These questions are about how you feel and how things have been with you during the past month. For each question, please circle the one number that comes closest to the way you have been feeling.
Score each item as the number circled. If two consecutive numbers are circled, score the higher (more distress) number. If the numbers are not consecutive, do not score the item. The scale score is the mean of the four items. If more than 1 item missing, set the value of the scale to missing. Scores range from 0-5; higher score indicating more distress about health.
Tested on 1,130 subjects with chronic disease. N=51 for test-retest.
Source of Psychometric Data
Stanford Chronic Disease Self-Management Study. Psychometrics reported in: Lorig R., Sobel, DS, Stewart AL, Brown BW, Bandura, A, Ritter P, Gonzalez VM, Laurent, DD and Holman, HR. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization. Medical Care, 37, 1999, pp. 3-14.
This is a modified version of the Medical Outcomes Study health distress scale. We use 4 of the original 6 items, and changed the wording slightly. Items should be scrambled among other items using the same response categories, if possible (e.g., Energy/Fatigue scale). Because of the problems we have had using scales to measure negative emotion (e.g., depression) across cultures, we have substituted this scale. While it is not a depression or an anxiety scale, it does give us a good idea of distress caused by illness. It correlates .61 with the MOS depressive symptoms scale and .63 with the CES-D scale. Reprinted with permission, Duke University Press. This scale available in Spanish.
Lorig K, Stewart A, Ritter P, González V, Laurent D, & Lynch J, Outcome Measures for Health Education and other Health Care Interventions. Thousand Oaks CA: Sage Publications, 1996, pp.25,52-53.
Stewart AL, Hays RD, & Ware JE, Health Perceptions, energy/fatigue, and health distress measures, in Stewart AL & Ware JE, Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham NC: Duke University Press, pp. 143-172.
To download this scale and scoring instructions, right click the link below with your mouse and "Save as" to you hard disk or desktop (for Windows), or double click (Mac):