The RAND (v.1) 36-Item Short Form Survey Instrument (SF-36)
A 36-item, patient-reported survey (RAND v.1) measuring health status and quality of life across eight health domains.
Provided by
EVAL FoundationInstructions
- This survey asks for your views about your health.
- If you are unsure how to answer a question, please give the best answer you can.
About
A 36-item short-form (SF-36) was constructed by RAND to survey health status in the Medical Outcomes Study. The SF-36 is a widely used, generic, patient-reported measure of health status and quality of life. Developed as part of the Medical Outcomes Study (MOS) by the RAND Corporation, it is designed for use in clinical practice, research, health policy evaluations, and general population surveys. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys.
The SF-36 includes one multi-item scale that assesses eight health concepts:
- Limitations in physical activities because of health problems
- Limitations in social activities because of physical or emotional problems
- Limitations in usual role activities because of physical health problems
- Bodily pain
- General mental health (psychological distress and well-being)
- Limitations in usual role activities because of emotional problems
- Vitality (energy and fatigue)
- General health perceptions
The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone.
Scoring and Interpretation
The RAND Corporation provides the official survey instrument, scoring instructions, and further documentation on its website, ensuring standardized application and interpretation. Scoring the SF-36 involves a multi-step process. First, the response value for each question is recoded according to the official scoring key. Next, the recoded values for all items within the same health domain are summed to create a raw score. Finally, this raw score is transformed into a scale from 0 to 100, where 0 represents the worst possible health state and 100 represents the best possible health state for that domain. A higher score indicates a more favorable health status. For details on questions, choices and scoring, go to 36-Item Short Form Survey (SF-36) | RAND.
Sources and Literature
The SF-36 was developed and validated through the Medical Outcomes Study. Its conceptual framework and development are detailed in the following key publication:
- Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical care, 473-483.
All questions & possible results
General Health RatingTitle not visible
1. In general, would you say your health is:
Select one option:
- Excellent
- Very Good
- Good
- Fair
- Poor
2. Compared to one year ago, how would you rate your health in general now?
Select one option:
- Much better now than one year ago
- Somewhat better now than one year ago
- About the same
- Somewhat worse now than one year ago
- Much worse now than one year ago
Limitations
- The following items are about activities you might do during a typical day.
- Does your health now limit you in these activities? If so, how much?
3. Vigorous activities
- Such as running, lifting heavy objects, participating in strenuous sports
Select one option:
- Yes, limited a lot
- Yes, limited a little
- No, not limited at all
4. Moderate activities
- Such as moving a table, pushing a vacuum cleaner, bowling, or playing golf
Select one option:
- Yes, limited a lot
- Yes, limited a little
- No, not limited at all
5. Lifting or carrying groceries
Select one option:
- Yes, limited a lot
- Yes, limited a little
- No, not limited at all
6. Climbing several flights of stairs
Select one option:
- Yes, limited a lot
- Yes, limited a little
- No, not limited at all
7. Climbing one flight of stairs
Select one option:
- Yes, limited a lot
- Yes, limited a little
- No, not limited at all
8. Bending, kneeling, or stooping
Select one option:
- Yes, limited a lot
- Yes, limited a little
- No, not limited at all
9. Walking more than a mile
Select one option:
- Yes, limited a lot
- Yes, limited a little
- No, not limited at all
10. Walking several blocks
Select one option:
- Yes, limited a lot
- Yes, limited a little
- No, not limited at all
11. Walking one block
Select one option:
- Yes, limited a lot
- Yes, limited a little
- No, not limited at all
12. Bathing or dressing yourself
Select one option:
- Yes, limited a lot
- Yes, limited a little
- No, not limited at all
Problems Resulting From Physical Health
- 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?
13. Cut down on the amount of time you spent on work or other activities
Select one option:
- Yes
- No
14. Accomplished less than you would like
Select one option:
- Yes
- No
15. Were limited in the kind of work or other activities
Select one option:
- Yes
- No
16. Had difficulty performing the work or other activities (for example, it took extra effort)
Select one option:
- Yes
- No
Problems Resulting From Emotional Problems
- 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)?
17. Cut down the amount of time you spent on work or other activities
Select one option:
- Yes
- No
18. Accomplished less than you would like
Select one option:
- Yes
- No
19. Didn't do work or other activities as carefully as usual
Select one option:
- Yes
- No
Social Impact
20. During the past 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbors, or groups?
Select one option:
- Not at all
- Slightly
- Moderately
- Quite a bit
- Extremely
Pain
21. How much bodily pain have you had during the past 4 weeks?
Select one option:
- None
- Very mild
- Mild
- Moderate
- Severe
- Very severe
22. During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?
Select one option:
- Not at all
- A little bit
- Moderately
- Quite a bit
- Extremely
Past 4 Weeks
- 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...
