LB. Leave-behind Questionnaires (respondent)

LB. Leave-behind Questionnaires (respondent) module of HRS 2004

item label type description
HHID Question Household identification number
PN System generated Respondent person identification number
JSUBHH System generated 2004 sub household identification number
HSUBHH System generated 2002 sub household identification number
JPN_SP System generated 2004 spouse/partner person number
JCSR System generated 2004 whether coversheet respondent
JFAMR System generated 2004 whether family respondent
JFINR System generated 2004 whether financial respondent
JV900 Question Leave behind instructions
JLBTYPE Question Type of questionnaire r answered
JLB001 Question Introduction to disability qnaire
JLB002 System generated Disability qnaire topic order
JLB003 Question Limits on work b/c of health prob
JLB004 Question Affect- enjoys work very much
JLB005 Question Affect- mood swings on job
JLB006 Question Affect- worried all the time
JLB007 Question Affect- depressed most of the time
JLB008 Question Pain- occasional back pain at work
JLB009 Question Pain- stiffness in back at work
JLB010 Question Pain- constant back pain
JLB011 Question Pain-changes in position affect work
JLB012 Question Pain-back and leg pain almost always
JLB013 Question Cvd- active and fit
JLB014 Question Cvd- heart problems in the past
JLB015 Question Cvd- history of heart problems
JLB016 Question Cvd- diagnosed high blood pressure
JLB017 Question Cvd- triple bypass heart surgery
JLB018 Question Who answered disability qnaire
JLB501 Question Which statements apply
JLB502 Question Attend meetings or programs
JLB503 Question Age prevents me from doing things
JLB504 Question Lack companionship
JLB505 Question Life is close to ideal
JLB506 Question Control over what happens
JLB507 Question Live with spouse or partner
JLB508 Question Sp/p understand the way you feel
JLB509 Question How close with sp/p
JLB510 Question Q10. have any children
JLB511 Question Q11a. children understand way you feel
JLB512 Question Q12a. meet up with children
JLB513 Question Q13. # children close relationship
JLB514 Question Q14. have any other immediate family
JLB515 Question Q15a. oth fam members understand you
JLB516 Question Q16a. meet up with oth family members
JLB517 Question Q17. # oth fam mem close relationship
JLB518 Question Q18. have any friends
JLB519 Question Q19a. friends understand way you feel
JLB520 Question Q20a. meet up with friends
JLB521 Question Q21. # friends close relationship
JLB522 Question Q22. work for pay last month
JLB523 Question Q23a. satisfied with job
JLB524 Question Q24. position on job ladder
JLB525 Question Q25. position on ladder change
JLB526 Question Q26. rate the exp of growing older
JLB527 Question Q27a. exp death of any child of yours
JLB528 Question Q28a. lost job at any point last 5 years
JLB529 Question Q29a. satisfied w/ pres financial status
JLB530 Question Q30a. ongoing health problem - yourself
JLB531 Question Q31. who answered the questions
JVDATE Question 2004 data model version
JVERSION System generated 2004 data release version
Start of LB. Leave-behind Questionnaires (respondent)
 
JLB001

Introduction to disability qnaire

BLUE= OTHER THAN THE CONDITIONS EXPLICITLY MENTIONED, YOU SHOULD IMAGINE THE INDIVIDUAL IS IN REASONABLY GOOD HEALTH.

RED= OTHER THAN THE CONDITIONS EXPLICITLY MENTIONED, YOU SHOULD IMAGINE THE INDIVIDUAL IS LIKE YOURSELF.
expand
 
JLB002

Disability qnaire topic order

expand
 
JLB003

Limits on work b/c of health prob

DURING OUR INTERVIEW WITH YOU WE ASKED YOU WHETHER YOU HAVE ANY IMPAIRMENT OR HEALTH PROBLEM THAT LIMITS THE KIND OR AMOUNT OF PAID WORK YOU CAN DO. THE PURPOSE OF THE FOLLOWING QUESTIONS IS TO EXPLORE THE MEANING OF YOUR ANSWERS. THE FIRST QUESTION IS VERY SIMILAR TO THE ONE WE ASKED BEFORE. IN THE INTERVIEW, WE ASKED YOU TO RESPOND WITH A SIMPLE YES OR NO. THIS TIME, WE WOULD LIKE YOU TO RESPOND USING A FIVE-POINT SCALE FROM 'NOT AT ALL LIMITED' TO 'CANNOT DO ANY WORK.'

