INSTRUMENTS VARIABLES SUBCATEGORY. Screening Battery. Movement Scale (AIMS) Acculturation Scale for Individual

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1 Center for Reducing Risks in Vulnerable Populations (CRRVP) University of Illinois at Chicago College of Nursing Instrument Bank Table Current to June 29, 2009 Contact information: Linda Graham at INSTRUMENTS VARIABLES SUBCATEGORY 7 Minute Neurocognitive Screening Battery Abnormal Involuntary Outcome Measures Movement (AIMS) Acculturation & Structural Individual Acculturation Assimilation (modified) Acculturation Attitudes Individual Acculturation Acculturation for Individual Acculturation African American ACT Recall (ADL) Index Adverse Event/Side Effects Outcome Measures Form African American Individual Acculturation Acculturation Agitated Behavior Mapping Instrument AIDS Risk Behavior Health Perception Knowledge (ARBA) Alcohol Use Disorders Health Perception Risk Factor Identification Test (AUDIT) Alienation Individual Acculturation Alzheimer s Disease (ADAS) Cognitive and Non- Cognitive Sections (ADAS-Cog, ADAS-Non- Cog) APACHE (Acute Biological & Physiological General Health Physiology and Chronic Status Health Evaluation) III Apathy for Parkinson's Disease Arc s Self-Determination Assertive Stress ATS-DLD-78 Health Perception Risk Factor Baecke of Habitual Barnes Rating for Outcome Measures Drug-Induced Akathasia Barthel Index Bayer (B-A-DL) BEAM-D (A new scale for assessing behavioral agitation in dementia) BEHAVE-AD (Behavioral 1

2 Symptoms in Alzheimer's Disease) Behavior Rating for (BRSD) Behavioral Activities in Demented Geriatric Patients Behavioral Risk Factor Surveillance System Behavioral and Mood Behavior Mood Disturbance (BMDS) Beliefs and Attitudes Pain Blessed (incorporating the Information- Memory- Concentration (IMC) Test and the ) Block 98 Biological & Physiological Nutrition Bonner & Ferrans' Black Environment Individual Caregivers Trust in Nurse Bonner & Ferrans' Black Environment Individual Caregivers Trust in Physicians Bouchard Three-day Record Brief for Brief Schedule Cards (BASDEC) Brief Cognitive Rating (BCRS) Brief Psychiatric Rating (BPRS) Brief Spiritual Beliefs Spiritual Inventory Brief Symptom Inventory (BSI) Bristol Burden Interview Caregiver Calgary Camberwell of Need for the Elderly (CANE) Cambridge Mental Disorders of the Elderly Examination (CAMDEX) Cambridge Neurological Physical Inventory Examination Canada Fitness Survey Canberra Interview for the Elderly (CIE) CARDIA History Caregiver Activity Survey Caregiver (CAS) Caregiver Time Use Environment Caregiver Caregiving Hassles Environment Caregiver 2

3 Caretaker Obstreperous- Behavior Rating (COBRA) Carroll Rating (CRS) Census Environment Socioeconomic (2000) Center For Epidemiological Studies - (CES-D) Factors CERAD Behavioral Rating CES-D Charlson Health Perception Index (CCI) Checklist Differentiating Pseudodementia from Checklist Individual Strength Chicago Health and Experiences of Women Cholesterol Detection - Detection, Evaluation & Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Chronic Respiratory Index (CRQ) Cleveland for (CSADL) Client Satisfaction Clinical Global (CGI) Clifton Procedures for the Elderly (CAPE) Clinical Rating (CDR) Clinical Rating for Symptoms of Psychosis in Alzheimer s Disease (SPAD) Health Perception Biological & Physiological Women Cholesterol Respiratory Satisfaction Clinician s Global Impression of Change Clock Drawing Test Cognitive Abilities Screening Instrument (CASI) Cognitive Capacity Screening Examination Cognitive Drug Research omputerized assessment system (COGDRAS) Cognitive Failures Memory Function 3

