Miami Dade College, Miami

NUR 448

The questionnaire asks about difficulties due to health/mental health conditions. Health conditions include diseases or illnesses, or other health problems that may be short or long lasting, injuries, mental 1or emotional problems and problems with alcohol or drugs. Think back over the past 30 days and answer these questions thinking about how much difficulty you had doing the following activities. For each question, please circles only one response. Clinician Use Only Numerical scores assigned to each of the items 1 2 3 4 5 Raw Item score Raw Domain Score Average Domain Score In the last 30 days, how much difficulty did you have in Understanding and communicating D1.1 Concentration on doing something for ten minutes? None Mild Moderate Severe Extreme or cannot do 30 5 D1.2 Remembering to do important things? None Mild Moderate Severe Extreme or cannot do D1.3 Analyzing and finding solutions to problems in day-today life? None Mild Moderate Severe Extreme or cannot do D1.4 Learning a new task, for example, learning how to get to a new place? None Mild Moderate Severe Extreme or cannot do D1.5 Generally understanding what people say? None Mild Moderate Severe Extreme or cannot do D1.6 Starting and maintaining a conversation? None Mild Moderate Severe Extreme