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Start of C. Physical Health
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OC001
RATE HEALTH
[F1]--HELP
NEXT I HAVE SOME QUESTIONS ABOUT YOUR HEALTH.
WOULD YOU SAY YOUR HEALTH IS EXCELLENT, VERY GOOD, GOOD, FAIR, OR POOR?
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
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OC002
COMPARE HEALTH TO PREVIOUS WAVE
[F1]--HELP
COMPARED WITH YOUR HEALTH WHEN WE TALKED WITH YOU IN ^Z092IWMOV,
^PIRVARSZ093_IWYR_V, WOULD YOU SAY THAT YOUR HEALTH IS BETTER NOW, ABOUT THE
SAME, OR WORSE?
1 Better
2 About the same
3 Worse
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OC005
HIGH BLOOD PRESSURE
[F1]--HELP
^FLC005 ^FLC005B ^FLIWER
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION
4 DISPUTES PREVIOUS WAVE RECORD, DOES NOT HAVE CONDITION
5 NO
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If HIGH BLOOD PRESSURE = 1 Yes or HIGH BLOOD PRESSURE = 3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION »
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OC006
BLOOD PRESSURE MEDICATION
IN ORDER TO LOWER YOUR BLOOD PRESSURE, ARE YOU NOW TAKING ANY MEDICATION?
1 Yes
5 No
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OC010
DIABETES
[F1]--HELP
^FLC010 ^FLC010B ^FLIWER
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION
4 DISPUTES PREVIOUS WAVE RECORD, DOES NOT HAVE CONDITION
5 NO
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If DIABETES = 1 Yes or DIABETES = 3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION »
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OC214
YEAR DIABETES FIRST DIAGNOSED
IN WHAT YEAR WAS YOUR DIABETES FIRST DIAGNOSED?
1900..2014
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OC011
SWALLOWED MEDICATION FOR DIABETES
IN ORDER TO TREAT OR CONTROL YOUR DIABETES, ARE YOU NOW TAKING MEDICATION
THAT YOU SWALLOW?
1 Yes
5 No
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OC012
TAKING INSULIN - DIABETES
ARE YOU NOW USING INSULIN SHOTS OR A PUMP?
1 Yes
5 No
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If TAKING INSULIN - DIABETES = 5 No »
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OC236
DOC RECOMMEND INSULIN - DIABETES
HAS A DOCTOR EVER RECOMMENDED TO YOU THAT YOU USE INSULIN?
1 Yes
5 No
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OC018
CANCER OF ANY KIND EXCLUDING SKIN
[F1]--HELP
^FLC018 ^FLC018B ^FLIWER
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION
4 DISPUTES PREVIOUS WAVE RECORD, DOES NOT HAVE CONDITION
5 NO
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If CANCER OF ANY KIND EXCLUDING SKIN = 1 Yes or CANCER OF ANY KIND EXCLUDING SKIN = 3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION »
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OC019
R SEEN DOC CONCERNING CANCER
[F1]--HELP
^FLC019
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
5 No
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OC020
PAST CANCER TREATED
[F1]--HELP
WE WANT TO KNOW ABOUT ANY CANCER TREATMENT THAT MAY HAVE TAKEN PLACE DURING
THE LAST TWO YEARS. ^FLC020
1 Yes
5 No
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OC021M
CANCER TREATMENT-TYPE
[F1]--HELP
^FLC021M SORT OF TREATMENTS HAVE YOU RECEIVED FOR CANCER?
» CHOOSE ALL THAT APPLY
1 Chemotherapy
2 Surgery
3 Radiation
4 Medications/treatment for symptoms (pain, nausea, rashes)
5 Biopsy
6 X-ray
7 Other (Specify)
8 None
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OC023
CANCER BETTER/WORSE/SAME NOW
SINCE ^Z092IWMOV, ^PIRVARSZ093_IWYR_V, HAS THE CANCER GOTTEN WORSE, BETTER
OR STAYED ABOUT THE SAME?
1 Better
2 About the same
3 Worse
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OC024
NEW CANCER EXCLUDING SKIN
SINCE ^Z092IWMOV, ^PIRVARSZ093_IWYR_V, HAS A DOCTOR TOLD YOU THAT YOU HAD A NEW
CANCER OR MALIGNANT TUMOR, EXCLUDING MINOR SKIN CANCER?
