AFTER RECORDING SCORES PER TABLE 1, AVERAGE THE FOLLOWING
3, 4, 5, 6, 7, 8, 9, 10, 11, 12
Role limitations due to physical health
13, 14, 15, 16
Role limitations due to emotional problems
17, 18, 19
23, 27, 29, 31
Emotional well being
24, 25, 26, 28, 30
1, 33, 34, 35, 36
STEP 3: FIGURING SCORES:
RAND recommends the following
straightforward approach to scoring the RAND 36-Item Health
All questions are scored on a scale from 0
to 100, with 100 representing the highest level of functioning
possible. Aggregate scores are compiled as a percentage of the
total points possible, using the RAND scoring table (STEP I
The scores from those questions that
address each specific area of functional health status (STEP II
chart) are then averaged together, for a final score within each
of the 8 dimensions measured. (eg pain, physical functioning
For example, to measure the patient's
energy/fatigue level, add the scores from questions 23, 27, 29,
and 31. If a patient circled 4 on 23, 3 on 27, 3 on 29 and left
31 blank, use table 1 to score them.
An answer of 4 to Q23 is scored as 40, 3
to Q27 is scored as 60, and 3 to Q29 is scored as 40. Q31 is
omitted. The score for this block is 40+60+40 =140. Now we divide
by the 3 answered questions to get a total of 46.7. Since a score
of 100 represents high energy with no fatigue, the lower score of
46.7% suggests the patient is experiencing a loss of energy and
is experiencing some fatigue.
All 8 categories are scored in the same
way. Using this questionnaire at the beginning and during the
course of care, we can track the progress of the 8 parameters
mentioned in the STEP II chart. Pretty nifty, eh?
You might consider adding these 3 questions to the survey
of your patients.
Thanks to Steven G. Yeomans, D.C. who teaches the Outcomes portion of LACC's rehabilitation diplomate program for providing these additional questions:
In the past year, have you had 2 weeks or more during which you
felt sad, blue or depressed; or when you lost all interest or
pleasure in the things that you usually cared about or
Have you had 2 years or more in your life when you felt depressed
or sad most days, even if you felt okay sometimes?
Have you felt depressed or sad much of the time in the past
You can use the last 3 questions
to stage patients as:
YES = depression
YES = dysthemia (= Mild, Chronic Depression)
YES = dysthemia
In discussion with the patient, Dr. Yeomans suggests that you can say,
"By your questionnaire you have scored yourself as depressed".
In this way, you are not labeling the patient, but acknowledging what they have already told you. This provides an opportunity to discuss their feelings and to explore a potential referral for counselling.