RAND SF-36 Health Survey (SF-36)

Quick 36-item health status check across physical, emotional, and social function over the past four weeks.

Most items use the past four weeks; item 2 separately compares your health with one year ago.
The report keeps all eight RAND-36 domains visible and marks the profile, physical, and mental means as within-tool summaries.
Your responses stay only in this browser unless you export or share the encoded result.

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Domain function ladder

Lower-scored domains appear first, stronger anchors appear later, and the dashed line marks the within-tool profile mean.

Change and balance context

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Higher-burden vs better-function anchors

#	Better-function anchor	Lower-function area	Why it stands out	Next move	Copy
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Top priorities

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Practical adjustments

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What to bring into follow-up

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When to bring in extra help: {{ followUpNote }}

Answer review

The response ledger keeps every recoded item visible. Item 2 remains a separate health-change note and does not enter the eight domain means.

#	Domain	Item	Response	0-100	Profile use	Copy
{{ row.id }}	{{ row.domainLabel }}	{{ row.text }}	{{ row.answer }}	{{ row.scoreText }}	{{ row.profileUse }}

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A health-status survey is useful when the question is how health is affecting life, not only what condition a person has. Two people with the same diagnosis can have different walking limits, pain patterns, energy, social contact, and emotional strain. A broad self-report profile gives those day-to-day differences a structure.

The RAND 36-Item Health Survey is part of the SF-36 survey family. It uses 36 questions to cover physical function, usual-role limits, pain, general health, emotional well-being, role limits from emotional problems, social functioning, and energy or fatigue. Most of the survey is about recent current health, often the past four weeks. One item compares current health with health one year ago, so it belongs beside the profile rather than inside the current-status domain averages.

Profiles matter because averages can hide the part that needs attention. A person may have good Physical Functioning but weak Energy / Fatigue after a long illness. Another may report low Pain and Role-Physical scores while Emotional Well-being remains relatively stable. The useful reading is usually the pattern across domains, the gap between lower and stronger areas, and whether the same areas remain low across repeated check-ins.

Core RAND-36 concepts used in health-status interpretation
Concept	Plain meaning	Why it changes interpretation
Domain	A group of items about one health concept.	The profile is meant to be read by domain, not collapsed into one diagnostic score.
Role limitation	Health reduces time, output, care, or reliability in usual responsibilities.	Role limits can be physical or emotional, and those causes are scored separately.
Health transition	Current health compared with one year ago.	It gives direction-of-change context without being averaged into the eight domains.

RAND-36 is not a diagnosis. Low scores can reflect pain, fatigue, disability, mood strain, recovery, a temporary illness, medication effects, or several causes together. It is strongest as a common language for describing function and well-being, especially when a person can connect low domains to concrete examples from daily routines.

The survey also depends on consistent self-report. A different recall window, a recent flare, or a different expectation of what counts as "limited a little" can change the profile. Repeated results are most useful when the same person answers under similar conditions and looks for persistent domain patterns rather than one small point movement.

How to Use This Tool:

Answer all 36 items in one sitting when possible, using the time frame shown with each question. The full report appears only after the progress label reaches 36/36 answered.

Select Start assessment to open the question flow, progress bar, and question list.
Work through each radio-choice item. The question list adds a check mark for completed rows and keeps the active item highlighted.
If the final report is missing, use the question list to find the row without a check mark and answer it before interpreting the score summary.
Read Health profile first. It shows the profile mean, physical mean, mental mean, balance label, one-year change note, best anchor, and top burden.
Use Domain function ladder to see lower domains before stronger domains. The marker for the profile mean helps show which domains sit below or above the current run's average.
Review the comparison rows, Practical adjustments, and What to bring into follow-up before copying or exporting results.
Open Answer review when a domain surprises you. It shows the original answer, 0-to-100 recoded value, domain, and whether the item feeds a domain or only the one-year change note.

