Idaho State University Institute of Rural Health

National Child Traumatic Stress Network Rural Archive (coming soon!)

Telehealth Idaho

Aid Worker Support Site

Aid Worker Pocket Card

 

Life Status Review

PLEASE NOTE: these measures are experimental, and are offered for your educational use. The scores are shown only to you, and are not archived or retained in any way. The information on this Web site is presented for educational purposes only. It is not a substitute for informed medical advice or training.  Do not use this information to diagnose or treat a health problem without consulting a qualified health or mental health care provider.  If you have concerns, contact your health care provider, mental health professional, or your local community health center.

At this time, there are no established, published norms this measure, although research is ongoing. For general guidance, a 0 should indicate no problems in that area, -1 should suggest the area needs attention, but is not a crisis. +1 indicates that things are going well in this area. A -2 score suggests this area needs attention and perhaps intervention, while +2 indicates a major success in this area.


  Serious
-2		 An Issue
-1		 Fine
0		 Good
+1		 Great
+2
Medical  
health
medication
hospitalization
  Serious
-2		 An Issue
-1		 Fine
0		 Good
+1		 Great
+2
Health/Wellness  
exercise
rest/relaxation
nutrition/access to food
  Serious
-2		 An Issue
-1		 Fine
0		 Good
+1		 Great
+2
Financial  
debts
income
SSI/Disability/Assistance
  Serious
-2		 An Issue
-1		 Fine
0		 Good
+1		 Great
+2
Housing/Transportation  
apartment/home
access to shops, services
environmental conditions
access to transportation
  Serious
-2		 An Issue
-1		 Fine
0		 Good
+1		 Great
+2
Employment/School  
stability
working condiditions
relationships at work/school
  Serious
-2		 An Issue
-1		 Fine
0		 Good
+1		 Great
+2
Legal/Criminal  
civil
family
criminal
parole/probation
  Serious
-2		 An Issue
-1		 Fine
0		 Good
+1		 Great
+2
Alcohol/Substance Use  
other's complaining
arrested/hospitialized
problems related to use
  Serious
-2		 An Issue
-1		 Fine
0		 Good
+1		 Great
+2
Self/Social/Interpersonal  
family relations
intimate relations
spirituality/belief systems
children's health & wellbeing
friend/family communication
organizations (clubs, religious group...)

How satisfied were you with your ability to help the patient today?

-100%                    50                   0                   50                   100%

worse   the same   better

Compared to last time, would you say your (patient's) overall psychological well-being is; better? worse? about the same? (e.g) 100% better, 100% worse, about the same, 50% better, 50% worse?)
Patient Rating:  

-100%                    50                   0                   50                   100%

worse   the same   better

Clinician Rating:  

-100%                    50                   0                   50                   100%

worse   the same   better
 

  Medical:
  Health/Wellness:
  Financial:
  Housing/Transportation:
  Employment/School:
  Legal/Criminal:
  Alcohol/Substance Use:
  Self/Social/Interpersonal:

© B. Hudnall Stamm & Joseph M. Rudolph; Traumatic Stress Research Group, 1996, 1997 http://www.isu.edu/~bhstamm/index.htm . This form may be freely copied as long as (a) authors are credited, (b) no changes are made, & (c) it is sold.

This page was last updated on 10/25/05 19:24
© B. Hudnall Stamm, 1997-2003

The information on this Web site is presented for educational purposes only. It is not a substitute for informed medical advice or training.  Do not use this information to diagnose or treat a health problem without consulting a qualified health or mental health care provider.  If you have concerns, contact your health care provider, mental health professional, or your local community health center.