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Admin: Created page with "The Managing Health Assessment is a patient assessment designed to capture patient information with the goal of improving the patient's overall hea..."

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Created page with "The Managing Health Assessment is a patient assessment designed to capture patient information with the goal of improving the patient's overall hea..."

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The [[Managing Health Assessment]] is a [[Patient Assessments|patient assessment]] designed to capture patient information with the goal of improving the patient's overall health and well-being. It captures the patient's [[determinants]] (including [[Functional Limitations|functional limitations]]), [[symptoms]], and [[barriers]].

'''GENERAL WELL-BEING ASSESSMENT'''

'''Physical Activity''' 
[[Q1|1.]] In the past 7 days, how many days did you exercise? 
□ 6 or 7 days 
□ 4 or 5 days 
□ 2 or 3 days 
□ 1 day 
□ none

'''Tobacco Use''' 
[[Q4|4.]] In the last 30 days, have you used tobacco? □ yes □ no

'''Alcohol Use''' 
[[Q7|7.]] In the past 7 days, how many days did you drink alcohol? 
□ 6 or 7 days 
□ 4 or 5 days 
□ 2 or 3 days 
□ 1 day 
□ none

'''Nutrition''' 
[[Q10|10.]] In the past 7 days, how many servings of fruit and vegetables do you eat per day? 
(1 serving = 1 cup fresh vegetables, ½ cup cooked vegetables, or 1 medium piece of fruit. 1 cup = size of a baseball) 
□ 6 or more servings per day 
□ 4 or 5 servings per day 
□ 2 to 3 servings per day 
□ 1 serving per day 
□ none

[[Q11|11.]] In the past 7 days, how many servings of high fiber or whole grains food do you eat per day? 
(1 serving = 1 slice of 100% whole wheat bread, 1 cup of whole-grain or high-fiber ready-to-eat cereal, ½ cup of cooked cereal such as oatmeal, or ½ cup of brown rice or whole wheat pasta) 
□ 6 or more servings per day 
□ 4 or 5 servings per day 
□ 2 to 3 servings per day 
□ 1 serving per day 
□ none

[[Q12|12.]] In the past 7 days, how many servings of fried or high-fat foods did you typically eat each day? 
(Examples include fried chicken, fried fish, bacon, french fries, potato chips, corn chips, doughnuts, creamy salad dressing, and foods made with milk, cream, cheese, or mayonnaise.) 
□ 6 or more servings per day 
□ 4 or 5 servings per day 
□ 2 to 3 servings per day 
□ 1 serving per day 
□ none

[[Q13|13.]] In the past 7 days, how many ''sugar-sweetened'' (not diet) beverages did you consume each day? 
□ 6 or more servings per day 
□ 4 or 5 servings per day 
□ 2 to 3 servings per day 
□ 1 serving per day 
□ none

'''Depression''' 
[[Q15|15.]] In the past 2 weeks, how often have you been felt down, depressed, or hopeless? 
□ Nearly every day 
□ More than half the days 
□ Several days 
□ Not at all

[[Q16|16.]] In the past 2 weeks, how often have you felt little interest or pleasure in doing things? 
□ Nearly every day 
□ More than half the days 
□ Several days 
□ Not at all

'''Anxiety''' 
[[Q18|18.]] In the past 2 weeks, how often have you felt nervous, anxious, or on edge? 
□ Nearly every day 
□ More than half the days 
□ Several days 
□ Not at all

[[Q19|19.]] In the past 2 weeks, how often were you not able to stop worrying or control your worrying? 
□ Nearly every day 
□ More than half the days 
□ Several days 
□ Not at all

'''Stress''' 
[[Q20|20.]] How often is stress a problem for you in handling such things as: 
- Your health? 
- Your finances? 
- Your family or social relationships? 
- Your work? 
□ Never or rarely 
□ Sometimes 
□ Often 
□ Always

'''Support''' 
[[Q21|21.]] How often do you get the social and emotional support you need: 
□ Always 
□ Usually 
□ Sometimes 
□ Rarely 
□ Never

'''Pain''' 
[[Q22|22.]] In the past 7 days, how much pain have you felt? 
□ None 
□ Some 
□ A lot

'''General Health''' 
[[Q23|23.]] In general, would you say your health is 
□ Excellent 
□ Very Good 
□ Good 
□ Fair 
□ Poor

'''Dental Health''' 
[[Q24|24.]] How would you describe the condition of your mouth and teeth - including false teeth or dentures? 
□ Excellent 
□ Very Good 
□ Good 
□ Fair 
□ Poor

