Work Productivity and Activity Impairment Questionnaire: General Health V2.0 (WPAI:GH)
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.
1) Are you currently employed (working for pay)? 
_____NO ____ YES
If NO, check "NO" and skip to question 6.
The next questions are about the past seven days, not including today.
2) During the past seven days, how many hours did you miss from work because of your health problems? 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.
_____ HOURS
3) During the past seven days, how many hours did you miss from work because of any other reason, such as vacation, holidays, time off to participate in this study?
______HOURS
4) During the past seven days, how many hours did you actually work?
______HOURS (If "0", skip to question 6.)
5) During the past seven days, how much did health problems affect your productivity while you were working?
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.
Consider only how much health problems affected
productivity while you were working.
Health problems Health problems
had no effect on __________________________________________ completely prevented
my work 0 1 2 3 4 5 6 7 8 9 10 me from working
6) During the past seven days, how much did health problems affect your ability to do your regular daily activities, other than work at a job?
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.
Consider only how much health problems affected your ability
to do your regular daily activities, other than work at a job.
Health problems Health problems
had no effect on __________________________________________ completely prevented my daily 0 1 2 3 4 5 6 7 8 9 10 me from doing my
activities daily activities
