Please tick the following questions to describe the past week that best represents you
| 从未这样Never | 很少这样Rarely | 有时这样Sometimes | 经常这样Often | 一直这样Always | |
| 1. 我的体重使我在捡起物品时感到困难。My weight makes it difficult for me to pick up things | |||||
| 2. 我的体重使我在绑鞋带时感到困难。My weight makes it difficult for me to lace up my shoes | |||||
| 3. 我的体重使我从椅子上起来有困难。My weight makes it difficult for me to stand up from chair | |||||
| 4. 我的体重使我爬楼梯有困难。My weight makes it difficult for me to walk up and down stairs | |||||
| 5. 我的体重使我穿、脱衣服有困难。My weight makes it difficult for me put on and take off my clothes | |||||
| 6. 我的体重使我在活动时有困难。My weight makes it difficult for me to exersise | |||||
| 7. 我的体重使我双腿交叉有困难。My weight makes it difficult for me to cross legs | |||||
| 8. 仅仅是轻微的费力活动，我就感到呼吸急促。I feel shortness of breath with just a little strenuous activity | |||||
| 9. 疼痛或僵硬的关节是我的困扰。Painful or stiff joints are my problem | |||||
| 10. 到了晚上，我的踝关节及下肢就会肿胀。My ankles and lower limbs swell at night | |||||
| 11. 我担忧我自己的健康。Im worried about my health | |||||
| 12. 因为我的体重，我特别注意我自己。I pay special attention to myself because of my weight | |||||
| 13. 我的体重使我的自尊无法和常人一样。My weight keeps my self-esteem from being normal | |||||
| 14. 我的体重使我对自我感到不确定。My weight made me doubt myself | |||||
| 15. 我的体重使我不喜欢自己。My weight makes me dislike myself | |||||
| 16. 我的体重使我害怕被拒绝。My weight scared me to be rejected | |||||
| 17. 我的体重使我避免照镜子或看到照片中自己的样子。My weight keeps me away from looking in the mirror or seeing myself in the picture | |||||
| 18. 我的体重使我在公众场合露脸感到困窘。My weight makes me feel embarrassed in public | |||||
| 19. 我的体重使我无法享受性生活。My weight is preventing me from enjoying sex | |||||
| 20. 我的体重使我少有或几乎没有性欲望。My weight makes me almost sexless | |||||
| 21. 我的体重使我在性方面的表现有困难。My weight makes it difficult for me to perform sexually | |||||
| 22. 我的体重使我尽可能避免会发生性行为的情境。My weight keeps me from having sex as much as possible | |||||
| 23. 我的体重使我受到戏弄、嘲笑或不必要的注意。My weight makes me teased, ridiculed or unnecessarily noticed. | |||||
| 24. 我的体重使我很担心公共场所（如戏院、餐厅、车子、飞机等）的座椅是否适合我。My weight makes me worry about whether the seats in public places (such as theater, restaurant, car, plane, etc.) are suitable for me | |||||
| 25. 我的体重使我担心自己是否能通过狭长通道、或十字旋转门。My weight makes me worry about whether I can get through a narrow passage or a revolving door | |||||
| 26. 我的体重使我担心是否能找到一张够坚固、能够承担我体重的椅子。My weight makes me worry if I can find a chair strong enough to bear my weight | |||||
| 27. 我的体重使我体验到与他人的差别待遇。My weight makes me feel different from others |
The following questions are about work: (if you are retired, housewife or unemployed, please answer according to your daily activities.)
| 从未这样Never | 很少这样Rarely | 有时这样Sometimes | 经常这样Often | 一直这样Always | |
| 28. 我的体重使我在完成事情或达成我的职责时有困难。My weight makes it difficult for me to accomplish things or fulfill my duties | |||||
| 29. 我的体重使我的劳动成果少于应有的程度。My weight makes me less productive than I should be | |||||
| 30. 我的体重使我在工作上无法得到适当的加薪、升值或认同。My weight prevents me from getting a proper raise, appreciation or recognition at work | |||||
| 31. 我的体重使我在面临工作面试时，感到害怕。My weight scares me in the face of work |
2题 | 被引用24次