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Wednesday, October 10, 2012

Pitsburgh Sleep Quality Index



Untuk Instrumen silakan unduh disini

Form Administration Instructions


The range of values for questions 5 through 10 are all 0 to 3.

Questions 1 through 9 are not allowed to be missing except as noted below.  If these questions are missing then any scores calculated using missing questions are also missing.  Thus it is important to make sure that all questions 1 through 9 have been answered. 

In the event that a range is given for an answer (for example, ‘30 to 60’ is written as the answer to Q2, minutes to fall asleep), split the difference and enter 45.

Reference


Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ:  The Pittsburgh Sleep Quality Index:  A new instrument for psychiatric practice and research.  Psychiatry Research 28:193-213, 1989.
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Barthel Index Instrument


THE                                   Patient Name: ___________________________ 
BARTHEL                                   Rater Name: ___________________________ 
INDEX                                            Date: ___________________________

Activity Score

FEEDING
0 = unable
5 = needs help cutting, spreading butter, etc., or requires modified diet
10 = independent
            ______  
BATHING
0 = dependent
5 = independent (or in shower)  ______ 
GROOMING
0 = needs to help with personal care
5 = independent face/hair/teeth/shaving (implements provided)  ______

DRESSING
0 = dependent
5 = needs help but can do about half unaided
10 = independent (including buttons, zips, laces, etc.)  ______ 
BOWELS
0 = incontinent (or needs to be given enemas)
5 = occasional accident
10 = continent ______ 
BLADDER
0 = incontinent, or catheterized and unable to manage alone
5 = occasional accident
10 = continent ______ 
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