Health Assessment Questionnaire (HAQ)
The Stanford Health Assessment Questionnaire
Fries‚ 1980
DRESSING & GROOMING
Without ANY Difficulty‚ With SOME Difficulty‚ With MUCH Difficulty‚ UNABLE To Do
Are you able to:
1. Dress yourself‚ including shoelaces and buttons?
2. Shampoo your hair?
ARISING
Are you able to:
3. Stand up from a straight chair?
4. Get in and out of bed?
EATING
Are you able to:
5. Cut your meat?
6. Lift a full cup or glass to your mouth?
7. Open a new milk carton?
WALKING
Are you able to:
8. Walk outdoors on flat ground?
9. Climb up five steps?
• Please check any AIDS OR DEVICES that you usually use for any of the above activities:
Cane‚ Walker‚ Crutches‚ Wheelchair‚ Devices Used for Dressing (button hook‚ zipper pull‚ etc.)‚ Built Up or Special Utensils‚ Special or Built Up Chair
• Please check any categories for which you usually need HELP FROM ANOTHER PERSON:
Dressing & Grooming‚ Eating‚ Arising‚ Walking
• Please place an ‘x’ ( ) in the box which best describes your usual abilities OVER THE PAST WEEK:
Without ANY Difficulty‚ With SOME Difficulty‚ With MUCH Difficulty‚ UNABLE To Do
HYGIENE
Are you able to:
10.Wash and dry your body?
11.Take a tub bath?
12.Get on and off the toilet?
REACH
Are you able to:
13.Reach and get down a 5 pound object (such as a bag of sugar) from above your head?
14.Bend down to pick up clothing from the floor?
GRIP
Are you able to:
15.Open car doors?
16.Open previously opened jars?
17.Turn faucets on and off?
ACTIVITIES
Are you able to:
18.Run errands and shop?
19.Get in and out of a car?
20.Do chores such as vacuuming or yard work?
• Please check any AIDS OR DEVICES that you usually use for any of these activities:
Raised Toilet Seat‚ Bathtub Bar‚ Bathtub Seat‚ Long-Handled Appliances for Reach‚ Jar Opener (for previously opened)‚ jars Long-Handled Appliances in Bathroom
• Please check any categories for which you usually need HELP FROM ANOTHER PERSON:
Hygiene‚ Gripping and Opening Things‚ Reach‚ Errands and Chores
• How much pain have you had because of your arthritis IN THE PAST WEEK?
NO PAIN 0 _________________________________ 100 VERY SEVERE PAIN
• In general‚ how would you rate your current health?
VERY WELL0 _________________________________ 100 VERY POOR
Stanford HAQ 8-Item Disability Scale
Lorig‚ et al. 2001
1. Dress yourself‚ including tying shoelaces and doing buttons?
2. Get in and out of bed?
3. Lift a full cup or glass to your mouth?
4. Walk outdoors on flat ground?
5. Wash and dry your entire body?
6. Bend down to pick up clothing from the floor?
7. Turn faucets/taps on and off?
8. Get in and out of a car?
Score the number circled for each item. If more than one consecutive number is circled for one item‚ code the higher number (more difficulty). If responses are not consecutive‚ code as blank.
There are eight categories; first score within each category:
Dressing and Grooming‚ includes items 1 and 2
Arising‚ includes items 3 and 4
Eating‚ includes items 5‚ 6 and 7
Walking‚ includes items 8 and 9
Hygiene‚ includes items 10‚ 11‚ and 12
Reach‚ includes items 13 and 14
Grip‚ includes items 15‚ 16 and 17
Activities‚ includes items 18‚ 29‚ and 20
Each of the items has a companion aids-devices variable that is used to record what type(s) of assistance‚ if any‚ the subject uses for his/her usual activities. These variables are coded as follows:
0 = No assistance is needed
1 = A special device is used by the subject in his/her usual activities
2 = The subject usually needs help from another person
3 = The subject usually needs BOTH a special device AND help from another person
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