| RPT |
.| ******Brief Battery for Health Improvement 2 (BBHI-2)******||
Validity:|
| 38. My physical problems really don't bother me that much.| <*Answer_8264*>|
| 39. I protect my health by staying at home.| <*Answer_8265*>|
| 40. My pain never changes.| <*Answer_8266*>|
| 41. I feel well enough to work.| <*Answer_8267*>|
| 42. I'm afraid that my poor health will ruin my most important relationships.| <*Answer_8268*>|
| 43. There are many jobs that I am capable of doing.| <*Answer_8269*>|
| 44. My life is full and satisfying.| <*Answer_8270*>|
| 45. I am afraid of pushing myself too hard.| <*Answer_8271*>|
| 46. With my kind of problems, there's little hope of getting better.| <*Answer_8272*>|
| 47. This has been one of the worst times of my life.| <*Answer_8273*>|
<*Answer_7771*>|
| 48. I get so restless at times that I can't stand still.| <*Answer_8274*>|
| 49. My life used to be much better than it is now.| <*Answer_8275*>|
| 50. I am allergic to the glass found in jars.| <*Answer_8276*>|
| 51. I am afraid that my physical problems might kill me.| <*Answer_8277*>|
| 52. Lately, I have been thinking about suicide a lot.| <*Answer_8278*>|
| 53. I am content with my life.| <*Answer_8279*>|
| 54. I fear being struck down by an attack of some illness.| <*Answer_8280*>|
| 55. My life seems like one defeat after another.| <*Answer_8281*>|
| 56. My health problems really aren't that serious.| <*Answer_8282*>|
| 57. When I think about my physical problems, I get depressed.| <*Answer_8283*>|
PAIN COMPLAINTS (0-10 ANALOG PAIN SCALE)|
| 58. My life shouldn't be this hard.| <*Answer_8284*>|
| 59. I often get depressed; it's like I fall in a hole and can't get out.| <*Answer_8285*>|
| 60. I have many severe problems that come and go.| <*Answer_8286*>|
| 61. There are many things I won't do for fear of hurting myself.| <*Answer_8287*>|
| 62. Recently my life has been a nightmare.| <*Answer_8288*>|
| 63. I'm often afraid that something bad will happen to me.| <*Answer_8289*>|||
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|
conjunction with other diagnostic activities.||
Copyright 2002 NCS Pearson, Inc. All rights reserved.|
<*Answer_7787*>|
Pearson, the PSI Design, PsychCorp, and BBHI are trademarks in the US and/or other countries, of|
Pearson Education, Inc., or its affiliates.|
| $~
PAIN DIMENSIONS Pt <*Answer_7791*> Median for|
Median* Community**|
Highest in the Past Month:<*Answer_7788*> 8 4|
Lowest in the Past Month: <*Answer_7789*>|
Maximum Tolerable Pain: <*Answer_7790*>|
Pain Range: <*Answer_7773*>|
Date Given: <.Date_Given.>|
Peak Pain: <*Answer_7774*>|
Pain Tolerance: <*Answer_7775*>|
Overall Pain at Testing: <*Answer_7772*>|
|
The pain ratings above are based on the patient's highest pain level in the past month and|
are ranked on a scale of 0 to 10 (0 = No pain, 10 = Worst pain imaginable). The degree to|
which the patient's pain reports are consistent with objective medical findings should be|
considered. Diffuse pain reports, a nonanatomic distribution of pain, or a pattern of pain|
that is inconsistent with the reports of patients with a similar diagnosis increases the|
risk that psychological factors are influencing his pain reports.||
Clinician: <.Staff_Ordered_By.>|
*Based on a sample of <*Answer_7792*>.|
**Based on a community sample of over 700 individuals.||
PATIENT SCALE SCORES, NORMS AND PROFILE|
--------------------------------------|
Scale Raw Pt-T Com-T Profile|
-----Validity Scale---------------- 10 40 50 60 90|
