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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Health profile

Within-tool mean across the eight RAND-36 domains; item 2 stays separate as a one-year change note.

Physical {{ format(physicalMean) }} Mental {{ format(mentalMean) }} {{ balanceLabel }} Change vs prior: {{ healthChangeShortLabel }} Best anchor: {{ topDomainRow ? topDomainRow.name : '—' }} Top burden: {{ lowDomainRow ? lowDomainRow.name : '—' }}

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
{{ row.id }}	{{ row.anchorLabel }}	{{ row.focusLabel }}	{{ row.whyItMatters }}	{{ row.nextMove }}

Top priorities

{{ item }}

Practical adjustments

{{ item }}

What to bring into follow-up

{{ item }}

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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Health-related quality of life is not the same as a diagnosis, a lab value, or a single symptom rating. It describes how health shows up in ordinary life: walking, climbing stairs, doing work or home tasks, handling pain, keeping up with social contact, feeling calm, and having enough energy to get through the day. A person can have the same medical condition as someone else and report a very different day-to-day burden.

The RAND 36-Item Health Survey belongs to the SF-36 family of patient-reported health status measures. It uses 36 self-report questions to summarize several parts of physical, emotional, and social function. The result is best read as a profile because the survey is deliberately broad. Pain, role limits, fatigue, mood, social interference, and general health perception can move in different directions, especially during recovery, chronic illness, rehabilitation, or treatment follow-up.

Domain: One health concept measured by a group of related items, such as Physical Functioning, Pain, or Energy / Fatigue.
Role limitation: A restriction in usual work, home, school, or other responsibilities because physical or emotional health got in the way.
Health transition: The single comparison of current health with health one year ago. It gives direction of change, not another current-status domain.

A common mistake is to look for one grand score and treat it as the answer. That can hide the useful part of the survey. A profile with strong physical functioning and weak energy says something different from a profile with heavy pain and stable emotional well-being, even if the averages are similar. The domain shape is often the clue that helps someone decide what to track next or what examples to bring into a clinical conversation.

Several details affect interpretation. Most items ask about the past four weeks, so a flare, acute illness, surgery, or temporary stressor can pull scores down. The survey also depends on the respondent's frame of reference. One person may judge "limited a little" against athletic routines, while another judges it against basic daily tasks. Repeat results are most useful when the same person answers with the same recall window and similar expectations.

RAND-36 results can support follow-up discussions, population surveys, rehabilitation notes, and personal tracking, but they cannot explain why a domain is low. A low Pain score may come from a short-term injury, a chronic condition, or something not yet evaluated. A low Emotional Well-being score can reflect distress without proving a specific mental-health diagnosis. The profile is a structured starting point, not a substitute for qualified care when health is worsening or daily function becomes unsafe.

How to Use This Tool:

Answer the survey in one sitting when possible, using the time frame shown with each question. The final report appears only after all 36 items are answered.

Select Start assessment to open the question flow, progress bar, and question list.
Work through the radio choices for all 36 questions. The list marks completed questions with a check icon, and the progress text moves toward 36/36 answered.
Use the question list if you need to go back. If the final report is missing, find the row without a check mark and answer it.
Read Health profile first for the profile mean, physical mean, mental mean, balance label, one-year change note, strongest domain, and top burden.
Use Domain function ladder to see the domains from lower to higher score. The dashed line marks the profile mean shown in the report.
Review Top priorities, Practical adjustments, and What to bring into follow-up before saving or sharing anything.
Open Answer review when a score surprises you. It shows the original response, the 0-to-100 recoded value, and whether the item feeds a domain or only the one-year change note.

Interpreting Results:

Start with the eight domain scores, not the profile mean. RAND-36 is most useful when it shows which parts of everyday health are weaker and which parts still act as anchors. The profile mean can summarize the run, but it can also smooth over the exact area that needs attention.

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 domains with scores under 50 in the current run.

The one-year change answer belongs beside the domain profile. Someone can say health is better than last year and still have a low Energy / Fatigue score. Someone can say health is worse than last year while one current domain remains strong enough to protect routines. Treat the transition item as direction-of-change context, not a replacement for the current domain scores.