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
5 No
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If NEW CANCER EXCLUDING SKIN = 1 Yes »
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OC028
YEAR RECENT CANCER
IN WHAT YEAR WAS YOUR (MOST RECENT) CANCER DIAGNOSED?
YEAR:
1900..2014
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OC029
MONTH RECENT CANCER
IN WHAT MONTH WAS THAT?
MONTH:
1 Jan
2 Feb
3 Mar
4 Apr
5 May
6 Jun
7 Jul
8 Aug
9 Sep
10 Oct
11 Nov
12 Dec
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OC030
LUNG DISEASE
[F1]--HELP
^FLC030 ^FLC030B ^FLIWER
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION
4 DISPUTES PREVIOUS WAVE RECORD, DOES NOT HAVE CONDITION
5 NO
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If LUNG DISEASE = 1 Yes »
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OC031
LUNG DISEASE BETTER/WORSE/SAME
SINCE THEN, HAS THIS CONDITION GOTTEN BETTER, WORSE, OR STAYED ABOUT THE SAME?
1 Better
2 About the same
3 Worse
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If LUNG DISEASE = 1 Yes or LUNG DISEASE = 3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION »
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OC032
LUNG MEDICATION
ARE YOU NOW TAKING MEDICATION OR OTHER TREATMENT FOR YOUR LUNG CONDITION?
1 Yes
5 No
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OC033
LUNG OXYGEN
ARE YOU RECEIVING OXYGEN FOR YOUR LUNG CONDITION?
1 Yes
5 No
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OC034
LUNG RESPIRATORY THERAPY
ARE YOU RECEIVING PHYSICAL OR RESPIRATORY THERAPY FOR YOUR LUNG CONDITION?
1 Yes
5 No
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OC036
HEART CONDITION
[F1]--HELP
^FLC036 ^FLC036B ^FLIWER
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION
4 DISPUTES PREVIOUS WAVE RECORD, DOES NOT HAVE CONDITION
5 NO
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If HEART CONDITION = 1 Yes or HEART CONDITION = 3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION »
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OC037
HEART MEDICATION
ARE YOU NOW TAKING OR CARRYING MEDICATION FOR YOUR HEART PROBLEM?
1 Yes
5 No
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OC038
HAS R SEEN HEART DOCTOR
^FLC038 HAVE YOU SEEN A DOCTOR FOR YOUR HEART PROBLEM?
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
5 No
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If HEART MEDICATION != 5 No or HAS R SEEN HEART DOCTOR != 5 No »
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OC039
HEART BETTER/WORSE/SAME
SINCE ^Z092IWMOV, ^PIRVARSZ093_IWYR_V, HAS THIS CONDITION GOTTEN BETTER, WORSE,
OR STAYED ABOUT THE SAME?
1 Better
2 About the same
3 Worse
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If HEART MEDICATION != 5 No or HAS R SEEN HEART DOCTOR != 5 No or (OZ105 and OZ076 = REINTERVIEW) »
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OC040
HEART ATTACK
[F1]--HELP
^FLC038 HAVE YOU HAD A HEART ATTACK OR MYOCARDIAL INFARCTION?
1 Yes
5 No
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If HEART ATTACK = 1 Yes »
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OC041
R SEEN DOCTOR FOR HEART ATTACK
^FLC041 YOU SEEN A DOCTOR IN CONNECTION WITH YOUR HEART ATTACK?
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
5 No
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OC042
HEART ATTACK MEDICATION
[F1]--HELP ARE YOU NOW TAKING OR CARRYING MEDICATION BECAUSE OF YOUR HEART ATTACK?
1 Yes
5 No
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OC043
YR RECENT HEART ATTACK
IN WHAT YEAR WAS YOUR (MOST RECENT) HEART ATTACK?
YEAR:
1900..2014
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If YR RECENT HEART ATTACK = LESS THAN 2 YEARS AGO »
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OC044
MO RECENT HEART ATTACK
IN WHAT MONTH WAS THAT?
MONTH:
1 Jan
2 Feb
3 Mar
4 Apr
5 May
6 Jun
7 Jul
8 Aug
9 Sep
10 Oct
11 Nov
12 Dec
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OC045
ANGINA
[F1]--HELP ^FLC038 HAVE YOU HAD ANY ANGINA OR CHEST PAINS DUE TO YOUR HEART?
