|
A Multiple Cause Indicator Measurement Model in the HAQ Disability Index |
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| Can you: |
Without ANY Difficulty |
With SOME Difficulty |
With MUCH Difficulty |
Unable To Do |
|
|
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| Dress, including tying shoelaces |
□ |
□ |
□ |
□ |
| Shampoo your hair |
□ |
□ |
□ |
□ |
| Stand up from a straight chair |
□ |
□ |
□ |
□ |
| Get in and out of bed |
□ |
□ |
□ |
□ |
| Cut your meat |
□ |
□ |
□ |
□ |
| Lift a full cup or glass to your mouth |
□ |
□ |
□ |
□ |
| Open a new milk carton |
□ |
□ |
□ |
□ |
| Walk outdoors on flat ground |
□ |
□ |
□ |
□ |
| Climb up five steps |
□ |
□ |
□ |
□ |
| Wash and dry your body |
□ |
□ |
□ |
□ |
| Take a tub bath |
□ |
□ |
□ |
□ |
| Get on and off the toilet |
□ |
□ |
□ |
□ |
| Reach and get down a five pound object |
□ |
□ |
□ |
□ |
| Bend down & pick up clothing from floor |
□ |
□ |
□ |
□ |
| Open car doors |
□ |
□ |
□ |
□ |
| Open jars which have been opened |
□ |
□ |
□ |
□ |
| Turn faucets on and off |
□ |
□ |
□ |
□ |
| Run errands and shop |
□ |
□ |
□ |
□ |
| Get in and out of a car |
□ |
□ |
□ |
□ |
| Do chores i.e. vacuuming or yard work |
□ |
□ |
□ |
□ |
Atkinson and Lennox Health and Quality of Life Outcomes 2006 4:65 doi:10.1186/1477-7525-4-65 |
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