Contents

Search


Mayo Portland Adaptability Inventory

Indications: - inventory for traumatic brain injury * Self report, scaled 0-3 Procedure: Physical/Medical 1) Walking and Mobility - 0 No problem - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities or requires me to use an aid like a cane or wheelchair - 3 Need someone else to help me move about 2) Use of one or both hands - 0 No problem - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities - 3 Cannot use either hand 3) Hearing (with a hearing aid, if needed/used) - 0 No problem - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities - 3 Deaf or nearly deaf 4) Vision (with glasses, if needed/used) - 0 No problem - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities - 3 blind or nearly blind 5) Speech - 0 No problem - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities - 3 Cannot speak or can barely speak 6) Pain (headaches, backache, other pain) - 0 No problem - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities - 3 Can hardly do anything because of pain Cognition 1) Communicating with other people - 0 No problem - 1 A little problem but usually communicate effectively - 2 A bigger problem that often interferes with communication or requires use of a communicating aid - 3 extreme difficulty communicating with anyone 2) Remembering new things - 0 No problem - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities - 3 Hardly remember anything new 3) Concentration - 0 No problem - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities - 3 Cannot keep attention on anything for more than a few seconds 4) Solving new problems - 0 No problem - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities - 3 Unable to solve any new problems without help 5) Spatial Relationships - 0 No problem - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities - 3 Need help with all activities that require spatial relationship skills 6) Fund of information - 0 Remember about as much of what I learned in school as most people - 1 Probably remember a little less of what I learned in school than most - 2 Remember a lot less of what I learned in school than most - 3 Hardly remember anything of what I learned in school Emotion 1) Anger and irritability - 0 No problem - 1 Other people feel I have a problem with this, but I do not agree - 2 Sometimes I yell or scream at people - 3 Sometimes I strike or hit people 2) Anxiety and tension - 0 No problem - 1 A little problem that does not interfere with activities or for which I am receiving treatment - 2 A bigger problem that does interfere with activities - 3 I feel like I should be hospitalized for this 3) Depression - 0 No problem - 1 A little problem that does not interfere with activities or for which I am receiving treatment - 2 A bigger problem that does interfere with activities - 3 I feel like I should be hospitalized for this Everyday activities 1) Independent living - 0 Lives independently, handles own finances - 1 Lives independently but does not handle own finances - 2 Lives with help (i.e half-way house, supervised apartment, or with attendant) - 3 Needs full-time supervision or is homeless 2) Dressing, personal hygiene, feeding - 0 No problem - 1 Sometimes needs reminders or a little help - 2 Often needs help - 3 Always needs help 3) Work or school - 0 Working, homemaking, or school without special help - 1 Working, homemaking, or school with some restrictions, but without special help - 2 Working, homemaking, or school with special help - 3 Not working, homemaking, or going to school 4) Leisure activities - 0 Normal participation in leisure activities - 1 Normal participation in leisure activities, but sometimes need reminders - 2 Normal participation in leisure activities, but always need reminders - 3 Little participation in leisure activities 5) Driving - 0 No problem or choose not to drive - 1 Sometimes I or others worry I am not a safe driver - 2 Have been in an accident of gotten fines for driving - 3 Cannot drive due to injury or illness Social Behavior 1) Getting along with family and very close friends - 0 No problem - 1 Little problem - 2 Big problems - 3 Have no family of very close friends 2) Getting along with other friends and acquaintances - 0 No problem - 1 Often count on friends - 2 Almost always count on friends - 3 Have very few friends or aquaintances 3) Social behavior - 0 No problem - 1 Sometimes people seem a little offended by my behavior - 2 Often people are offended by my behavior - 3 Very serious problems, such as with the law, have occurred because of my behavior Behavior 1) Understanding brain injury - 0 Understand what my disabilities are and how they affect my life - 1 Understand what my disabilities are, but do not see how they interfere with my life - 2 Other people see much bigger problems related to my brain injury than I do - 3 Brain injury has not changed anything 2) Delusions and hallucination - 0 None - 1 A little problem that does not interfere with activities or for which I am receiving treatment - 2 A bigger problem that does interfere with activities - 3 I feel like I should be hospitalized for this 3) Paronia - 0 No problem - 1 A little problem that does not interfere with activities or for which I am receiving treatment - 2 A bigger problem that does interfere with activities - 3 I feel like I should be hospitalized for this 4) Initiation - 0 None - 1 A little problem that does not interfere with activities - 2 A bigger problem that does interfere with activities - 3 Always need someone to remind me to get going 5) Law violations - 0 None - 1 Convicted of misdemeanor(s) - 2 A felony conviction - 3 More than 1 felony convictions 6) Alcohol use - 0 None or occasional use - 1 Sometimes I or someone else feels I should cut down on drinking - 2 Interferes with some activities - 3 Interferes greatly with activities of in need of treatment 7) Illegal drug use - 0 None - 1 Sometimes others think I have a drug problem - 2 Interferes with some activities - 3 Interferes greatly with activities of in need of treatment

Related

traumatic brain injury (TBI)

General

numerical rating scale (NRS)