1 Yes
5 No
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OC046
ANGINA MEDICATION
[F1]--HELP
ARE YOU NOW TAKING OR CARRYING MEDICATIONS BECAUSE OF ANGINA OR CHEST PAIN?
1 Yes
5 No
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OC048
CONGESTIVE HEART FAILURE
[F1]--HELP
^FLC048
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
5 No
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If CONGESTIVE HEART FAILURE = 1 Yes »
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OC049
HOSPITALIZED DUE TO HEART FAILURE
^FLC038 HAVE YOU BEEN ADMITTED TO THE HOSPITAL OVERNIGHT BECAUSE OF IT
(CONGESTIVE HEART FAILURE)?
1 Yes
5 No
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OC050
CONGESTIVE HEART FAILURE MEDICATION
ARE YOU TAKING OR CARRYING ANY MEDICATION FOR CONGESTIVE HEART FAILURE?
1 Yes
5 No
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OC051
HEART TREATMENT
[F1]--HELP
^FLC038 HAVE YOU HAD A SPECIAL TEST OR TREATMENT OF YOUR HEART WHERE
TUBES WERE INSERTED INTO YOUR VEINS OR ARTERIES (CARDIAC CATHETERIZATION,
CORONARY ANGIOGRAM, ANGIOPLASTY, OR BYPASS GRAFT NOTATION)?
1 Yes
5 No
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OC052
HEART SURGERY
^FLC038 HAVE YOU HAD SURGERY ON YOUR HEART?
1 Yes
5 No
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OC053
STROKE
[F1]--HELP
^FLC053 ^FLC053B ^FLIWER
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
2 [Vol] Possible stroke or tia (transient ischemic attack)
3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION
4 DISPUTES PREVIOUS WAVE RECORD, DOES NOT HAVE CONDITION
5 NO
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If STROKE = 1 Yes or STROKE = 2 [Vol] Possible stroke or tia (transient ischemic attack) or STROKE = 3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION »
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OC054
R SEEN DOCTOR FOR STROKE
^FLC054 HAVE YOU SEEN A DOCTOR BECAUSE OF THIS OR ANY OTHER STROKE?
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
5 No
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OC055
STROKE PROBLEMS
DO YOU STILL HAVE ANY REMAINING PROBLEMS BECAUSE OF YOUR STROKE(S)?
1 Yes
5 No
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If R SEEN DOCTOR FOR STROKE != 5 No or STROKE PROBLEMS != 5 No »
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OC060
STROKE MEDICATION
[F1]--HELP
ARE YOU NOW TAKING ANY MEDICATIONS BECAUSE OF YOUR STROKE OR ITS COMPLICATIONS?
1 Yes
5 No
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OC061
STROKE THERAPY
[F1]--HELP
ARE YOU RECEIVING PHYSICAL OR OCCUPATIONAL THERAPY BECAUSE OF YOUR STROKE OR ITS
COMPLICATIONS?
1 Yes
5 No
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OC062
ANOTHER STROKE SINCE PREVIOUS WAVE
SINCE ^Z092IWMOV, ^PIRVARSZ093_IWYR_V, HAS A DOCTOR TOLD YOU THAT YOU HAD ANOTHER STROKE?
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
5 No
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If ANOTHER STROKE SINCE PREVIOUS WAVE = 1 Yes »
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OC064
MOST RECENT STROKE-YEAR
IN WHAT YEAR WAS YOUR MOST RECENT STROKE?
YEAR:
1900..2014
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If MOST RECENT STROKE-YEAR = LESS THAN 2 YEARS AGO »
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OC063
MOST RECENT STROKE-MONTH
IN WHAT MONTH WAS THAT?
MONTH:
1 Jan
2 Feb
3 Mar
4 Apr
5 May
6 Jun
7 Jul
8 Aug
9 Sep
10 Oct
11 Nov
12 Dec
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OC065
EMOTIONAL/PSYCHIATRIC PROBLEMS
[F1]--HELP
^FLC065 ^FLC065B ^FLIWER
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION
4 DISPUTES PREVIOUS WAVE RECORD, DOES NOT HAVE CONDITION
5 NO
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If EMOTIONAL/PSYCHIATRIC PROBLEMS = 1 Yes or EMOTIONAL/PSYCHIATRIC PROBLEMS = 3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION »
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OC067
PSYCHIATRIC TREATMENT
DO YOU NOW GET PSYCHIATRIC OR PSYCHOLOGICAL TREATMENT FOR YOUR PROBLEMS?