EXAMPLE:

1A. TO WHAT EXTENT ARE YOU LIMITED IN THE KIND OR AMOUNT OF WORK YOU CAN DO BECAUSE OF AN IMPAIRMENT OR HEALTH PROBLEM?
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JLB004

Affect- enjoys work very much

(JIM/ANN) ENJOYS WORK VERY MUCH. (HE/SHE) FEELS THAT (HE/SHE) IS DOING A VERY GOOD JOB AND IS OPTIMISTIC ABOUT THE FUTURE.
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If Affect- enjoys work very much = 1. Not at all limited »
 
   
 
JLB005

Affect- mood swings on job

(BOB/NANCY) HAS MOOD SWINGS ON THE JOB. WHEN (HE/SHE) GETS DEPRESSED, EVERYTHING (HE/SHE) DOES AT WORK IS AN EFFORT FOR (HIM/HER) AND (HE/SHE) NO LONGER ENJOYS (HIS/HER) USUAL ACTIVITIES AT WORK. THESE MOOD SWINGS ARE NOT PREDICTABLE AND OCCUR TWO OR THREE TIMES DURING A MONTH.
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JLB006

Affect- worried all the time

(FRANK/BARB) FEELS WORRIED ALL THE TIME. (HE/SHE) GETS DEPRESSED ONCE A WEEK AT WORK FOR A COUPLE OF DAYS IN A ROW, THINKING ABOUT WHAT COULD GO WRONG AND THAT (HIS/HER) BOSS WILL DISAPPROVE OF (HIS/HER) CONDITION. BUT (HE/SHE) IS ABLE TO COME OUT OF THIS MOOD IF (HE/SHE) CONCENTRATES ON SOMETHING ELSE.
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JLB007

Affect- depressed most of the time

(GARY/KATHLEEN) FEELS DEPRESSED MOST OF THE TIME. (HE/SHE) WEEPS FREQUENTLY AT WORK AND FEELS HOPELESS ABOUT THE FUTURE. (HE/SHE) FEELS THAT (HE/SHE) HAS BECOME A BURDEN ON (HIS/HER) CO-WORKERS AND THAT (HE/SHE) WOULD BE BETTER DEAD.
expand
 
If Affect- depressed most of the time = 1. Not at all limited »
 
   
 
JLB008

Pain- occasional back pain at work

(MICHAEL/SUE) OCCASIONALLY FEELS BACK PAIN AT WORK, BUT THIS HAS NOT HAPPENED FOR THE LAST SEVERAL MONTHS NOW. IF (HE/SHE) FEELS BACK PAIN, IT TYPICALLY LASTS ONLY FOR A FEW DAYS.
expand
   
 
JLB009

Pain- stiffness in back at work

(CARL/CAROL) SUFFERS FROM BACK PAIN THAT CAUSES STIFFNESS IN (HIS/HER) BACK, ESPECIALLY AT WORK, BUT IS RELIEVED WITH LOW DOSES OF MEDICATION. (HE/SHE) DOES NOT HAVE ANY PAINS OTHER THAN THIS GENERALIZED DISCOMFORT.
expand
   
 
JLB010

Pain- constant back pain

(MATTHEW/RUTH) HAS ALMOST CONSTANT PAIN IN (HIS/HER) BACK AND THIS SOMETIMES PREVENTS (HIM/HER) FROM DOING (HIS/HER) WORK.
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JLB011

Pain-changes in position affect work

(GEORGE/LINDA) HAS BACK PAIN THAT MAKES CHANGES IN BODY POSITION WHILE (HE/SHE) IS WORKING VERY UNCOMFORTABLE. (HE/SHE) IS UNABLE TO STAND OR SIT FOR MORE THAN HALF AN HOUR. MEDICINES DECREASE THE PAIN A LITTLE, BUT IT IS THERE ALL THE TIME AND INTERFERES WITH (HIS/HER) ABILITY TO CARRY OUT EVEN DAY-TO- DAY TASKS AT WORK.
expand
 
If Pain-changes in position affect work = 1. Not at all limited »
 
   
 