'''Activities of Daily Living''' 
[[Q25|25.]] In the past 7 days, did you need help from others to perform everyday activities such as eating, getting dressed, grooming, bathing, walking or using the toilet? 
□ yes □ no

'''Instrumental Activities of Daily Living''' 
[[Q26|26.]] In the past 7 days, did you need help from others to take care of things such as laundry and housekeeping, banking, shopping, using the telephone, food preparation, transportation or taking your medications? 
□ yes □ no

'''Sleep''' 
[[Q27|27.]] Each night, how many hours of sleep do you usually get? 
□ 10 or more hours per day 
□ 8 or 9 hours per day 
□ 6 or 7 hours per day 
□ 4 or 5 hours per day 
□ Less than 4

[[Q29|29.]] In the past 7 days, how often have you felt sleepy during the daytime? 
□ Always 
□ Usually 
□ Sometimes 
□ Rarely 
□ Never

'''Physiological Metrics - Self Reported''' 
[[Q30|30.]] If your blood pressure was checked ''within the past year'', what was it when it was last checked? 
□ Low or normal (at or below 120/80) 
□ Borderline high (120/80 to 139/89) 
□ High (140/90 or higher) 
□ Don't know/not sure

[[Q31|31.]] If your cholesterol was checked ''within the past year'', what was it when it was last checked? 
□ Desirable (below 200) 
□ Borderline high (200-239) 
□ High (240 or higher) 
□ Don't know/not sure

[[Q32|32.]] If your glucose was checked, what was your fasting blood glucose (blood sugar) level the last time it was checked? 
□ Desirable (below 100) 
□ Borderline high (100-125) 
□ High (126 or higher) 
□ Don't know/not sure

'''Fall Risk''' 
[[Q40|40.]] How many time have you fallen in the past 12 months? 
□ more than 10 times 
□ 5 to 10 times 
□ 2 to 5 times 
□ 1 times 
□ none

'''Cognitive''' 
[[Q41|41.]] In the past 7 days, I've had instances when I have forgotten things that recently happened 
□ More than 10 times 
□ 3 to 10 times 
□ Once or twice 
□ None

'''Resilience''' 
[[Q42|42.]] All things considered, are you satisfied with each of the following (Please check each): 
□ Emotional fitness - ability to manage positive and negative emotions in a constructive way 
□ Social fitness - trust, friendships, balance between social/privacy and social/loneliness 
□ Family fitness - trust, friendship, intimacy, supportive dialog, manage conflict, avoid escalation 
□ Spiritual fitness - positive levels of purpose and meaning through religious or non-religious means 
□ Overall Life Satisfaction

'''Purpose, Meaning & Goals''' 
[[Q43|43.]] My health conditions do not prevent me from pursuing my passions or what provides me purpose and meaning in my life? 
□ Agree 
□ Somewhat Agree 
□ Disagree

'''Patient Activation''' 
[[Q44|44.]] I fully understand my chronic conditions (i.e, asthma, high blood pressure), their potential risks and how they can be managed? 
□ Agree 
□ Somewhat Agree 
□ Disagree

[[Q45|45.]] I am confident I can self-manage my chronic conditions to prevent them from worsening or impacting my well-being? 
□ Agree 
□ Somewhat Agree 
□ Disagree

'''Support''' 
[[Q46|46.]] In the past year, my family has provided physical and emotional support when I needed it 
□ Always 
□ Usually 
□ Sometimes 
□ Rarely 
□ Never

[[Q47|47.]] In the past year, I suffered through health conditions, medical concerns, or skipped medical treatments because I didn't have someone to help me? 
□ Always 
□ Usually 
□ Sometimes 
□ Rarely 
□ Never

'''Responsibilities''' 
[[Q48|48.]] I have responsibilities (i.e., children, sick parent, job) that I've had to put in front of my personal health in the past 12 months? 
□ Always 
□ Usually 
□ Sometimes 
□ Rarely 
□ Never

'''Financial''' 
[[Q49|49.]] In the past year, I've experienced interruptions in nutritional food, medicine, or treatment due to financial constraints? 
□ Always 
□ Usually 
□ Sometimes 
□ Rarely 
□ Never

'''Access & Logistics''' 
[[Q50|50.]] I have missed medical treatments (including medications) because I lacked transportation or it wasn't convenient enough? 
□ Always 
□ Usually 
□ Sometimes 
□ Rarely 
□ Never

'''Community''' 
[[Q51|51.]] I feel safe walking on my street and through my neighborhood? 
□ Always 
□ Usually 
□ Sometimes 
□ Rarely 
□ Never