1 Yes
5 No
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OC070
ARTHRITIS
[F1]--HELP
^FLC070 ^FLC070B ^FLIWER
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION
4 DISPUTES PREVIOUS WAVE RECORD, DOES NOT HAVE CONDITION
5 NO
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If ARTHRITIS = 1 Yes or ARTHRITIS = 3 DISPUTES PREVIOUS WAVE RECORD, BUT NOW HAS CONDITION »
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OC071
ARTHRITIS BETTER/WORSE/SAME
SINCE ^Z092IWMOV, ^PIRVARSZ093_IWYR_V, HAS THIS ARTHRITIS GOTTEN BETTER, WORSE, OR STAYED
ABOUT THE SAME?
1 Better
2 About the same
3 Worse
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OC076
ARTHRITIS JOINT REPLACE
^FLC072 HAVE YOU HAD SURGERY OR ANY JOINT REPLACEMENT BECAUSE OF ARTHRITIS?
1 Yes
5 No
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If ARTHRITIS JOINT REPLACE = 1 Yes »
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OC218
ARTHRITIS JOINT REPLACE- TYPE
(WHICH DID YOU HAVE: JOINT REPLACEMENT, SURGERY NOT INVOLVING JOINT REPLACEMENT, OR BOTH?)
1 Joint replacement
2 Surgery without joint replacement
3 Both
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OC077M
WHICH JOINT
WHICH JOINT WAS (REPLACED/AFFECTED)?
» SELECT ALL THAT APPLY
1 Hip(s)
2 Knee(s)
3 Hand/wrist area
4 Foot/ankle area
5 Shoulder(s)
6 Spine
7 Other (Specify)
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OC219
ARTHRITIS TYPE- OSTEOARTHRITIS
WHICH TYPE OR TYPES OF ARTHRITIS DO YOU HAVE?
» READ OUT EACH IN TURN AND CODE ALL THAT APPLY
DO YOU HAVE OSTEOARTHRITIS?
DEF: (OSTEOARTHRITIS IS ALSO CALLED DEGENERATIVE OR `WEAR AND TEAR` ARTHRITIS)
1 Yes
5 No
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OC220
ARTHRITIS TYPE- RHEUMATOID
(WHICH TYPE OR TYPES OF ARTHRITIS DO YOU HAVE?)
» READ OUT EACH IN TURN AND CODE ALL THAT APPLY
(DO YOU HAVE) RHEUMATOID ARTHRITIS?
DEF: (RHEUMATOID ARTHRITIS IS SOMETIMES CALLED AUTOIMMUNE ARTHRITIS)
1 Yes
5 No
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OC221
ARTHRITIS TYPE- GOUT/LUPUS
(WHICH TYPE OR TYPES OF ARTHRITIS DO YOU HAVE?)
» READ OUT EACH IN TURN AND CODE ALL THAT APPLY
(DO YOU HAVE) GOUT OR LUPUS?
1 Yes
5 No
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OC222
ARTHRITIS TYPE- RELATED TO INJURY
(WHICH TYPE OR TYPES OF ARTHRITIS DO YOU HAVE?)
» READ OUT EACH IN TURN AND CODE ALL THAT APPLY
(DO YOU HAVE) ARTHRITIS RELATED TO A PREVIOUS INJURY?
1 Yes
5 No
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OC240
HAS HAD SHINGLES
[F1]--HELP
^FLC240?
1 Yes
5 No
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OC246
SHINGLES VACCINE
[F1]--HELP
HAVE YOU EVER HAD THE SHINGLES VACCINE?
1 Yes
5 No
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If R CURRENT AGE CALCULATION > 65 »
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OC079
FALLEN IN PAST TWO YEARS
HAVE YOU FALLEN DOWN ^FLC079?
1 Yes
5 No
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If FALLEN IN PAST TWO YEARS = 1 Yes »
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OC080
NUMBER TIMES FALLEN
HOW MANY TIMES HAVE YOU FALLEN ^FLC079?
# TIMES:
0..50
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OC081
INJURY DUE TO FALL
^FLC081 TO NEED MEDICAL TREATMENT?