Interpreting Results:

Use the eight domain scores as the main result. The profile mean is a compact summary, but it can smooth over the exact area that is creating difficulty. A Pain score below 40 has a different practical meaning from a broad profile mean near 65.

Higher burden means a domain score below 40.
Lower function means 40 to 59.9.
Mixed function means 60 to 74.9.
Better-function anchor means 75 or higher.
Domains below 50 counts current-status domains that may need closer review in this run.

The one-year change answer should be read next to the domain profile. Someone can report that overall health is better than last year while Energy / Fatigue remains low. Someone can report worse health than last year while one current domain still acts as a strong anchor. The transition item gives direction, not a ninth domain.

A false sense of precision is the main risk. Before reacting to a small difference, check the item rows behind the lowest domain and compare the same domain across repeated runs. Persistent low scores and worsening transition answers deserve more attention than a one-time shift of a few points.

Technical Details:

RAND scoring for the 36-item survey recodes responses so higher values represent a more favorable health state, then averages the recoded items within each scale. The method produces eight scale scores on a 0-to-100 range. It does not produce one official total score, and the one-year health transition item is not averaged into the eight current-status domains.

The recoding step is the technical core. Some items are favorable when the first choice is selected, such as Excellent general health or None for pain. Other items are favorable when the last choice is selected, such as No, not limited at all for physical activities or Definitely false for a negative health belief. Once every item is pointed in the same favorable direction, domain means are simple arithmetic averages.

Formula Core

Each domain is the mean of its recoded item values. The profile, physical, and mental means are transparent comparison aids built from those domain scores.

D_{j} = \frac{\sum_{i = 1}^{k_{j}} r_{i}}{k_{j}}

P = \frac{\sum_{j = 1}^{8} D_{j}}{8}

Physical = \frac{D_{PF} + D_{RP} + D_{Pain} + D_{GH}}{4}

Mental = \frac{D_{EWB} + D_{RE} + D_{SF} + D_{EF}}{4}

r_i is one recoded item value, k_j is the number of scored items in domain j, D_j is a domain score, and P is the profile mean. The page rounds domain and mean values to one decimal place.

RAND-36 domain item counts and summary grouping
Domain	Items	Grouped here as	Higher score means
Physical Functioning	10	Physical mean	Less limitation in movement, stairs, walking, lifting, and self-care.
Role-Physical	4	Physical mean	Fewer usual-role limits caused by physical health.
Pain	2	Physical mean	Less bodily pain and less pain interference.
General Health	5	Physical mean	More favorable general health perception and beliefs.
Emotional Well-being	5	Mental mean	More calm, less distress, and more positive mood.
Role-Emotional	3	Mental mean	Fewer usual-role limits caused by emotional problems.
Social Functioning	2	Mental mean	Less health interference with normal social activity.
Energy / Fatigue	4	Mental mean	More vitality and less tiredness.

The health transition item is recoded to the same 0-to-100 direction for review, where better-than-last-year answers sit higher than worse-than-last-year answers. It remains outside the domain means because it describes change over a year rather than current function over the recent recall frame.

RAND-36 recoding patterns used by the assessment
Item pattern	Recoded values	Examples
Five-choice favorable first	`100, 75, 50, 25, 0`	General health rating, social interference extent, pain interference, health change.
Three-choice limitation	`0, 50, 100`	Physical Functioning activity-limit items.
Yes/no limitation	`0, 100`	Role-Physical and Role-Emotional limitation items.
Six-choice favorable first	`100, 80, 60, 40, 20, 0`	Pain severity, pep, calmness, energy, happiness.
Six-choice unfavorable first	`0, 20, 40, 60, 80, 100`	Nervousness, low mood, feeling worn out or tired.
Five-choice unfavorable first	`0, 25, 50, 75, 100`	Social interference time and negative health-belief items.