'''Home''' 
[[Q52|52.]] In the past year, I have lived uninterrupted in a safe home with heat/ac, hot water, conducive to sleeping and no structural barrier (i.e., not wheel chair accessible)? 
□ Always 
□ Usually 
□ Sometimes 
□ Rarely 
□ Never

← Older revision		Revision as of 21:51, 10 April 2018
Line 1:		Line 1:
−	The [[Managing Health Assessment]] '''(MHA)''' is a [[Patient Assessments\|patient assessment]] designed to capture patient information with the goal of improving the patient's overall health and well-being. It captures the patient's [[determinants]] (including [[Functional Status\|functional status]]), [[symptoms]], and [[barriers]].	+	The [[Managing Health Assessment]] '''(MHA)''' is a [[Patient Assessments\|patient assessment]] designed to capture patient information with the goal of improving the patient's overall health and well-being. It captures the patient's [[Health Determinants\|determinants]] (including [[Functional Status\|functional status]]), [[symptoms]], and [[barriers]].

	'''GENERAL MANAGING HEALTH ASSESSMENT'''		'''GENERAL MANAGING HEALTH ASSESSMENT'''

← Older revision		Revision as of 20:16, 10 August 2016
Line 1:		Line 1:
−	The [[Managing Health Assessment]] (MHA) is a [[Patient Assessments\|patient assessment]] designed to capture patient information with the goal of improving the patient's overall health and well-being. It captures the patient's [[determinants]] (including [[Functional Status\|functional status]]), [[symptoms]], and [[barriers]].	+	The [[Managing Health Assessment]] '''(MHA)''' is a [[Patient Assessments\|patient assessment]] designed to capture patient information with the goal of improving the patient's overall health and well-being. It captures the patient's [[determinants]] (including [[Functional Status\|functional status]]), [[symptoms]], and [[barriers]].

	'''GENERAL MANAGING HEALTH ASSESSMENT'''		'''GENERAL MANAGING HEALTH ASSESSMENT'''

← Older revision		Revision as of 20:16, 10 August 2016
Line 1:		Line 1:
−	The [[Managing Health Assessment]] is a [[Patient Assessments\|patient assessment]] designed to capture patient information with the goal of improving the patient's overall health and well-being. It captures the patient's [[determinants]] (including [[Functional Status\|functional status]]), [[symptoms]], and [[barriers]].	+	The [[Managing Health Assessment]] (MHA) is a [[Patient Assessments\|patient assessment]] designed to capture patient information with the goal of improving the patient's overall health and well-being. It captures the patient's [[determinants]] (including [[Functional Status\|functional status]]), [[symptoms]], and [[barriers]].

	'''GENERAL MANAGING HEALTH ASSESSMENT'''		'''GENERAL MANAGING HEALTH ASSESSMENT'''

@@ Line 1: / Line 1: @@
 The [[Managing Health Assessment]] is a [[Patient Assessments|patient assessment]] designed to capture patient information with the goal of improving the patient's overall health and well-being. It captures the patient's [[determinants]] (including [[Functional Status|functional status]]), [[symptoms]], and [[barriers]].
-'''GENERAL WELL-BEING ASSESSMENT'''
+'''GENERAL MANAGING HEALTH ASSESSMENT'''
 '''Physical Activity''' <br>

← Older revision		Revision as of 19:02, 6 July 2016
Line 1:		Line 1:
−	The [[Managing Health Assessment]] is a [[Patient Assessments\|patient assessment]] designed to capture patient information with the goal of improving the patient's overall health and well-being. It captures the patient's [[determinants]] (including [[Functional ~~Limitations~~\|functional ~~limitations~~]]), [[symptoms]], and [[barriers]].	+	The [[Managing Health Assessment]] is a [[Patient Assessments\|patient assessment]] designed to capture patient information with the goal of improving the patient's overall health and well-being. It captures the patient's [[determinants]] (including [[Functional Status\|functional status]]), [[symptoms]], and [[barriers]].

	'''GENERAL WELL-BEING ASSESSMENT'''		'''GENERAL WELL-BEING ASSESSMENT'''

Managing Health Assessment - Revision history

Admin at 21:51, 10 April 2018

Admin at 20:16, 10 August 2016

Admin at 20:16, 10 August 2016

Admin at 20:15, 10 August 2016

Admin at 19:02, 6 July 2016

Admin: Created page with "The Managing Health Assessment is a patient assessment designed to capture patient information with the goal of improving the patient's overall hea..."