WPAI

 

Work Productivity and Activity Impairment Questionnaire: 

General Health V2.0 (WPAI:GH) 

 

 

 productividad en el trabajo y el impedimento de las actividades

 

The following questions ask about the effect of your health problems on your ability to work and perform regular activities. By health problems we mean any physical or emotional problem or symptom. Please fill in the blanks or circle a number, as indicated. 

 

NAME
NAME
DATE OF BIRTH
DATE OF BIRTH
Formato MM-DD-AAAA es decir mes-dia-año
If NO, check “NO” and skip to question 6.
During the past seven days Include hours you missed on sick days, times you went in late, left early, etc., because of your health problems. Do not include time you missed to participate in this study.
During the past seven days
During the past seven days (If “0”, skip to question 6.)
During the past seven days Think about days you were limited in the amount or kind of work you could do, days you accomplished less than you would like, or days you could not do your work as carefully as usual. If health problems affected your work only a little, choose a low number. Choose a high number if health problems affected your work a great deal.
During the past seven days By regular activities, we mean the usual activities you do, such as work around the house, shopping, childcare, exercising, studying, etc. Think about times you were limited in the amount or kind of activities you could do and times you accomplished less than you would like. If health problems affected your activities only a little, choose a low number. Choose a high number if health problems affected your activities a great deal.