Easy Test Creator 
Health of the Nation Outcomes Scale



Rate client over a rating period e.g. 2 weeks or two months.

Training in the use of this instrument is advised.

Question  1

Overactive, aggressive, disruptive behaviour

No problems of this kind during the period rated.

Some irritability, quarrels, restlessness, etc.

Occassional aggressive gestures, pushing or pestering others; threats or verbal aggression; lesser damage to property (e.g. broken cup, window); marked overactivity or agitation.

Physically aggressive to others or animals; persistently threatening manner; more serious overactivity or destruction of property.

At least one serious physical attack on others or on animals; destructive of property (e.g. fire setting); persistent serious intimidation or obscene behaviour.

Not known or not applicable
Question  2

Non-accidental self-injury

No problems of this kind during the period rated.

Fleeting thoughts about ending it all but little risk; no self harm.

Minor risk during period; includes non-hazardous self-harm, e.g. wrist-scratching.

Moderate to serious risk of deliberate self-harm; includes preparatory acts e.g. collecting tablets.

Serious suicide attempt and/or serious deliberate self-harm injury during period.

Not known or not applicable
Question  3

Problem-drinking or drug-taking

No problems of this kind during the period rated.

Over-indulgence but within social norm

Loss of control of drinking or drug-taking, but not seriously addicted

Marked dependence on alcohol or drugs with frequent loss of control, drunk driving, etc.

Incapacitated by alcohol/drug problems

Not known or not applicable
Question  4

Cognitive problems

No problems of this kind during the period rated.

Minor problems with memory or understanding, e.g. forgets names occasionally.

Mild but definite problems, e.g. has lost the way in a familiar place or failed to recognise a familiar person, sometimes mixed up about simple decisions

Marked disorientation in time, place or person, bewildered by everyday events; speech is sometimes incoherent, mental slowing.

Severe disorientation, e.g. unable to recognise relatives, at risk of accidents, speech incomprehensible; clouding or stupor.

Not known or not applicable
Question  5

Physical illness or disability problems

No physical health problem during the period rated.

Minor health problem during the period (e.g. cold, non-serious fall, etc.).

Physical health problem imposes mild restriction on mobility and activity.

Moderate degree of restriction on activity due to physical health problem.

Severe or complete incapacity due to physical health problem.

Not known or not applicable
Question  6

Problems associated with hallucinations and delusions

No evidence of hallucinations or delusion during the period rated.

Somewhat odd or eccentric beliefs not in keeping with cultural norms.

Delusions or hallucinations (e.g. voices, visions) are present but there is little distress to patient or manifestation in bizarre behaviour, i.e. clinically present but mild.

Marked preoccupation with delusions or hallucinations, causing much distress and/or manifested in obviously bizarre behaviour, i.e. moderately severe clinical problem.

Mental state and behaviour is seriously and adversely affected by delusions or hallucinations, with severe impact on patient and/or others.

Not known or not applicable
Question  7

Problems with depressed mood

No problems associated with depressed mood during the period rated.

Gloomy; or transient mood changes.

Mild but definite depression and distress: e.g. feelings of guilt; sleep disturbance; loss of appetite; loss of self-esteem.

Depression with inappropriate self-blame, preoccupied with feelings of guilt.

Severe or very severe depression, with guilt or self-accusation.

Not known or not applicable
Question  8

Other mental and behavioural problems (Specify condition e.g. phobic, somatoform, anxiety etc)

No evidence of these problems during the period rated.

Minor non-clinical problems.

A problem is clinically present, but there are relatively symptom-free intervals and patient/client has a degree of control i.e. mild level.

Constant preoccupation with problem. Occasional severe attack or distress, with loss of control (e.g. has to avoid anxiety provoking situations altogether, call in a neighbour to help, etc.). i.e. moderately severe level of problem

Severe persistent problem dominates most activities

Not known or not applicable
Question  9

Problems with relationships

No significant problems during the period rated.

Minor non-clinical problem.

Definate problems in making or sustaining supportive relationships; patient complains and/or problems are evident to others.

Persisting major problems due to active or passive withdrawal from social relationships that provide little or no comfort or support.

Severe and distressing social isolation due to inability to communicate socially and/or withdrawal from social relationships.

Not known or not applicable
Question  10

Problems with activities of daily living

No problems during the period rated; good ability to function in all areas.

Minor problems only; e.g. untidy, disorganised

Self-care adequate, but major lack of performance of one or more complex skills.

Major problems in one or more area of self-care (eating, washing, dressing, toilet) as well as major inability to perform several complex skills.

Severe disability or incapacity in all or nearly all areas of self-care and complex skills.

Not known or not applicable
Question  11

Problems with living conditions

Accommodation and living conditions are acceptable; helpful in keeping any disability rated at scale 10 to the lowest level possible, and supportive of self-help.

Accommodation is reasonably acceptable although there are minor or transient problems (e.g. not ideal location, not preferred option, doesn't like the food, etc.).

Significant problems with one or more aspects of the accommodation and/or regime: e.g. restricted choice; staff or household have little understanding of how to limit disability, or how to use or develop new or intact skills.

Distressing multiple problems with accommodation: e.g. some basic necessities absent; housing environment has minimal or no facilities to improve patient's independence.

Accommodation is unacceptable: e.g. lack of basic necessities, patient is at risk of eviction, or 'roofless', or living conditions are otherwise intolerable and making patient's problems worse.

Not known or not applicable
Question  12

Problems with occupation and activities

Patient's day-time environment is acceptable: helpful in keeping any disability rated at scale 10 to the lowest possible, and supportive of self-help

Minor or temporary problems e.g. late social security or health benefit payments; reasonable facilities available but not always at the desired times, etc.

Limited choice of activities: e.g. there is a lack of reasonable tolerance (e.g. unfairly refused entry to public library or baths, etc.); or handicapped by lack of permanent address; or insufficient carer or professional support; or helpful day setting available but for very limited hours.

Marked deficiency in skilled services available to help minimise level of existing disability; no opportunities to use intact skills or add new ones; unskilled care difficult to access.

Lack of any opportunity for day time activities makes patient's problems worse.

Not known or not applicable

Complete all questions, Check your answers ...

Click FINISHED button when test is complete.