RAND-36 result bands used by this assessment
Band shown	Boundary	How to use it
Higher burden	`score < 40`	Start review with this domain and its answer rows.
Lower function	`40 <= score < 60`	Function or well-being is meaningfully weaker in this run.
Mixed function	`60 <= score < 75`	The domain is neither clearly low nor a strong anchor.
Better-function anchor	`score >= 75`	Use this as a stronger comparison point when reviewing lower domains.

Limitations and Privacy Notes:

RAND-36 is a health-status survey, not a diagnostic instrument. It can show that pain, fatigue, physical limits, emotional strain, or social interference is affecting life, but it cannot identify the cause or decide treatment.

Scores depend on self-report, recall frame, expectations, and recent events, so one run should be interpreted cautiously.
The result bands are report reading aids, not universal clinical thresholds.
Answers are scored in the browser, but copied links, CSV files, DOCX exports, and chart images can preserve sensitive health information.
Bring persistent low domains, worsening one-year change, severe symptoms, or unsafe daily function to a qualified health professional.

Advanced Tips:

Use the Domain function ladder before the profile mean when you need to decide which domain deserves attention first.
Check Answer review for the lowest domain. Recoding direction changes by item, so the original response gives useful context.
Read the one-year change item beside the domain profile. Better-than-last-year can coexist with one low current domain, and worse-than-last-year can coexist with one strong anchor.
When repeating the survey, compare the same domain under the same recall frame before treating a few points of movement as meaningful.
Use exported files and copied result links as private follow-up materials, not casual screenshots, because they can reveal individual health answers.

Worked Examples:

Moderate profile with one clear burden

Physical Functioning is 85, General Health is 70, Emotional Well-being is 72, and Pain is 35. The Health profile mean may still look moderate, but Pain falls in the Higher burden band and should be checked first in Answer review.

Several low domains at once

General Health is 30, Energy / Fatigue is 35, Social Functioning is 40, and Pain is 45. The report counts multiple domains below 50, so the pattern is broader than one isolated low value. Recent examples from daily activity will matter more than the profile mean alone.

Improvement with a lagging area

The one-year change note says Somewhat better now than one year ago, while Energy / Fatigue is 38. Both can be true. Overall health may be improving while stamina still limits ordinary plans.

No final report appears

If the progress label is below 36/36 answered, the summary, chart, comparison rows, and Answer review remain hidden. Use the question list to find the item without a check mark, answer it, and then review the completed profile.

FAQ:

Does RAND-36 have one official total score?

No. RAND scoring produces eight scale scores. The profile mean, physical mean, and mental mean shown here are transparent comparison aids.

Is RAND-36 the same as SF-36?

The questions come from the SF-36 survey family. RAND's published scoring instructions use a 0-to-100 recoding method and say results scored this way should be called the RAND 36-Item Health Survey 1.0.

Why is the one-year change answer separate?

It reports perceived change from one year ago. The eight domains describe current health status, so the transition answer is kept as context instead of being averaged into a domain.

Can I compare two runs?

Yes, but compare the same domains under a similar recall frame. Repeated low Pain, Energy / Fatigue, or Social Functioning scores are more useful than reacting to the profile mean alone.

Why can a copied result link reveal answers?

The result link can preserve the response pattern so the completed report can reopen. Share it only with someone you trust to see the health answers and scores.

Glossary:

Health-status survey: A self-report survey that describes how health affects ordinary function and well-being.
Domain: One RAND-36 health concept built from a defined group of recoded items.
Profile mean: The simple average of the eight domain scores shown in the completed report.
Physical mean: The average of Physical Functioning, Role-Physical, Pain, and General Health.
Mental mean: The average of Emotional Well-being, Role-Emotional, Social Functioning, and Energy / Fatigue.
Health transition: The one-year comparison item that stays separate from the eight current-status domains.

References:

36-Item Short Form Survey (SF-36), RAND Health.
36-Item Short Form Survey (SF-36) Scoring Instructions, RAND Health.
The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection, Ware and Sherbourne, Medical Care, 1992.
Psychometric Evaluation of the SF-36 Health Survey in Medicare Managed Care, Health Care Financing Review.