4 s Cognitive Performance Test Cognitively Impaired Life Quality (CILQ) Cohen-Mansfield Agitation Inventory (CMAI) Long Form Collection of Physical Activity s Colorado Symptom Index Behavior Mood Columbia University for Psychopathology in Alzheimer s Disease (CUSPAD) Comorbid Conditions Health Perception Measure Conditions Health Perception Checklist Health Perception Health Perception Comprehensive and Referral Evaluation (CARE) Comprehensive Psychopathological Rating (CPRS Confusion Delirium Model (CAM) Coping Strategies Pain Cornell for in Cornell-Brown for in Critchton Royal Behavioural Rating (CRBRS) Critical Care Family Need Environment Family Inventory Cumulative Illness Rating Health Perception Cumulative Illness Rating Illness (CIRS) Daily Activities (DAQ) Daily Stress Inventory Stress D.C. Trauma Collaboration Violence Study: Violence and Trauma Screening Delirium Symptom Delirium Interview (DSI) Demands of Immigration Individual Acculturation Behavior Disturbance Rating Depressive Signs (DSS) Deterioration de Cognitive 4

5 Observee (DECO) Diabetes Distress QOL Diabetes Diabetes QOL Diabetes Diet History (DHQ) by National Cancer Biological & Physiological Nutrition Institute (NCI) Direct of in Alzheimer s Disease Direct of (DAFS) Direct Measures of Poverty as Indicators of Economic Need: Evidence from the Survey of Income and Program Participation Environment Socioeconomic Factors Disruptive Behavior Rating (DBRS) Dressing Performance Drug Attitude Inventory (DAI-10) Duke Social Support Index Environment Social Support Duke University Severity Health Perception of Illness (DUSOI) Duncan Socioeconomic Index (DSI) Environment Socioeconomic Factors Dysfunctional Behavior Rating Instrument (DBRI) Early Signs of Checklist EASYcare: Elderly System Emotionalism and Mood Disorders After Stroke Empowerment Empowerment Epworth Sleepiness Sleep-related (ESS) EuroQol EuroQol (EQ-5D) Exercise Belief Instrument Exercise for Adolescent Experiences of Individual Discrimination Discrimination (EOD) Family Empowerment Empowerment (FES) Family Hardiness Index Environment Family Family Problem Solving Environment Family Communication (FPSC) Instrument (FAI) (Schwartz et al.) Checklist Rating (FRS) Severity (FSS) Symptom Inventory (FSI) Feetham Family Environment Family 5

6 Functioning Survey Framingham Physical Activity Index Functional Activities (FAQ) Functional of Chronic Illness Therapy (FACIT) Functional of Chronic Illness Therapy (FACIT) Functional Staging (FAST) Functional Index (FCI) Functional (FDS) Functional Outcomes of Sleep (FOSQ) Functional Performance Inventory (FPI) Health Perception QOL Sleep-related II GBS Gedragsobservatieschaal voor de Intramurale Psychogeriatrie (GIP) General Ethnicity General Health (GHQ) Geriatric (GDS) Geriatric Evaluation by Relative s Rating Instrument (GERRI) Geriatric Mental State Schedule (GMSS) Geriatric Rating (GRS) Global of Psychiatric Symptoms (GAPS) Individual Demographics Health Behavior Global Deterioration (GDS) Godin Leisure-Time Exercise GPRA Client Outcome Individual Demographics Measures Hachinski Ischaemia Score Biological & Physiological Hamilton Rating Health Insurance Plan of New York (HIP) Activity Health of the Nation Outcome s for Older People (HoNOS 65+) Health Self Determinism Index Health Self Determination 6

7 Hierarchic Historical Leisure Activity HIV and AIDS Knowledge Health Perception Knowledge HIV Knowledge Health Perception Knowledge (HIV-K-Q) HIV Knowledge Health Perception Knowledge (HIV-KQ-18) HIV-Risk Individual Drug-related (ARBA) HIV Stigma HIV Hospital Anxiety & (HADS) Anxiety and Hypoglycemic Fear Diabetes Immunosuppressant Side Effect Instrument Index of Co-existent Health Perception Disease (ICED) Informant on Memory Function Cognitive Decline in the Elderly (IQCODE) INSIGHT, Awareness and Insight and Treatment Attitudes (ITAQ) Instrumental Activities of Daily (IADL) Interview for Deterioration in Daily Activities in (IDDD) Inventory for the Subjective Symptoms of Irritability, Aggression and Apathy Kew Cognitive Test Lancashire Profile (Residential) Lifelong Lipid Research Clinics London Handicap Physical Manchester and Oxford Universities for the Psychopathological of (MOUSEPAD) Examination Mania Rating Marital Intimacy Intimacy Marlow-Crowne Social Desirability (M-C SDS) Social Desirability MAST-G (Michigan Alcoholism Screening Test Geriatric Version) Biological & Physiological Alcohol 7

