SF-36 Score (Short Form Health Survey)

Evaluates quality of life and disease severity in different chronic conditions.

Refer to the text below the score for more information on its 8 subscales and scoring method.

The Short Form-36 health survey is one of the most widely used measures of health that assess quality of life, disease severity and help discriminate between different chronic conditions.

One of the main populations is patients with multiple sclerosis. This is a structured, self-report questionnaire that takes around 10 minutes to complete.

The SF-36 consists of 36 items – that are grouped in 8 subscales or domains:

  • Physical functioning (10 items);
  • Role limitations due to physical health (4 items);
  • Role limitations due to emotional problems (4 items);
  • Energy/fatigue;
  • Emotional well-being;
  • Social functioning (2 items);
  • Pain (2 items);
  • General health.

Aggregate scores for each domain range from 0 to 100, compiled as a percentage – where the higher the score, the more favourable the health state.

1In general, would you say your health is:
2Compared to one year ago, how would you rate your health in general now?
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
3Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports.
4Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf
5Lifting or carrying groceries
6Climbing several flights of stairs.
7Climbing one flight of stairs.
8Bending, kneeling, or stooping
9Walking more than a mile
10Walking several blocks
11Walking one block
12Bathing or dressing yourself.
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
13Cut down the amount of time you spent on work or other activities.
14Accomplished less than you would like
15Were limited in the kind of work or other activities.
16Had difficulty performing the work or other activities (for example, it took extra effort).
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
17Cut down the amount of time you spent on work or other activities.
18Accomplished less than you would like.
19Didn't do work or other activities as carefully as usual.
20During the past 4 weeks, to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbors, or groups?
21How much bodily pain have you had during the past 4 weeks?
22During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?
These questions are about how you feel and how things have been with you during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling.
How much of the time during the past 4 weeks…
23Did you feel full of pep?
24Have you been a nervous person?
25Have you felt so down in the dumps that nothing could cheer your up?
26Have you felt calm and peaceful?
27Did you have a lot of energy?
28Have you felt downhearted and blue?
29Did you feel worn out?
30Have you been a happy person?
31Did you feel tired?
32During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?
How TRUE or FALSE is each of the following statements for you.
33I seem to get sick a little easier than other people
34I am as healthy as anybody I know
35I expect my health to get worse
36My health is excellent
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SF-36 Score Explained

The Short Form-36 health survey is one of the most widely used measures of health that assess quality of life, disease severity and help discriminate between different chronic conditions. One of the main populations is patients with multiple sclerosis. This is a structured, self-report questionnaire that takes around 10 minutes to complete.

The SF-36 consists of 36 items – that are grouped in 8 subscales or domains:

  • Physical functioning (10 items);
  • Role limitations due to physical health (4 items);
  • Role limitations due to emotional problems (4 items);
  • Energy/fatigue (4 items);
  • Emotional well-being (5 items);
  • Social functioning (2 items);
  • Pain (2 items);
  • General health (5 items).

In order to score the SF-36, items must be recoded, as per the below table:

SF-36 Items Item recoding for scoring
1 2 3 4 5 6
1, 2, 20, 22, 34, 36 100 75 50 25 0 -
3, 4, 5, 6, 7, 8, 9, 10, 11, 12 0 50 100 -
13, 14, 15, 16, 17, 18, 19 0 100 -
21, 23, 26, 27, 30 100 80 60 40 20 0
24, 25, 28, 29, 31 0 20 40 60 80 100
32, 33, 35 0 25 50 75 100 -

Aggregate scores for each domain range from 0 to 100, compiled as a percentage – where the higher the score, the more favourable the health state.

Domain SF-36 items Formula
Physical functioning 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 Sum of recoding points / 10
Role limitations due to physical health 13, 14, 15, 16 Sum of recoding points / 4
Role limitations due to emotional problems 17, 18, 19 Sum of recoding points / 3
Energy/fatigue 23, 27, 29, 31 Sum of recoding points / 4
Emotional well-being 24, 25, 26, 28, 30 Sum of recoding points / 5
Social functioning 20, 32 Sum of recoding points / 2
Pain 21, 22 Sum of recoding points / 2
General health 1, 33, 34, 35 36 Sum of recoding points / 5

In a multiple sclerosis population, the Cronbach's alphas for the various subscales of the SF-36 range from .67 to .94.

The score was originally published by Ware and Sherbourne in 1992 and have since been reiterated in several versions and translations.

The SF-36 items are part of the Multiple Sclerosis Quality of Life Inventory (MSQLI), as well as the Multiple Sclerosis Quality of Life-54 (MSQOL-54).

 

References

Original reference

Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992; 30(6):473-483.

Other references

Hays RD, Sherbourne CD, Mazel RM. The RAND 36-Item Health Survey 1.0. Health Econ. 1993; 2(3):217-227.

Laucis NC, Hays RD, Bhattacharyya T. Scoring the SF-36 in Orthopaedics: A Brief Guide. J Bone Joint Surg Am. 2015; 97(19):1628-1634.

Specialty: Disability

Abbreviation: SF-36

Article By: Denise Nedea

Published On: July 22, 2020 · 12:00 AM

Last Checked: July 22, 2020

Next Review: July 22, 2025