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Cancer Care PHI
My Story: Personal Health Inventory
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Rate where you feel you are on the scales below from 1-5, with 1 being miserable and 5 being great.
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Physical Well-Being: |
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1 |
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3 |
4 |
5 |
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Miserable |
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Great |
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1 |
2 |
3 |
4 |
5 |
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Miserable |
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Great |
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1 |
2 |
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4 |
5 |
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Miserable |
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Great |
What do you live for? What matters to you? Why do you want to be healthy?
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Where You Are and Where You Would Like to Be
For each area below, consider “Where you are” and “Where you want to be”. Write a number between 1 (low) and 5 (high) that best represents where you are and where you want to be. The goal is not to be perfect in all areas. You do not need to be a “5” in any of the areas now, nor even wish to be a “5” in the future.
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Area of Whole Health |
Where I am Now (1-5) |
Where I Want to Be (1-5) |
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Physical Activity: “Movement and Flexibility” Moving and doing physical activities like walking, dancing, gardening, sports, lifting weights, yoga, cycling, swimming, and working out in a gym. |
1 |
4 |
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Recharge: “Sleep and Rest” Getting enough rest, relaxation, and sleep. |
1 |
5 |
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Nutrition: “Nourishing and Fueling” Eating healthy, balanced meals with plenty of fruits and vegetables each day. Drinking enough water and limiting sodas, sweetened drinks, and alcohol. |
2 |
4 |
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Personal Development: “Personal and Work life” Learning and growing. Developing abilities and talents. Balancing responsibilities where you live, volunteer, and work. |
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5 |
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Family, Friends, and Co-Workers: “Relationships” Feeling listened to and connected to people you love and care about. The quality of your communication with family, friends, and people you work with. |
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5 |
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Spirit and Soul: “Meaning & Purpose” Having a sense of purpose and meaning in your life. Feeling connected to something larger than yourself. Finding strength in difficult times. |
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4 |
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Surroundings: “Physical and Emotional” Feeling safe. Having comfortable, healthy spaces where you work and live. The quality of lighting, color, air, and water. Decreasing unpleasant clutter, noises, and smells. |
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5 |
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Mind & Emotions: “Relaxing and Healing” Tapping into the power of your mind to heal and cope. Using mind-body techniques like relaxation, breathing, or guided imagery. |
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4 |
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Professional Care: “Prevention and Clinical Care” Staying up to date on prevention and understanding your health concerns, care options, treatment plan, and their role in your health. |
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Reflections
Now that you have thought about what matters to you in all of these areas, what is your vision of your best possible self? What would your life look like? What kind of activities would you be doing?
Are there any areas you would like to work on? Where might you start?
After completing the Personal Health Inventory, talk to your healthcare provider, a friend, family member, health coach, a peer, or someone on your healthcare team about areas you would like to explore further.
This document is informed by work being done through a collaboration between UW Integrative Health and the Veteran’s Health Administration’s Office of Patient Centered Care and Cultural transformation.