Sorani Kurdish Version

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Developed by the Pathways to Wellness project and generously funded by Robert Wood Johnson Foundation, Bill and Melinda Gates Foundation, United Way of King County, Medina Foundation, The Seattle Foundation, Boeing Employees Community Fund and

M.J. Murdock Charitable Trust.

Pathways to Wellness: Integrating Refugee Health and Well-Being is a project of Lutheran Community Services Northwest, Asian Counseling and Referral Service, Public Health Seattle & King County, and Michael Hollifield, M.D. of Pacific Institute for Research & Evaluation. For more information, please contact The Pathways Project at 206-816-3253 or pathways@lcsnw.org.

Administered by: Date of Screen:

Name: Date of Birth:

Gender: Date of Arrival: Health ID:

Refugee Health Screener-15 (RHS-15)

Sorani Kurdish Version

Produced in partnership with Mercy Corps- Iraq

Bilingual versions of the RHS-15 have been translated by an iterative process involving experts in the field, professional translators, and members of the refugee community so that each question is asked correctly according to language and culture. The English text is provided for reference only; using the English alone negates the sensitivity of this instrument.

DEMOGRAPHIC INFORMATION

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SCREENING IS POSITIVE IF: 1 ITEMS 1–14 IS 12 OR ² DISTRESS THERMOMETER IS 5 SELF-ADMINISTERED NOT SELF-ADMINISTERED CHECK ONE: POSITIVE NEGATIVE

SCORING

LEGAL NOTICE 2013 © Pathways to Wellness: Integrating Refugee Health and Wellbeing. Pathways to Wellness is a partnership of Lutheran Community Services Northwest, Asian Counseling and Referral Service, Public Health Seattle and King County and Michael Hollifield, MD of Pacific

ەل کەیامێه .ادوودرباڕ یگنام ەل ۆت ۆب ەنووب رەکرازێب ناکەناشین ەک ەکب یراید ەیەلپ وەئ ەیاکت ،کەیەناشین رەه تشینەت یەناوێپ ینانێهراک ەب ەب

:ناكەییامنێڕ

.”کەیەوێش چیهەب“ یروەد ەب ەشێکب ەوامەچ ،ادوودرباڕ یگنام ىەوام ەل ۆت ۆب ەووبەن رەکرازێب ەکەناشین رەگەئ .ێنباد ادواجنوگ ینووتس INSTRUCTIONS: Using the scale beside each symptom, please indicate the degree to which the symptom has been bothersome to you over the past month. Place a mark in the appropriate column. If the symptom has not been bothersome to you during the past month, circle “NOT AT ALL.”

ناكەناشین

SYMPTOMS

کەیەوێش چیهەب NOT A

T ALL

کێمەک A LITTLE BIT

یکەیەوێش ەب یدنەوانمام MODERATELY

رۆز کێزۆت QUITE A BIT

رۆز کێلەگ EXTREMELY

ن ەك هد ناژو شێئ ەگموج و ەکلوسام .1 Muscle, bone, joint pains

0 1 2

3 4

یماوەدرەب ەب یەکەد یرابمەخ و یتەقاتێب ەب تسەه .2 Feeling down, sad, or blue most of the time

0 1 2

3 4

تیادەوەندرکریب ەل تاک یەبرۆز ۆت ایائ .3 Too much thinking or too many thoughts

0 1 2

3 4

یاناوت ێب ەب ندرکتسەه .4 Feeling helpless

0 1 2

3 4

ؤه ئبو واكان ەل ناسرت .5 Suddenly scared for no reason

0 1 2

3 4

یتەقات ێب و ەشێئرەس و یزاولا ەب ندرکتسەه .6 Faintness, dizziness, or weakness

0 1 2

3 4

تیەکەد ەوەخان ەل نیزرەل نای ینارەگین ەب تسەه ایائ .7 Nervousness or shakiness inside

0 1 2

3 4

تێشینباد تێناوتان اتشێه ،یتەقات ێب ەب ندرکتسەه .8 Feeling restless, can’t sit still

0 1 2

3 4

یناسائەب نایرگ .9 Crying easily

0 1 2

3 4

#ID )RHS-15( 15 رەبانەپ یتسوردنەت ینینکشپ ىسرپار REFUGEE HEALTH SCREENER-15 (RHS-15)