23. Did you feel full of pep?
Select one option:
- All of the time
- Most of the time
- A good bit of the time
- Some of the time
- A little of the time
- None of the time
24. Have you been a very nervous person?
Select one option:
- All of the time
- Most of the time
- A good bit of the time
- Some of the time
- A little of the time
- None of the time
25. Have you felt so down in the dumps that nothing could cheer you up?
Select one option:
- All of the time
- Most of the time
- A good bit of the time
- Some of the time
- A little of the time
- None of the time
26. Have you felt calm and peaceful?
Select one option:
- All of the time
- Most of the time
- A good bit of the time
- Some of the time
- A little of the time
- None of the time
27. Did you have a lot of energy?
Select one option:
- All of the time
- Most of the time
- A good bit of the time
- Some of the time
- A little of the time
- None of the time
28. Have you felt downhearted and blue?
Select one option:
- All of the time
- Most of the time
- A good bit of the time
- Some of the time
- A little of the time
- None of the time
29. Did you feel worn out?
Select one option:
- All of the time
- Most of the time
- A good bit of the time
- Some of the time
- A little of the time
- None of the time
30. Have you been a happy person?
Select one option:
- All of the time
- Most of the time
- A good bit of the time
- Some of the time
- A little of the time
- None of the time
31. Did you feel tired?
Select one option:
- All of the time
- Most of the time
- A good bit of the time
- Some of the time
- A little of the time
- None of the time
32. 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.)?
Select one option:
- All of the time
- Most of the time
- Some of the time
- A little of the time
- None of the time
Health Status
- How TRUE or FALSE is each of the following statements for you.
33. I seem to get sick a little easier than other people
Select one option:
- Definitely true
- Mostly true
- Don't know
- Mostly false
- Definitely false
34. I am as healthy as anybody I know
Select one option:
- Definitely true
- Mostly true
- Don't know
- Mostly false
- Definitely false
35. I expect my health to get worse
Select one option:
- Definitely true
- Mostly true
- Don't know
- Mostly false
- Definitely false
36. My health is excellent
Select one option:
- Definitely true
- Mostly true
- Don't know
- Mostly false
- Definitely false
Possible results
Pain: A higher score indicates less pain and interference.
- This score represents the severity of bodily pain and its interference with normal work.
- A higher score indicates less pain and interference.
General Health: A higher score indicates a more positive health perception.
- This score represents the patient's overall perception of their general health.
- A higher score indicates a more positive health perception.
Emotional well-being: A higher score indicates better mental health.
- This score represents general mental health, including depression, anxiety, and positive affect.
- A higher score indicates better mental health.
Physical Functioning (PF) Score: A higher score indicates less limitation.
- This score represents limitations in physical activities such as self-care, walking, bending, and moderate/vigorous activities.
- A higher score indicates less limitation.
Role limitations due to emotional problems: A higher score indicates less limitation.
- This score represents limitations in usual role activities due to emotional problems.
- A higher score indicates less limitation.
Role limitations due to physical health: A higher score indicates less limitation.
- This score represents limitations in usual role activities due to physical health problems.
- A higher score indicates less limitation.
Social Functioning: A higher score indicates less interference.
- This score represents the extent to which physical health or emotional problems interfere with normal social activities.
- A higher score indicates less interference.
Energy/fatigue: A higher score indicates higher energy and less fatigue.
- This score represents energy level and fatigue.
- A higher score indicates higher energy and less fatigue.
Citation
The SF-36 was developed and validated through the Medical Outcomes Study by the RAND Corporation. Its conceptual framework and development are detailed in the following key publication:
- Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical care, 473-483.
The 36-items, presented here, are identical to the MOS SF-36 described in Ware and Sherbourne (1992). They were adapted from longer instruments completed by patients participating in the Medical Outcomes Study (MOS), an observational study of variations in physician practice styles and patient outcomes in different systems of health care delivery (Hays & Shapiro, 1992; Stewart, Sherbourne, Hays, et al., 1992).
Literature
- “The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection,”. Medical Care, 30:473-483, 1992. — Ware, J.E., Jr., & Sherbourne, C.D.
- An Overview of Generic Health-Related Quality of Life Measures For HIV Research. Quality of Life Research, 1, 91-97. — Hays, R.D. and Shapiro, M.F. (1992)
- Summary and Discussion of MOS Measures. In: Stewart, A.L. and Ware, J.E., Eds., Measuring Functioning and Well-Being: The Medical Outcome Study Approach, Duke University Press, Durham, 345-371. — Stewart, A.L., Sherbourne, C., Hays, R.D., Wells, K.B., Nelson, E.C., Kamberg, C., et al. (1992)