1 Yes
5 No
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OC082
BROKEN HIP
[F1]--HELP
^FLC082
1 Yes
5 No
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OC087
INCONTINENCE
[F1]--HELP
THIS MIGHT NOT BE EASY TO TALK ABOUT, BUT DURING THE LAST 12 MONTHS,
HAVE YOU LOST ANY AMOUNT OF URINE BEYOND YOUR CONTROL?
1 Yes
5 No
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If INCONTINENCE = 1 Yes »
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OC088
INCONTINENCE # DAYS
ON ABOUT HOW MANY DAYS IN THE LAST MONTH HAVE YOU LOST ANY URINE?
» DO NOT PROBE DK/RF
USE 31 FOR 'EVERY DAY'
0..31
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If INCONTINENCE # DAYS was not answered »
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OC089
INCONTINENCE 5 DAYS DK-1
WAS THAT MORE THAN 5 DAYS?
1 Yes
5 No
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If INCONTINENCE 5 DAYS DK-1 = 1 Yes »
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OC090
INCONTINENCE 15 DAYS DK-2
MORE THAN 15 DAYS?
1 Yes
5 No
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OC095
RATE EYESIGHT
[F1]--HELP
IS YOUR EYESIGHT EXCELLENT, VERY GOOD, GOOD, FAIR, OR POOR USING GLASSES OR
CORRECTIVE LENSES AS USUAL?
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
6 [Vol] legally blind
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| |
If RATE EYESIGHT != 6 [Vol] legally blind »
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OC096
RATE DISTAL VISION
[F1]--HELP
HOW GOOD IS YOUR EYESIGHT FOR SEEING THINGS AT A DISTANCE, LIKE RECOGNIZING A FRIEND ACROSS THE STREET, USING GLASSES OR CORRECTIVE LENSES AS USUAL?
(IS IT EXCELLENT, VERY GOOD, GOOD, FAIR, OR POOR?)
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
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OC097
RATE NEAR VISION
[F1]--HELP
HOW GOOD IS YOUR EYESIGHT FOR SEEING THINGS UP CLOSE, LIKE READING ORDINARY NEWSPAPER PRINT, USING GLASSES OR CORRECTIVE LENSES AS USUAL?
(IS IT EXCELLENT, VERY GOOD, GOOD, FAIR, OR POOR?)
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
|
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If R CURRENT AGE CALCULATION > 65 »
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OC098
Cataract surgery
[F1]--HELP
^FLC098
1 Yes
5 No
|
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|
| |
If Cataract surgery = 1 Yes »
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OC099
CATARACT SURGERY ON ONE OR BOTH EYES
HAVE YOU HAD CATARACT SURGERY ON BOTH EYES, OR JUST ONE?
1 One eye only
2 Both eyes
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OC100
CATARACT IMPLANT LENS
DID THE CATARACT SURGERY (ON EITHER EYE) INCLUDE IMPLANTING A LENS?
1 Yes
5 No
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OC101
GLAUCOMA
HAS A DOCTOR EVER TREATED YOU FOR GLAUCOMA?
DEF: (MEDICAL DOCTORS INCLUDE SPECIALISTS SUCH AS DERMATOLOGISTS,
PSYCHIATRISTS, OPHTHALMOLOGISTS, OSTEOPATHS, CARDIOLOGISTS,
AS WELL AS FAMILY DOCTORS, INTERNISTS AND PHYSICIANS' ASSISTANTS.
ALSO INCLUDE DIAGNOSES MADE BY NURSES AND NURSE PRACTITIONERS.)
1 Yes
5 No
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OC237
LOST PERMANENT TEETH
THIS NEXT QUESTION IS ABOUT YOUR TEETH.
HAVE YOU LOST ALL OF YOUR UPPER AND LOWER NATURAL PERMANENT TEETH?
1 Yes
5 No
|
| |
If OZ090 != YES or DIFFERENT RESPONDENT FROM PREV IW = 1 Yes »
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OC102
WEAR HEARING AID
DO YOU EVER WEAR A HEARING AID?
1 Yes
5 No
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OC103
RATE HEARING
[F1]--HELP
IS YOUR HEARING EXCELLENT, VERY GOOD, GOOD, FAIR, OR POOR ^FLC103?
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
|
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OC083
TROUBLE FALLING ASLEEP
HOW OFTEN DO YOU HAVE TROUBLE FALLING ASLEEP?
WOULD YOU SAY MOST OF THE TIME, SOMETIMES, OR RARELY OR NEVER?
