From: Quality of death after elective surgery: a questionnaire survey for the bereaved family
Assessment instrument that can measure health and disability | |
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1 Standing for long periods such as 30 min? | |
2 Taking care of your household responsibilities? | |
3 Learning a new task, for example, learning how to get to a new place? | |
4 Joining in community activities (for example, festivities, religious, or other activities) in the same way as anyone else can? | |
5 How much have you been emotionally affected by your health problems? | |
6 Concentrating on doing something for 10 min? | |
7 Walking a long distance such as a kilometer [or equivalent]? | |
8 Washing your whole body? | |
9 Getting dressed? | |
10 Dealing with people you do not know? | |
11 Maintaining a friendship? | |
12 Your day-to-day work/school? |