http://www.strokecenter.org/trials/scales/ssqol.html
Stroke Specific Quality of Life Scale (SS-QOL)Scoring:
each item shall be scored with the following keyTotal help
- Couldn't do it at all - Strongly agree 1A lot of help - A lot of trouble - Moderately agree 2Some help - Some trouble - Neither agree nor disagree 3A little help - A little trouble - Moderately disagree 4No help needed - No trouble at all
- Strongly disagree 5--------------------------------------------------------------------------------ITEM SCORE
Energy ___
1. I felt tired most of the time. ___
2. I had to stop and rest during the day. ___
3. I was too tired to do what I wanted to do. ___
Family Roles
1. I didn't join in activities just for fun with my family. ___
2. I felt I was a burden to my family. ___
3. My physical condition interfered with my personal life. ___
Language
1. Did you have trouble speaking? For example, get stuck, stutter, stammer, or slur your words? ___
2. Did you have trouble speaking clearly enough to use the telephone? ___
3. Did other people have trouble in understanding what you said? ___
4. Did you have trouble finding the word you wanted to say? ___
5. Did you have to repeat yourself so others could understand you? ___
Mobility
1. Did you have trouble walking? (If patient can't walk, go to question 4 and score questions 2-3 as 1.) ___
2. Did you lose your balance when bending over to or reaching for something? ___
3. Did you have trouble climbing stairs? ___
4. Did you have to stop and rest more than you would like when walking or using a wheelchair? ___
5. Did you have trouble with standing? ___
6. Did you have trouble getting out of a chair? ___
Mood
1. I was discouraged about my future. ___
2. I wasn't interested in other people or activities. ___
3. I felt withdrawn from other people. ___
4. I had little confidence in myself. ___
5. I was not interested in food. ___
Personality
1. I was irritable. ___
2. I was inpatient with others. ___
3. My personailty has changed. ___
Self Care
1. Did you need help preparing food? ___
2. Did you need help eating? For example, cutting food or preparing food? ___
3. Did you need help getting dressed? For example, putting on socks or shoes, buttoning buttons, or zipping? ___
4. Did you need help taking a bath or a shower? ___
5. Did you need help to use the toilet? ___
Social Roles
1. I didn't go out as often as I would like. ___
2. I did my hobbies and recreation for shorter periods of time than I would like. ___
3. I didn't see as many of my friends as I would like. ___
4. I had sex less often than I would like. ___
5. My physical condition interfered with my social life. ___
Thinking
1. It was hard for me to concentrate. ___
2. I had trouble remebering things. ___
3. I had to write things down to remember them. ___
Upper Extremity Function
1. Did you have trouble writing or typing? ___
2. Did you have trouble putting on socks? ___
3. Did you have trouble buttoning buttons? ___
4. Did you have trouble zipping a zipper? ___
5. Did you have troouble opening a jar? ___
Vision
1. Did you have trouble seeing the television well enough to enjoy a show? ___
2. Did you have trouble reaching things because of poor eyesight? ___
3. Did you have trouble seeing things off to one side? ___
Work / Productivity
1. Did you have trouble doing daily work around the house? ___
2. Did you have trouble finishing jobs that you started? ___
3. Did you have trouble doing the work you used to do? ___
TOTAL SCORE: ___
