5/2/2021 Quality of Life Questionnaire (Post-Assessment): HLAC-1057-408-Sp21

Quality of Life Questionnaire (Post-Assessment)

Due Apr 18 at 11:59pm Points 12 Questions 13 Available Apr 11 at 12am - Apr 21 at 11:59pm 11 days Time Limit None

Instructions
The Short Form Health Survey version 2 (SF-12v2) is a commonly used, validated measure of health-related quality of life (HRQOL). Please thoughtfully answer the following questions taken from this
survey. You will get full credit for answering the questions regardless of your answer.

This is the same questionnaire you took at the beginning of the semester; you are taking it again to be able to reflect on the progress you made over the semester. Please do not refer back to your pre-
assessment results for this questionnaire until after you have completed this post-assessment questionnaire.

This quiz was locked Apr 21 at 11:59pm.

 Correct answers are hidden.

Score for this survey: 12 out of 12

Submitted Apr 18 at 10:35pm
This attempt took 1 minute.

Question 1

I understand that my answers on this survey will only be used for academic purposes and remain internal to SLCC.

You Answered Yes, I understand.

Question 2

In general, would you say your health is:

Excellent

Very Good

Good

You Answered Fair

Poor

Question 3

The following question is about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?

Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf

Yes, limited a lot

Yes, limited a little

You Answered No, not limited at all

Question 4

The following question ais about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?

Climbing several flights of stairs

Yes, limited a lot

You Answered Yes, limited a little

No, not limited at all

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5/2/2021 Quality of Life Questionnaire (Post-Assessment): HLAC-1057-408-Sp21

Question 5

During the past 4 weeks, how much of the time have you had any of the following problems with your work or other regular daily activities as a result of your
physical health?

Accomplished less than you would like

All of the time

You Answered Most of the time

Some of the time

A little of the time

None of the time

Question 6

During the past 4 weeks, how much of the time have you had any of the following problems with your work or other regular daily activities as a result of your
physical health?

Were limited in the kind of work or other activities

All of the time

Most of the time

You Answered Some of the time

A little of the time

None of the time

Question 7

During the past 4 weeks, how much of the time 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)?

Accomplished less than you would like

All of the time

You Answered Most of the time

Some of the time

A little of the time

None of the time

Question 8

During the past 4 weeks, how much of the time 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)?

Did work or activities less carefully than usual

All of the time

Most of the time

Some of the time

You Answered A little of the time

None of the time

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Question 9

During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?

Not at all

A little bit

Moderately

You Answered Quite a bit

Extremely

Question 10

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 have you felt calm and peaceful?

All of the time

Most of the time

You Answered Some of the time

A little of the time

None of the time

Question 11

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 Did you have a lot of energy?

All of the time

Most of the time

You Answered Some of the time

A little of the time

None of the time

Question 12

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 have you felt downhearted and depressed?

All of the time

Most of the time

You Answered Some of the time

A little of the time

None of the time

Question 13

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During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting friends,
relatives, etc.)?

All of the time

Most of the time

Some of the time

You Answered A little of the time

None of the time

Survey Score: 12 out of 12

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