1 = male
2 = female

1 = ≤3000
2 = ＞3000

1 = Primary school
2 = Junior high school
3 = High school
4 = Diploma
5 = Bachelor and above

1 = Unmarried
2 = Married/Cohabiting
3 = Divorced
4 = Widowed

1 = Unemployed
2 = Employed
3 = Retired

1 = Couple living together
2 = Living with children
3 = Living alone
4 = Others

B1. My motivation is lower when I am fatigued
1 = Completely disagree
2 = Disagree
3 = Slightly disagree
4 = Neutral
5 = Slightly agree
6 = Agree
7 = Fully agree

C1. Did you need help taking a bath or shower?
1 = Strongly agree
2 = Moderately agree
3 = Neither agree nor disagree
4 = Moderately disagree
5 = Strongly disagree

D1. Little interest or pleasure in doing things
0 = Not at all
1 = Several days
2 = More than half the days
3 = Nearly every day

E1. Feeding
0 = unable
5 = needs help cutting, spreading butter, etc., or requires modified diet
10 = independent

E2. Bathing
0 = dependent
5 = independent (or in shower)

E3. Grooming
0 = needs to help with personal care
5 = independent face/hair/teeth/shaving (implements provided)

E4. Dressing
0 = dependent
5 = needs help but can do about half unaided
10 = independent (including buttons, zips, laces, etc.)

E5. Bowels
0 = ncontinent (or needs to be given enemas)
5 = occasional accident
10 = continent

E6. Bladder
0 = incontinent, or catheterized and unable to manage alone
5 = occasional accident
10 = continent

E7. Toilet use
0 = dependent
5 = needs some help, but can do something alone
10 = independent (on and off, dressing, wiping)

E8. Transfers (Bed to chair and back)
0 = unable, no sitting balance;
5 = major help (one or two people, physical), can sit
10 = minor help (verbal or physical)
15 = independent

E9. Mobility (On level surfaces)
0 = immobile or < 50 yards
5 = wheelchair independent, including corners, > 50 yards
10 = walks with help of one person (verbal or physical) > 50 yards
15 = independent (but may use any aid; for example, stick) > 50 yards

E10. Stairs
0 = unable
5 = needs help (verbal, physical, carrying aid)
10 = independent

1 = 18~39
2 = 40~59

1 = No Depression
2 = Mild depression
3 = Moderate depression
4 = Moderately severe depression
5 = Severe depression

1 = Low quality of life
2 = Medium quality of life
3 = High quality of life

1 = Intact ability
2 = Mildly impaired
3 = Moderately impaired
4 = Severely impaired
5 = Extremely impaired