<*Answer_7777*>|
-----Physical Symptom Scales------- :....:....:|
<*Answer_7778*>|
<*Answer_7779*>|
Location: <.Location.>| |
<*Answer_7780*>|
-----Affective Scales-------------- :....:....:|
<*Answer_7781*>|
<*Answer_7782*>||
Notes on Interpreting the Profile: The T-Score Profile plots T scores based on both patient|
and community norms. Approximately 68% of the samples scored in the average range of 40 to|
60. Scores above or below this range are clinically significant. The longer the bar, the|
more significantly [V 1.0] the score deviates from the mean. One value outside the average|
range is significant. Both values outside is more significant.||
SCALE RATING Percentile (Based on T-Score)|
Veteran: <.Patient_Name_Last_First.>|
<*Answer_7783*>||
CRITICAL ITEMS/AREAS|
<*Answer_7784*>||
OMITTED ITEMS|
<*Answer_7785*>||
RANDOM RESPONDING CHECK|
<*Answer_7786*>||
|Questions and Answers|
| 0. Please select the primary area where you have pain: (this question is REQUIRED)| <*Answer_8402*>|
| 1. Head (headache pain)?| <*Answer_8227*>|
SSN: <.Patient_SSN.>|
| 2. Jaw or face?| <*Answer_8228*>|
| 3. Neck or shoulders?| <*Answer_8229*>|
| 4. Arms or hands?| <*Answer_8230*>|
| 5. Chest?| <*Answer_8231*>|
| 6. Abdomen or stomach?| <*Answer_8232*>|
| 7. Middle back?| <*Answer_8233*>|
| 8. Lower back?| <*Answer_8234*>|
| 9. Genital area?| <*Answer_8235*>|
| 10. Legs or feet?| <*Answer_8236*>|
| 11. Taking into account all the parts of your body that hurt, what was your overall highest level|
DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)|
of pain during the past month?| <*Answer_8237*>|
| 12. Taking into account all the parts of your body that hurt, what was your overall lowest level of|
pain during the past month?| <*Answer_8238*>|
| 13. Taking into account all the parts of your body that hurt, what is your overall level of pain|
right now?| <*Answer_8239*>|
| 14. Taking into account all the parts of your body that hurt, what level of pain could you tolerate|
and still work and get on with your life?| <*Answer_8240*>|
| 15. Feeling exhausted but being unable to sleep?| <*Answer_8241*>|
| 16. Irritability?| <*Answer_8242*>|
| 17. Shakiness or jitters?| <*Answer_8243*>|
Gender: <.Patient_Gender.>||
| 18. Being unable to relax?| <*Answer_8244*>|
| 19. Feeling that nothing seems real?| <*Answer_8245*>|
| 20. Lump in throat/difficulty swallowing?| <*Answer_8246*>|
| 21. Pounding or racing heart when not exerting yourself?| <*Answer_8247*>|
| 22. Hearing voices that other people don't hear?| <*Answer_8248*>|
| 23. Feeling bloated or gassy?| <*Answer_8249*>|
| 24. Lack of interest in sex?| <*Answer_8250*>|
| 25. Difficulty concentrating?| <*Answer_8251*>|
| 26. I am satisfied with the medical care I am receiving.| <*Answer_8252*>|
| 27. I am barely able to keep up with my work.| <*Answer_8253*>|
RESULTS|
| 28. I worry about becoming dependent on prescription medication.| <*Answer_8254*>|
| 29. I walk and move very carefully so I won't cause myself pain.| <*Answer_8255*>|
| 30. Things have been terrible at home lately.| <*Answer_8256*>|
| 31. I've had no problems with sleeping.| <*Answer_8257*>|
| 32. I am not disabled.| <*Answer_8258*>|
| 33. I have never abused alcohol or drugs.| <*Answer_8259*>|
| 34. I can't work.| <*Answer_8260*>|
| 35. Somebody owes me for all of my pain and suffering.| <*Answer_8261*>|
| 36. Pain would not stop me from doing my favorite things.| <*Answer_8262*>|
| 37. I am very angry with one or more of my doctors.| <*Answer_8263*>|
|