For a confidence check, compare the lowest domain with its item rows in Answer review. A low domain that matches several concrete answers is more informative than a small shift in the profile mean. Across repeat runs, compare the same domains under the same recall frame before drawing conclusions from a few points of change.

Technical Details:

RAND scoring uses the same 36 questions as the MOS SF-36, but RAND's published scoring instructions define the result as the RAND 36-Item Health Survey 1.0. The scoring logic is intentionally simple: recode each answered item to a 0-to-100 value where higher means a more favorable health state, then average the recoded items that belong to each scale.

The recoding step matters because response directions differ across the questionnaire. For some items, the first response is most favorable. For other items, the last response is most favorable. Items about nervousness, tiredness, poor health expectations, pain interference, and social interference have to be turned in the correct direction before they can be averaged with related items.

Formula Core

Each scored response is first mapped to a recoded value. Domain scores are then arithmetic means of the recoded values in that domain.

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 displayed profile mean. The physical, mental, and profile means are transparent comparison aids here, not official RAND total scores.

Domain means are rounded to one decimal place. A Pain score of 50, for example, could come from one pain-severity response recoded to 75 and one pain-interference response recoded to 25. The arithmetic is simple after recoding, but the response direction is what makes the score comparable inside a domain.

RAND-36 domains and item counts used by this assessment
Domain	Items	Grouped here as	Higher score means
Physical Functioning	10	Physical mean	Less limitation in movement, stairs, walking, lifting, and self-care tasks.
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.
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.

Item 2 is handled differently. It is recoded on the same 0-to-100 direction for review, but it is not averaged into any of the eight domains. Its visible short label is based on the original answer: better than last year, about the same, or worse than last year.

Result bands shown by this RAND-36 assessment
Band shown	Boundary	How to read it	Main caution
Higher burden	`score < 40`	Start review with this domain.	Not an official diagnostic cutoff.
Lower function	`40 <= score < 60`	Function or well-being is meaningfully weaker in this run.	Check the item rows before deciding what changed.
Mixed function	`60 <= score < 75`	The domain is neither clearly weak nor clearly strong.	Small differences near the edge should not be overread.
Better-function anchor	`score >= 75`	A stronger area to compare against lower domains.	A strong domain does not cancel a low one.

Limitations and Privacy Notes:

RAND-36 is a health-status survey, not a diagnostic instrument. It can show that pain, fatigue, emotional strain, or social interference is affecting life, but it cannot identify the cause or decide treatment. Bring persistent low scores, worsening one-year change, or safety concerns to a qualified clinician or other appropriate health professional.

Scores depend on self-report and the recall period, so recent events can strongly affect one run.
The result bands are report reading aids and should not be treated as universal clinical thresholds.
Your answers stay in the browser during scoring, but copied links, CSV files, DOCX exports, and chart images can contain sensitive health information.

Worked Examples:

One low domain inside a moderate profile. Physical Functioning is 85, General Health is 70, Emotional Well-being is 72, and Pain is 35. The Health profile average may look moderate, but Pain falls in the Higher burden band and becomes the first domain to review.

A broad function gap. General Health is 30, Energy / Fatigue is 35, Social Functioning is 40, and Pain is 45. The report counts several domains below 50, so the useful question is not only which score is lowest, but whether recent examples from several areas point to the same burden.

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. Health may be improving overall while stamina still limits ordinary plans.

No final report appears. If the progress text is below 36/36 answered, the summary, chart, and Answer review remain hidden. Use the question list to find the row 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 simple comparison aids.

Is RAND-36 the same as SF-36?

The questions are the same as the MOS SF-36, but RAND's scoring instructions use a simpler method and say results scored this way should be called RAND 36-Item Health Survey 1.0.

Why is the one-year change answer separate?

It reports perceived health transition from one year ago. The eight domains measure 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. A repeated low Pain, Energy / Fatigue, or Social Functioning score is more useful than reacting to the profile mean alone.

Why can a copied result link reveal answers?

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

Glossary:

Domain score: The 0-to-100 score for one RAND-36 health concept, such as Pain or Social Functioning.
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.