8 Mattis Rating (DRS) McGill-Melzack Pain Pain Measurement of Morale in Morale the Elderly Measures Used In Individual Delirium Outcomes of Delirium in the Elderly Study Medical Outcomes Study Environment Social Support (MOS) Social Support Medication Adherence Health Perception Illness Perception Rating (MARS) Memory Functioning Memory Function (MFQ) Mental Inventory Mental Status (MSQ)/ Face-Hand Test (FHT) Mental Test Score (MTS) Abbreviated Mental Test Score (AMTS) Metamemory In Adulthood Memory Function (MIA) Migration QOL QOL Milan Overall Mini-Mental State Minnesota Leisure-Time Modifiable Activity Modifiable Activity for Adolescents Modified Baecke for Older Adults Modified Charlson Health Perception Index Modified Chronic Respiratory Respiratory Index Modified Symptom Checklist (MFSC) Modified Pulmonary Respiratory & Dyspnea (PFSDQ) Montgomery and Asberg Rating (MADRS) Mood Disorder Mood Mood s Elderly (MS-E) Multidimensional of (MAF) 8

9 Multidimensional Caregiver Burden Inventory Multidimensional Inventory (MFI) Multidimensional Symptom Inventory Short Form (-SF) Multidimensional Symptom Inventory (MFSI) Multidimensional Observation for Elderly Subjects (MOSES) Multidimensional of Perceived Social Support Multiphasic Environment Procedure (MEAP) National Children and Youth Fitness Study I & II National Health and Nutrition Examination Survey I, II, and III National Health Interview Survey National Health Interview Survey on Disability (NHIS-D) Neurobehavioral Rating (NRS) Neurological Evaluation (NES) Inventory (NPI) NIMH Mood (DMAS) Nurses Observation for Geriatric Patients (NOSGER) Nurses Observation for Inpatient Evaluation (NOSIE) Nursing Home Behavior Problem (NHBPS) Environment Environment Caregiver Social Support Disability Physical Examination OARS Depressive Observed Agitation in Patients with DAT (SOAPD) Overt Aggression (OAS) Overt Agitation Severity (OASS) Paffenbarger Physical Activity PAINReportIt (computerized McGill Pain, Ron Melzack Pain PAMIE (Physical 9

10 and Mental Impairment-of- Function Evaluation in the Aged) Parent-Adolescent Stress Communication Patient Health (PHQ)-9 Patient Self-Advocacy Individual Self-Advocacy (PSAS) Perceived Coercion Well-being Perceived Stress Stress Performance Test of (PADL) Personal Control Inventory Self-esteem Personality Inventory Philadelphia Geriatric Morale Center Morale s of the Kuopio Ischemic Heart Disease Study (KIHD) for the Elderly (PASE) Physical Self Maintenance (PSMS) and Instrumental Activities of Daily (IADL) Piper Pittsburgh Agitation (PAS) Pittsburgh Sleep Quality Sleep-related Index (PSQI) Pitzner Maltreatment Checklist POMS (The Profile of Mood Mood States) Positive and Negative Syndrome (PANSS) Present Functioning (PFQ) and Functional Rating (FRS) Problem Checklist and Caregiver Strain Profile of -Related Symptoms (PFRS) Progressive Deterioration (PDS) Psychogeriatric Dependency Rating s (PGDRS) Psychomotor Vigilance Motor Performance Task (PVT-192) PTSD checklist-stressor Stress specific version (PCL-S) Pulmonary Functional Respiratory 10