JLB012

Pain-back and leg pain almost always

(MARK/JANE) HAS PAIN IN (HIS/HER) BACK AND LEGS, AND THE PAIN IS PRESENT ALMOST ALL THE TIME. IT GETS WORSE WHILE (HE/SHE) IS WORKING. ALTHOUGH MEDICATION HELPS, (HE/SHE) FEELS UNCOMFORTABLE WHEN MOVING AROUND, HOLDING AND LIFTING THINGS AT WORK.
expand
   
 
JLB013

Cvd- active and fit

(PETER/KAREN) IS VERY ACTIVE AND FIT. (HE/SHE) TAKES AEROBIC CLASSES 3 TIMES A WEEK.
expand
   
 
JLB014

Cvd- heart problems in the past

(JACOB/LORI) HAS HAD HEART PROBLEMS IN THE PAST AND (HE/SHE) HAS BEEN TOLD TO WATCH (HIS/HER) CHOLESTEROL LEVEL. SOMETIMES IF (HE/SHE) FEELS STRESSED AT WORK (HE/SHE) FEELS PAIN IN (HIS/HER) CHEST AND OCCASIONALLY IN (HIS/HER) ARMS.
expand
   
JLB015

Cvd- history of heart problems

(PAUL/BETH)'S FAMILY HAS A HISTORY OF HEART PROBLEMS. (HIS/HER) FATHER DIED OF A HEART ATTACK WHEN (PAUL/BETH) WAS STILL VERY YOUNG. THE DOCTORS HAVE TOLD (PAUL/BETH) THAT (HE/SHE) IS AT SEVERE RISK OF HAVING A SERIOUS HEART ATTACK (HIMSELF/HERSELF) AND THAT (HE/SHE) SHOULD AVOID STRENUOUS PHYSICAL ACTIVITY OR STRESS. (HE/SHE) SOMETIMES FEELS SEVERE PAIN IN (HIS/HER) CHEST AND ARMS, AND SUFFERS FROM DIZZINESS, FAINTING, SWEATING, NAUSEA OR SHORTNESS OF BREATH.
expand
 
If Cvd- history of heart problems = 1. Not at all limited »
 
   
 
JLB016

Cvd- diagnosed high blood pressure

(TOM/DIANE) HAS BEEN DIAGNOSED WITH HIGH BLOOD PRESSURE. (HIS/HER) BLOOD PRESSURE GOES UP QUICKLY IF (HE/SHE) FEELS UNDER STRESS. (TOM/DIANE) DOES NOT EXERCISE MUCH AND IS OVERWEIGHT. LIFE CAN SOMETIMES CAN BE HECTIC FOR (HIM/HER). (HE/SHE) DOES NOT GET ALONG WITH (HIS/HER) BOSS VERY WELL.
expand
   
 
JLB017

Cvd- triple bypass heart surgery

(DAN/JUDY) HAS UNDERGONE TRIPLE BYPASS HEART SURGERY. (HE/SHE) IS A HEAVY SMOKER AND STILL EXPERIENCES SEVERE CHEST PAIN SOMETIMES.
expand
   
 
JLB018

Who answered disability qnaire

WERE THE QUESTIONS IN THIS BOOKLET ANSWERED BY THE PERSON WHOSE INITIALS ARE WRITTEN ON THE FRONT COVER, OR DID SOMEONE ELSE PROVIDE THEIR OWN ANSWERS? (CHECK ONE.)
expand
   
End of LB. Leave-behind Questionnaires (respondent)
Start of LB. Leave-behind Questionnaires (respondent)

========================================================================
JLB001
Introduction to disability qnaire

BLUE= OTHER THAN THE CONDITIONS EXPLICITLY MENTIONED, YOU SHOULD IMAGINE THE INDIVIDUAL IS IN REASONABLY GOOD HEALTH.

RED= OTHER THAN THE CONDITIONS EXPLICITLY MENTIONED, YOU SHOULD IMAGINE THE INDIVIDUAL IS LIKE YOURSELF.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Blue introduction
2. Red introduction
Blank. Inapplicable

========================================================================
JLB002
Disability qnaire topic order

- - - - - - - - - - - - - - - - - - - - - - - - -
1. Affect, pain, cvd
2. Affect, cvd, pain
3. Cvd, affect, pain
4. Cvd, pain, affect
5. Pain, affect, cvd
6. Pain, cvd, affect
Blank. Inapplicable

========================================================================
JLB003
Limits on work b/c of health prob

