| RPT |
| | World Health Organization Disability Assessment Schedule 2.0 -
Questions and Answers: |
S1. Standing for long periods such as 30 minutes?| <*Answer_7810*>|
S2. Taking care of your household responsibilities?|
<*Answer_7811*>| S3. Learning a new task, for example, learning how
to get to a new place? | <*Answer_7812*>| S4. How much of a
problem did you have joining in community activities (for example,
festivities, religious or other activities) in the same way
as anyone else can?| <*Answer_7813*>| S5. How much have you
been emotionally affected by your health problems? |
<*Answer_7814*>| S6. Concentrating on doing something for ten
12-item (WHODAS2.0-12) | |
minutes?| <*Answer_7815*>| S7. Walking a long distance such as a
kilometer (or equivalent)?| <*Answer_7816*>| S8.
Washing your whole body?| <*Answer_7817*>| S9. Getting dressed?|
<*Answer_7818*>| S10. Dealing with people you do not know?|
<*Answer_7819*>| S11. Maintaining a friendship?|
<*Answer_7820*>|
S12. Your day-to-day work?| <*Answer_7821*>|
| |Information contained in this note is based on a self-report
assessment and is not sufficient to use alone for diagnostic purposes.
Assessment results should be verified for accuracy and used in
Date Given: <.Date_Given.>| Clinician: <.Staff_Ordered_By.> |
conjunction with other diagnostic activities.
| |Copyright World Health Organization. 2009. All Rights Reserved.
Measuring health and disability: manual for WHO Disability Assessment
Schedule (WHODAS 2.0), World Health Organization, 2010, Geneva. $~
Location: <.Location.>| | Veteran: <.Patient_Name_Last_First.>|
SSN: <.Patient_SSN.>| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)
| Gender: <.Patient_Gender.> | | |
GLOBAL DISABILITY SCORE: <*Answer_7771*>| Scores range from 0-48, with
higher scores indicating more severe disability.
| |
|