11 Status (PFSS) Quality of Interactions Schedule (QUIS) Alzheimer s Disease: Patient and Caregiver Report (QOL-AD) Schedule (QoLAS) in Index (Ferrans & Powers) RAND 36-item Health Survey Rapid Disability Rating 2 (RDRS 2) Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) Rating Anxiety in (RAID) Rating for Aggressive Behavior in the Elderly (RAGE) Recovery (RAS) Refined ADL (RADL) Relative s of Global Symptomatology (RAGS) Environment QOL Environment Interaction QOL Communication Recovery Resilience (RS) Resilience Resistiveness to Care (RTC-DAT Respiratory Disturbance Sleep-related Index Retrospective Postmortem (RCD-I) Biological & Physiological Revised Hasegawa s (HDS-R) Revised Illness Perception (IPQ-R) Revised Memory and Behavior Problems Checklist Revised Memory and Behavior Problems Checklist Health Perception Illness Perception Memory Function Risk Factor Prediction Health Perception Risk Factor Worksheet Rosenberg Self-esteem Self-esteem (RSE) Ryden Aggression Sandoz Clinical -Geriatric (SCAG) of Well-being (short form) Well-being 11

12 Schwartz Cancer (SCFS) Screen for Caregiver Caregiver Burden (SCB) SELFCARE (D) Self Comprehensive and Referral Evaluation Sensation Seeking Well-Being Seven-Day Physical Activity Recall Severe Impairment Battery (SIB) Severe MMSE SHHS (Sleep Heart Health Sleep-related Study) sleep habits questionnaire Short Form (SF-12) Health Survey Short Form (SF-36) Health Survey Short Mental Status Short Orientation Memory Concentration Test Short Portable Mental Status Sickness Impact Profile (SIP) Simpson/Angus Motor Performance Modified Sleep Disorders Sleep-related (SDQ) Social Impact Stigma Social Support Environment Social Support (Norbeck) Societal, Attitudinal, Individual Acculturation Familial, and Environmental Acculturative Stress - Children version (SAFE-C) Spielberger s Anger Anger Expression Items/ Inventory (AEI) Standardized Mini-Mental State Examination Stanford Usual Activity State-Trait Anxiety Index Anxiety (STAI) Stepwise Comparative Status Analysis (STEP) Stigma Impact Stigma :Neurological Impairment :Caregiver Stockton Geriatric Rating Structured of 12

13 Independent Skills (SALES) Structured Telephone Interview for (STIDA) Subjective of COPD patients Survey Psychiatric Schedule (SPAS) Symptom Checklist-90 Symptom (SCL-90) Symptom Impact Inventory Symptom Tardive Dyskinesia Rating (TDRS) Physical Examination Tecumseh Occupational Test of Everyday Functional Abilities (TEFA) Functional ability Previously named: The Texas Functional The Aerobics Center Longitudinal Study The CAGE : Alcoholism Detecting Alcoholism The Delirium Index (DI) Delirium The Even Briefer for (EBAS-DEP) The The Frontal Behavioral Inventory The General Medical Physical Health Rating (GMHR) Examination The General Practitioner of Cognition The Hope Hope The Knowledge of Memory Function Memory Aging The Medical Outcomes Study (MOS) 36-item short-form health survey (SF-36) The Modified MMSE (3MS) Examination The MONICA Optional Study of (MOSPA) The Neuropsychological Impairment Senior (NIS-S) The Philadelphia Geriatric Center Multilevel 13

14 Instrument The Pleasant Event Caregiver Schedule AD The Resource Utilization in (RUD) Instrument The Telephone Interview for Cognitive Status The Ten Point Clock Test Toronto Alexithymia Stress Treatment Compliance Interview Independent Trait Anger Index/ Trait Anger Anger (TAS) TRIMS (Texas Research Institute of Mental Science) Behavioral Problem Checklist (BPC) Unstable Angina Symptoms (USAQ) UTSD PTSD Index (Adolescent version) Validity and Reliability of the Alzheimer's Disease Co-operative Study- Clinical, Global Impression of Change (ADCS-CGIC) Visual Analogue for (VAS-F) Ways of Coping Checklist: Revision and Psychometric Properties Physical Examination Stress Ways of Coping Coping Webster (and Other Parkinson's Disease s) Physical Examination WHOQOL-100 QOL QOL WRAT (Wide Range Cognitive Achievement Test) 3 YALE Survey Youth Risk Behavior Survey Zung Self - Rating Zutphen 14

Number of Items. Response Categories. Part V: Specific Behavior Scales-Sleep Scales. Based on past month

Number of Items. Response Categories. Part V: Specific Behavior Scales-Sleep Scales. Based on past month Part V: Specific Behavior Scales-Sleep Scales Based on past month First 4 items ask for time or amount of sleep 41. Pittsburgh Sleep Quality Index (PSQI) Sleep quality Sleep latency Sleep duration Habitual