1 Most of the time
2 Sometimes
3 Rarely or never
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OC084
TROUBLE WAKING UP DURING NIGHT
[F1]--HELP
HOW OFTEN DO YOU HAVE TROUBLE WITH WAKING UP DURING THE NIGHT?
(WOULD YOU SAY MOST OF THE TIME, SOMETIMES, OR RARELY OR NEVER?)
1 Most of the time
2 Sometimes
3 Rarely or never
|
| |
OC085
TROUBLE WAKING UP TOO EARLY
HOW OFTEN DO YOU HAVE TROUBLE WITH WAKING UP TOO EARLY AND NOT BEING ABLE TO FALL ASLEEP AGAIN?
(WOULD YOU SAY MOST OF THE TIME, SOMETIMES, OR RARELY OR NEVER?)
1 Most of the time
2 Sometimes
3 Rarely or never
|
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OC086
FEEL RESTED IN MORNING
HOW OFTEN DO YOU FEEL REALLY RESTED WHEN YOU WAKE UP IN THE MORNING?
WOULD YOU SAY MOST OF THE TIME, SOMETIMES, OR RARELY OR NEVER?
1 Most of the time
2 Sometimes
3 Rarely or never
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OC232
MEDICATIONS TO SLEEP
IN THE PAST TWO WEEKS, HAVE YOU TAKEN ANY MEDICATIONS OR USED OTHER TREATMENTS TO HELP YOU SLEEP?
1 Yes
5 No
|
| |
If MEDICATIONS TO SLEEP = 1 Yes »
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OC233
SLEEP MEDICATIONS RECOMMENDED BY DOCTOR
WERE THESE MEDICATIONS OR OTHER TREATMENTS RECOMMENDED TO YOU BY A DOCTOR?
1 Yes
5 No
|
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OC104
TROUBLED WITH PAIN
[F1]--HELP
ARE YOU OFTEN TROUBLED WITH PAIN?
1 Yes
5 No
|
| |
If TROUBLED WITH PAIN = 1 Yes »
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OC105
DEGREE PAIN MOST OF TIME
HOW BAD IS THE PAIN MOST OF THE TIME: MILD, MODERATE OR SEVERE?
1 Mild
2 Moderate
3 Severe
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OC106
DOES PAIN LIMIT ACTIVITIES
[F1]--HELP
DOES THE PAIN MAKE IT DIFFICULT FOR YOU TO DO YOUR USUAL ACTIVITIES
SUCH AS HOUSEHOLD CHORES OR WORK?
1 Yes
5 No
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OC107
OTHER MEDICAL CONDITIONS
[F1]--HELP
ARE THERE ANY MEDICAL DISEASES OR CONDITIONS THAT ARE IMPORTANT TO YOUR
HEALTH NOW, THAT WE HAVE NOT TALKED ABOUT?
1 Yes
5 No
|
| |
If OTHER MEDICAL CONDITIONS = 1 Yes »
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|
| |
OC108
OTHER MEDICAL CONDITIONS - SPECIFY
(WHAT ARE THEY?)
|
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OC109
PREVENTATIVE FLU SHOT SINCE PREV WAVE
^FLC109
THE FOLLOWING MEDICAL TESTS OR PROCEDURES?
A FLU SHOT?
» A FLU SHOT MAY NOW BE GIVEN BY A MIST IN THE NOSE
1 Yes
5 No
|
| |
OC110
CHOLESTEROL TEST SINCE PREV WAVE
( ^FLC109 THE FOLLOWING MEDICAL TESTS OR PROCEDURES?)
A BLOOD TEST FOR CHOLESTEROL?
1 Yes
5 No
|
| |
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OC112
MAMMOGRAM/XRAY OF BREAST SINCE PREV WAVE
( ^FLC109 THE FOLLOWING MEDICAL TESTS OR PROCEDURES?)
» (IF R IS FEMALE) DID YOU HAVE A MAMMOGRAM OR X-RAY OF THE BREAST, ^FLC112?
1 Yes
5 No
|
| |
|
| |
OC113
PAP SMEAR SINCE PREV WAVE
[F1]--HELP
( ^FLC109 THE FOLLOWING MEDICAL TESTS OR PROCEDURES?)
» (IF R IS FEMALE) A PAP SMEAR?
