Scales | Item no | Contents | Response categories |
---|---|---|---|
Physical Component Summary (PCS-12) | 1 | General health | Excellent/very good/good/fair/poor |
2 | Moderate activities | Limited a lot/limited a little/not limited at all | |
3 | Climb several flights of stairs | Limited a lot/limited a little/not limited at all | |
4 | Accomplished less (physical) | All of the time/most of the time/some of the time/a little of the time/none of the time | |
5 | Limited in kind of work | All of the time/most of the time/some of the time/a little of the time/none of the time | |
8 | Pain—interference | Not at all/a little bit/moderately/quite a bit/extremely | |
Mental Component Summary (MCS-12) | 6 | Accomplished less (emotional) | All of the time/most of the time/some of the time/a little of the time/none of the time |
7 | Did work less carefully | All of the time/most of the time/some of the time/a little of the time/none of the time | |
9 | Calm and peaceful | All of the time/most of the time/some of the time/a little of the time/none of the time | |
10 | Energy or vitality | All of the time/most of the time/some of the time/a little of the time/none of the time | |
11 | Downhearted and blue | All of the time/most of the time/some of the time/a little of the time/none of the time | |
12 | Social limitations | All of the time/most of the time/some of the time/a little of the time/none of the time |