DURING OUR INTERVIEW WITH YOU WE ASKED YOU WHETHER YOU HAVE ANY IMPAIRMENT OR HEALTH PROBLEM THAT LIMITS THE KIND OR AMOUNT OF PAID WORK YOU CAN DO. THE PURPOSE OF THE FOLLOWING QUESTIONS IS TO EXPLORE THE MEANING OF YOUR ANSWERS. THE FIRST QUESTION IS VERY SIMILAR TO THE ONE WE ASKED BEFORE. IN THE INTERVIEW, WE ASKED YOU TO RESPOND WITH A SIMPLE YES OR NO. THIS TIME, WE WOULD LIKE YOU TO RESPOND USING A FIVE-POINT SCALE FROM 'NOT AT ALL LIMITED' TO 'CANNOT DO ANY WORK.'

EXAMPLE:

1A. TO WHAT EXTENT ARE YOU LIMITED IN THE KIND OR AMOUNT OF WORK YOU CAN DO BECAUSE OF AN IMPAIRMENT OR HEALTH PROBLEM?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

========================================================================
JLB004
Affect- enjoys work very much

(JIM/ANN) ENJOYS WORK VERY MUCH. (HE/SHE) FEELS THAT (HE/SHE) IS DOING A VERY GOOD JOB AND IS OPTIMISTIC ABOUT THE FUTURE.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

If Affect- enjoys work very much (JLB004) = 1. Not at all limited »

|  ========================================================================
JLB005
Affect- mood swings on job

(BOB/NANCY) HAS MOOD SWINGS ON THE JOB. WHEN (HE/SHE) GETS DEPRESSED, EVERYTHING (HE/SHE) DOES AT WORK IS AN EFFORT FOR (HIM/HER) AND (HE/SHE) NO LONGER ENJOYS (HIS/HER) USUAL ACTIVITIES AT WORK. THESE MOOD SWINGS ARE NOT PREDICTABLE AND OCCUR TWO OR THREE TIMES DURING A MONTH.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

|  ========================================================================
JLB006
Affect- worried all the time

(FRANK/BARB) FEELS WORRIED ALL THE TIME. (HE/SHE) GETS DEPRESSED ONCE A WEEK AT WORK FOR A COUPLE OF DAYS IN A ROW, THINKING ABOUT WHAT COULD GO WRONG AND THAT (HIS/HER) BOSS WILL DISAPPROVE OF (HIS/HER) CONDITION. BUT (HE/SHE) IS ABLE TO COME OUT OF THIS MOOD IF (HE/SHE) CONCENTRATES ON SOMETHING ELSE.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

========================================================================
JLB007
Affect- depressed most of the time

(GARY/KATHLEEN) FEELS DEPRESSED MOST OF THE TIME. (HE/SHE) WEEPS FREQUENTLY AT WORK AND FEELS HOPELESS ABOUT THE FUTURE. (HE/SHE) FEELS THAT (HE/SHE) HAS BECOME A BURDEN ON (HIS/HER) CO-WORKERS AND THAT (HE/SHE) WOULD BE BETTER DEAD.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

If Affect- depressed most of the time (JLB007) = 1. Not at all limited »

|  ========================================================================
JLB008
Pain- occasional back pain at work

(MICHAEL/SUE) OCCASIONALLY FEELS BACK PAIN AT WORK, BUT THIS HAS NOT HAPPENED FOR THE LAST SEVERAL MONTHS NOW. IF (HE/SHE) FEELS BACK PAIN, IT TYPICALLY LASTS ONLY FOR A FEW DAYS.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

|  ========================================================================
JLB009
Pain- stiffness in back at work

(CARL/CAROL) SUFFERS FROM BACK PAIN THAT CAUSES STIFFNESS IN (HIS/HER) BACK, ESPECIALLY AT WORK, BUT IS RELIEVED WITH LOW DOSES OF MEDICATION. (HE/SHE) DOES NOT HAVE ANY PAINS OTHER THAN THIS GENERALIZED DISCOMFORT.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

|  ========================================================================
JLB010
Pain- constant back pain

(MATTHEW/RUTH) HAS ALMOST CONSTANT PAIN IN (HIS/HER) BACK AND THIS SOMETIMES PREVENTS (HIM/HER) FROM DOING (HIS/HER) WORK.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

========================================================================
JLB011
Pain-changes in position affect work