1 Yes
5 No
|
| |
|
| |
If OA007 != 1 and PROXY/SELF INTERVIEW = 1 »
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OC249
HAD HYSTERECTOMY
HAVE YOU EVER HAD A HYSTERECTOMY, THAT IS, SURGERY TO REMOVE YOUR
UTERUS OR WOMB?
1 Yes
5 No
|
| |
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OC250
HOW OLD HYSTERECTOMY
HOW OLD WERE YOU WHEN YOU HAD YOUR HYSTERECTOMY?
1..120
|
| |
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|
If HOW OLD HYSTERECTOMY > 45 »
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OC251
HYSTERECTOMY AFTER LAST MENSTRUAL PERIOD
DID YOU HAVE YOUR HYSTERECTOMY AFTER YOUR LAST MENSTRUAL PERIOD,
THAT IS, AFTER YOU WENT THROUGH MENOPAUSE?
1 Yes
5 No
|
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|
|
If R CURRENT AGE CALCULATION <= 55 or HAD HYSTERECTOMY = 1 Yes »
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OC253
HOW OLD FINISHED MENOPAUSE
ABOUT HOW OLD WERE YOU WHEN YOU FINISHED GOING THROUGH MENOPAUSE,
THAT IS, HAD YOUR LAST MENSTRUAL PERIOD?
» IF R IS STILL HAVING MENSTRUAL PERIODS, ENTER 97.
0..97
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OC252
PHASE OF MENOPAUSE
REGARDING MENOPAUSE, DO YOU THINK YOU ARE WITHOUT A SIGN, JUST
BEGINNING, IN THE MIDDLE, NEAR THE END, OR ALL THROUGH?
1 Without a sign
2 Just beginning
3 In the middle
4 Near the end
5 All through
|
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OC253
HOW OLD FINISHED MENOPAUSE
ABOUT HOW OLD WERE YOU WHEN YOU FINISHED GOING THROUGH MENOPAUSE,
THAT IS, HAD YOUR LAST MENSTRUAL PERIOD?
» IF R IS STILL HAVING MENSTRUAL PERIODS, ENTER 97.
0..97
|
| |
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OC254
MENOPAUSE END-OLDER/YOUNGER THAN 50
WERE YOU OLDER THAN AGE 50, YOUNGER THAN 50, OR WHAT?
1 Older than age 50
3 About age 50
5 Younger than 50
|
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OC255
MENOPAUSE END-OLDER/YOUNGER THAN 45
WERE YOU OLDER THAN AGE 45, YOUNGER THAN 45, OR WHAT?
1 Older than age 45
3 About age 45
5 Younger than 45
|
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OC256
MENOPAUSE END-OLDER/YOUNGER THAN 55
WERE YOU OLDER THAN AGE 55, YOUNGER THAN 55, OR WHAT?
1 Older than age 55
3 About age 55
5 Younger than 55
|
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OC114
PROSTATE EXAM SINCE PREV WAVE
( ^FLC109 THE FOLLOWING MEDICAL TESTS OR PROCEDURES?)
» (IF R IS MALE) A PSA BLOOD TEST OR OTHER EXAMINATION TO SCREEN FOR PROSTATE CANCER?
1 Yes
5 No
|
| |
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OC223
HOW OFTEN VIGOROUS ACTIVITY
[F1]--HELP
WE WOULD LIKE TO KNOW THE TYPE AND AMOUNT OF PHYSICAL ACTIVITY INVOLVED IN YOUR DAILY LIFE.
HOW OFTEN DO YOU TAKE PART IN SPORTS OR ACTIVITIES THAT ARE VIGOROUS, SUCH AS RUNNING OR
JOGGING, SWIMMING, CYCLING, AEROBICS OR GYM WORKOUT, TENNIS, OR DIGGING WITH A SPADE OR
SHOVEL: MORE THAN ONCE A WEEK, ONCE A WEEK, ONE TO THREE TIMES A MONTH, OR HARDLY EVER OR
NEVER?
1 More than once a week
2 Once a week
3 One to three times a month
4 Hardly ever or never
7 (Vol) every day
|
| |
OC224
HOW OFTEN MODERATE ACTIVITY
[F1]--HELP
AND HOW OFTEN DO YOU TAKE PART IN SPORTS OR ACTIVITIES THAT ARE MODERATELY ENERGETIC, SUCH AS GARDENING, CLEANING THE
CAR, WALKING AT A MODERATE PACE, DANCING, FLOOR OR STRETCHING EXERCISES: (MORE THAN ONCE A WEEK, ONCE A WEEK, ONE TO
THREE TIMES A MONTH, OR HARDLY EVER OR NEVER)?
