Module 17

Brief Health and Functioning Questionnaire (SF-21 Form):

Final Draft of January 18, 1996

Spanish Language Version: Final Draft of June 18, 1997


 
Main Purpose The purpose of this module is to assess health related quality of life in HIV disease.
Description
  • SF-21 consists of 8 subscales: physical functioning, role functioning, pain, current health perceptions, emotional well-being, cognitive functioning/distress, energy/fatigue, and social functioning. This module includes the SF-21 plus additional self-report items to assess disability days, symptoms, and an overall health rating as recommended by Ron Hays.
  • Data are collected on two letter-sized pages.
Target Projects for Form
  • Projects treating individual clients or patients.
  • Projects assessing changes in health related quality of life.
Major Evaluation Function
  • Measuring change and outcome for client-focused projects.
  • Predictor of responses to treatment.
  • Assessment for treatment needs.
Comments
  • This instrument will be supplemented with the Karnofsky Performance Status Index, the well-known single item clinical rating. Karnofsky ratings will replace SF-21 ratings for patients at the most advanced stages of HIV disease.
Implementation
  • Module 17 Current Version (dated 1/5/96) Activation Number: 17603.
  • Module 17 (Spanish) Current Version (dated 6/18/97) Activation Number: 63253.
Citation(s)
  • Huba, G. J., Melchior, L. A., Staff of The Measurement Group, and HRSA/HAB's SPNS Cooperative Agreement Steering Committee (1997). Module 17: Brief Health and Functioning Questionnaire. Available: www.TheMeasurementGroup.com. Culver City, California: The Measurement Group.
Source Citation(s)
  • Bozzette, S. A., Hays, R. D., Wu, A. W., Berry, S. H., and Kanouse, D. (1995). Derivation and psychometric properties of a brief health-related quality of life instrument for HIV disease.  Journal of Acquired Immunodeficiency Syndromes and Retrovirology, 8, 253-265.

Module 17

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Related Information:

Findings from Evaluating HIV/AIDS Programs
Reliability and Validity Studies

 


Copyright © 1997-2005 by The Measurement Group LLC. All rights reserved. This may not be current and will not be updated.