#ID /DATE

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SCORING

:ەووبەه تەنامەئ ەدنەچ ادوودرباڕ یگنام ەل ایائ .ندرکچۆک و گنەج ىەوام ەل ییامۆرت ینوومزەئ ەب نب تسەویەپ ەناناشین مەئ ەیەناوەل The following symptoms may be related to traumatic experiences during war and migration. How much in the past month have you:

ناكەناشین

SYMPTOMS

کەیەوێش چیهەب NOT A

T ALL

کێمەک A LITTLE BIT

یکەیەوێش ەب یدنەوانمام MODERATELY

رۆز کێزۆت QUITE A BIT

رۆز کێلەگ EXTREMELY

یەوەب ندرکتسەه نای ندرک توەکوسڵەه ؛امۆرت ەل نووب راگزڕ ینوومزەئ .10 ەوەتادب ووڕ ەرابوود یەوەئ کەو Had the experience of reliving the trauma; acting or feeling as if it were happening again?

0 1

2 3

4

)ڵد ینادێل ارێخ ،ەقەرائ وێن ەنتوەک ەنوومن ۆب( ییەتسەج یەوەنادراک ینووب .11

؟ەوەتێب تاه ریب تکەیامۆرت کێتاک Been having PHYSICAL reactions (for example, break out in a sweat, heart beats fast) when reminded of the trauma?

0 1

2 3

4

تیناوتان مڵاەب م ەخ ەب نرکتسەه ،ەنوومن ۆب( تسەه ینوووبەن ەب ندرکتسەه .12

؟)تێبەه تیتسیوەشۆخ یتسەه تیناوتان ،تیرگب Felt emotionally numb (for example, feel sad but can’t cry, unable to have loving feelings)?

0 1

2 3

4

)تاوڕەد ەوەتاود ەل کێسەک کێتاک ،ەنوومن ۆب( ییاسائ ەب نیک ەڵچاد .13 Been jumpier, more easily startled (for example,

when someone walks up behind you)?

0 1

2 3

4 #ID )RHS-15( 15 رەبانەپ یتسوردنەت ینینکشپ ىسرپار REFUGEE HEALTH SCREENER-15 (RHS-15)

#ID /DATE

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SCORING

:ۆت تیەکەد تسەه ایائ .ەشێکب ادمڵاەو نیرتشاب یروەدەب ەوامەچ .14 Circle the one best response below. Do you feel that you are:

تینێجنوگب کێتش ووم ەه ڵەگەل تۆخ تیناوتەد Able to handle (cope with) anything 0

ان نایووم ەه مڵاەب ،تینێجنوگب ناکەتش ڵەگەل تۆخ تیناوتەد Able to handle (cope with) most things 1

تیێجنوگب رت یناکەتش ڵەگەل تیناوتان مڵاەب ،تینێجنوگب ناکەتش ڵەگەل تۆخ تیناوتەد Able to handle (cope with) some things, but not able to cope with other things 2

تینێجنوگب ناکەتش یەنیرۆز ڵەگەل تۆخ تیناوتان Unable to cope with most things 3

تینێجنوگب کێتش چیه ڵەگەل تۆخ تیناوتان Unable to cope with anything 4

رەدەبەداڕەل یۆتسەپەڵاپ

”.ەوودرکەن یپارخ ەب متسەه او زیگرەه“

EXTREME DISTRESS

“I feel as bad as I ever have.”

ەین کەیۆتسەپەڵاپ چیه

”نشاب ناکەتش“

NO DISTRESS

“Things are good”

10 9 8 7 6 5 4 3 2 1 0

ۆتسەپەڵاپ یرەوێپ .15 Distress Thermometer یتەیدنەچ یفسەو نیرتشاب ەک ەشیكب اد)0-10( یروەدەب ەوامەچ ەیاکت

ینترگۆخەلەب ،ادوودرباڕ یەتفەه ەل تیووب یراچوود ەک تاکەد تۆتسەپەڵاپ .شۆڕمەئ Please circle the number (0 –10) that best describes how much distress you have been experiencing in the past week, including today.

Add Total Score of items 1–14

#ID )RHS-15( 15 رەبانەپ یتسوردنەت ینینکشپ ىسرپار REFUGEE HEALTH SCREENER-15 (RHS-15)

#ID /DATE