Version May 2024
| 1. Throughout our lives, most of us have times when we feel very tired or fatigued. Have you felt unusually tired or fatigued in the last week? | Yes/No |
| 2. Please answer the following questions by rating your fatigue (weariness, tiredness) on a scale from 0 to 10, with 0 representing "no fatigue" and 10 representing "the worst fatigue you can imagine." | |
| A) Which number best represents your fatigue right now? | |
| B) Which number best describes your usual level of fatigue within the past 24 hours? | |
| C) Which number best describes your worst level of fatigue within the past 24 hours? | |
| 3. Please use a scale from 0 to 10 to answer the following questions that describe how, during the past 24 hours, your fatigue has interfered with aspects of your life. 0 represents "no interference" and 10 represents "complete interference." | |
| A) General activity | |
| B) Mood | |
| C) Walking ability | |
| D) Normal work (including both work outside the home and daily chores) | |
| E) Relations with other people | |
| F) Enjoyment of life | |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
