McMaster Health Index Questionnaire – MHIQ

Today, are you physically able to run a short distance, say 300 feet, if you are in a hurry?

Today, do you (or would you) have any physical difficulty at all with walking as far as a mile?

Today, do you (or would you) have any physical difficulty at all with climbing up 2 flights of stairs?

Today, do you (or would you) have any physical difficulty at all with standing up from and/or sitting down in a chair?

Today, do you (or would you) have any physical difficulty at all with feeding yourself?

Today, do you (or would you) have any physical difficulty at all with undressing?

Today, do you (or would you) have any physical difficulty at all with washing (face and hands), shaving, and/or combing hair?

Today, do you (or would you) have any physical difficulty at all with shopping?

Today, do you (or would you) have any physical difficulty at all with cooking?

Today, do you (or would you) have any physical difficulty at all with dusting and/or light housework?

Today, do you (or would you) have any physical difficulty at all with cleaning floors?

Today, are you physically able to take part in any sports or exercise regularly?

At present, are you physically able to walk out-of-doors by yourself when the weather is good?

Today, do you (or would you) have any physical difficulty at all travelling by bus whenever necessary?

Today, do you have any physical difficulty at all travelling by car whenever necessary?

Do you have any physical difficulty at all driving a car by yourself?

Do you have any trouble seeing ordinary newsprint (with glasses if worn)?

Do you have a headache after watching television or reading (with glasses if worn)?

Do you have trouble hearing in a normal conversation with several other persons (with hearing aid if worn)?

Do you have trouble hearing the radio or television (with hearing aid if worn)?

I sometimes feel that my life is not very useful.

Everyone should have someone in his life whose happiness means as much to him as his own.

I am a useful person to have around.

I am inclined to feel that I'm a failure.

Many people are unhappy because they do not know what they want out of life.

In a society where almost everyone is out for himself, people soon come to distrust each other.

I am a quick thinker.

Some people feel that they run their lives pretty much the way they want to and this is the case with me.

There are many people who don't know what to do with their lives.

Most people don't realize how much their lives are controlled by plots hatched in secret by others.

People feel affectionate toward me.

I would say I nearly always finish things once I start them.

When I make plans ahead, I usually get to carry out things the way I expected.

I think most married people lead trapped (frustrated or miserable) lives.

It's hardly fair to bring children into the world the way things look for the future.

Some people feel as if other people push them around a good bit, and I feel this way too.

I am usually alert.

Nowadays a person has to live pretty much for today and let tomorrow take care of itself.

How would you say your health is today?

Taking all things together, how would you say things are today?

In general, how satisfying do you find the way you're spending your life today?

How would you say your physical functioning is today?

How would you say your social function is today?

How would you say your emotional functioning is today?

Are you presently working on a job for wages, either full- or part-time?

Do you regularly participate in social and recreational activities such as going to church?

Do you regularly participate in social and recreational activities such as going to a relative's home?

Has a relative visited you in the last week?

Has a friend visited you in the last week?

Has a religious group member visited you in the last week?

Has a social agency representative visited you in the last week?

Do you have a telephone?

Have you used your telephone in the last week to call a friend?

Have you used your telephone in the last week to call a religious group member?

Have you used your telephone in the last week to call a social agency representative?

Have you been called in the last week by a social agency representative?

During the last year, have you experienced separation from your spouse?

During the last year, have you experienced divorce?

During the last year, have you gone on welfare?

During the last year, have you had trouble getting along with friends or relatives?

During the last year, have you retired from work?