt calm and peaceful? | sf12_9 | N | radio | 1, 1- All of the time | 2, 2- Most of the time | 3, 3- A good bit of the time | 4, 4- Some of the time | 5, 5- A little bit of the time | 6, 6- None of the time | - | 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: | |
| 10. Did you have a lot of energy? | sf12_10 | N | radio | 1, 1- All of the time | 2, 2- Most of the time | 3, 3- A good bit of the time | 4, 4- Some of the time | 5, 5- A little bit of the time | 6, 6- None of the time | - | - | |
| 11. Have you felt down hearted and blue? | sf12_11 | N | radio | 1, 1- All of the time | 2, 2- Most of the time | 3, 3- A good bit of the time | 4, 4- Some of the time | 5, 5- A little bit of the time | 6, 6- None of the time | - | - | |
| 12. During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)? | sf12_12 | N | radio | 1, 1 - All of the time | 2, 2 - Most of the time | 3, 3 - Some of the time | 4, 4 - A little of the time | 5, 5 - None of the time | - | - | |
| Notes | sf12_notes | Y | notes | - | - | - |