(GEORGE/LINDA) HAS BACK PAIN THAT MAKES CHANGES IN BODY POSITION WHILE (HE/SHE) IS WORKING VERY UNCOMFORTABLE. (HE/SHE) IS UNABLE TO STAND OR SIT FOR MORE THAN HALF AN HOUR. MEDICINES DECREASE THE PAIN A LITTLE, BUT IT IS THERE ALL THE TIME AND INTERFERES WITH (HIS/HER) ABILITY TO CARRY OUT EVEN DAY-TO- DAY TASKS AT WORK.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

If Pain-changes in position affect work (JLB011) = 1. Not at all limited »

|  ========================================================================
JLB012
Pain-back and leg pain almost always

(MARK/JANE) HAS PAIN IN (HIS/HER) BACK AND LEGS, AND THE PAIN IS PRESENT ALMOST ALL THE TIME. IT GETS WORSE WHILE (HE/SHE) IS WORKING. ALTHOUGH MEDICATION HELPS, (HE/SHE) FEELS UNCOMFORTABLE WHEN MOVING AROUND, HOLDING AND LIFTING THINGS AT WORK.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

|  ========================================================================
JLB013
Cvd- active and fit

(PETER/KAREN) IS VERY ACTIVE AND FIT. (HE/SHE) TAKES AEROBIC CLASSES 3 TIMES A WEEK.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

|  ========================================================================
JLB014
Cvd- heart problems in the past

(JACOB/LORI) HAS HAD HEART PROBLEMS IN THE PAST AND (HE/SHE) HAS BEEN TOLD TO WATCH (HIS/HER) CHOLESTEROL LEVEL. SOMETIMES IF (HE/SHE) FEELS STRESSED AT WORK (HE/SHE) FEELS PAIN IN (HIS/HER) CHEST AND OCCASIONALLY IN (HIS/HER) ARMS.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

========================================================================
JLB015
Cvd- history of heart problems

(PAUL/BETH)'S FAMILY HAS A HISTORY OF HEART PROBLEMS. (HIS/HER) FATHER DIED OF A HEART ATTACK WHEN (PAUL/BETH) WAS STILL VERY YOUNG. THE DOCTORS HAVE TOLD (PAUL/BETH) THAT (HE/SHE) IS AT SEVERE RISK OF HAVING A SERIOUS HEART ATTACK (HIMSELF/HERSELF) AND THAT (HE/SHE) SHOULD AVOID STRENUOUS PHYSICAL ACTIVITY OR STRESS. (HE/SHE) SOMETIMES FEELS SEVERE PAIN IN (HIS/HER) CHEST AND ARMS, AND SUFFERS FROM DIZZINESS, FAINTING, SWEATING, NAUSEA OR SHORTNESS OF BREATH.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

If Cvd- history of heart problems (JLB015) = 1. Not at all limited »

|  ========================================================================
JLB016
Cvd- diagnosed high blood pressure

(TOM/DIANE) HAS BEEN DIAGNOSED WITH HIGH BLOOD PRESSURE. (HIS/HER) BLOOD PRESSURE GOES UP QUICKLY IF (HE/SHE) FEELS UNDER STRESS. (TOM/DIANE) DOES NOT EXERCISE MUCH AND IS OVERWEIGHT. LIFE CAN SOMETIMES CAN BE HECTIC FOR (HIM/HER). (HE/SHE) DOES NOT GET ALONG WITH (HIS/HER) BOSS VERY WELL.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

|  ========================================================================
JLB017
Cvd- triple bypass heart surgery

(DAN/JUDY) HAS UNDERGONE TRIPLE BYPASS HEART SURGERY. (HE/SHE) IS A HEAVY SMOKER AND STILL EXPERIENCES SEVERE CHEST PAIN SOMETIMES.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Not at all limited
2. Mildly limited
3. Moderately limited
4. Severely limited
5. Cannot do any work
Blank. Inapplicable

|  ========================================================================
JLB018
Who answered disability qnaire

WERE THE QUESTIONS IN THIS BOOKLET ANSWERED BY THE PERSON WHOSE INITIALS ARE WRITTEN ON THE FRONT COVER, OR DID SOMEONE ELSE PROVIDE THEIR OWN ANSWERS? (CHECK ONE.)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. The questions were answered by the person whose initials are written on the front cover.
2. Someone else provided their own answers.
Blank. Inapplicable

End of LB. Leave-behind Questionnaires (respondent)