1 More than once a week
2 Once a week
3 One to three times a month
4 Hardly ever or never
7 (Vol) every day
|
| |
OC225
HOW OFTEN MILD ACTIVITY
[F1]--HELP
AND HOW OFTEN DO YOU TAKE PART IN SPORTS OR ACTIVITIES THAT ARE MILDLY ENERGETIC, SUCH AS VACUUMING, LAUNDRY, HOME REPAIRS: (MORE
THAN ONCE A WEEK, ONCE A WEEK, ONE TO THREE TIMES A MONTH, OR HARDLY EVER OR NEVER)?
1 More than once a week
2 Once a week
3 One to three times a month
4 Hardly ever or never
7 (Vol) every day
|
| |
OC116
EVER SMOKE
[F1]--HELP
HAVE YOU EVER SMOKED CIGARETTES?
DEF: (BY SMOKING WE MEAN MORE THAN 100 CIGARETTES IN YOUR LIFETIME. DO NOT
INCLUDE PIPES OR CIGARS.)
1 Yes
5 No
|
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|
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OC117
SMOKE CIGARETTES NOW
[F1]--HELP
DO YOU SMOKE CIGARETTES NOW?
1 Yes
5 No
|
| |
|
| |
If SMOKE CIGARETTES NOW = 1 Yes »
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OC118
NUM CIGARETTES SMOKED PER DAY
ABOUT HOW MANY CIGARETTES OR PACKS DO YOU USUALLY SMOKE IN A DAY NOW?
» PROBE A RANGE. THERE ARE 20 CIGARETTES IN A PACK.
» THIS QUESTION REFERS TO CIGARETTE SMOKING ONLY. IF R SMOKES CIGARS OR PIPES,
ENTER THE TYPE AND AMOUNT SMOKED IN AN F2 COMMENT.
CIGARETTES PER DAY:
OR
PACKS PER DAY:
0..100
|
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If NUM CIGARETTES SMOKED PER DAY was assigned an EMPTY value »
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OC119
NUM PACKS SMOKED PER DAY
(ABOUT HOW MANY CIGARETTES OR PACKS DO YOU USUALLY SMOKE IN A DAY NOW?)
» PROBE A RANGE. THERE ARE 20 CIGARETTES IN A PACK.
» THIS QUESTION REFERS TO CIGARETTE SMOKING ONLY. IF R SMOKES CIGARS OR PIPES, ENTER THE TYPE AND AMOUNT SMOKED IN AN F2 COMMENT.
CIGARETTES PER DAY:
OR
PACKS PER DAY:
1..5
|
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OC120
AGE START SMOKING
^FLC120
ABOUT HOW OLD WERE YOU WHEN YOU STARTED SMOKING?
YEARS OLD:
OR
YEAR STARTED SMOKING:
OR
STARTED SMOKING YEARS AGO:
»IF R SAYS NEVER SMOKED, ENTER '95'
0..96
|
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|
| |
If AGE START SMOKING != 95 »
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OC121
YR STARTED SMOKING
(ABOUT HOW OLD WERE YOU WHEN YOU STARTED SMOKING?)
YEARS OLD:
OR
YEAR STARTED SMOKING:
OR
STARTED SMOKING YEARS AGO:
1880..2014
|
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OC122
YRS AGO STARTED SMOKING
(ABOUT HOW OLD WERE YOU WHEN YOU STARTED SMOKING?)
YEARS OLD:
OR
YEAR STARTED SMOKING:
OR
STARTED SMOKING YEARS AGO:
0..96
|
| |
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|
| |
If AGE START SMOKING != 95 and SMOKE CIGARETTES NOW != 1 Yes »
|
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OC123
NUM CIGS PER DAY- WHEN SMOKED MOST
^FLC123
WHEN YOU WERE SMOKING THE MOST, ABOUT HOW MANY CIGARETTES OR PACKS DID YOU USUALLY
SMOKE IN A DAY?
»IF R SAYS NEVER SMOKED, ENTER '95'
» PROBE A RANGE. THERE ARE 20 CIGARETTES IN A PACK.
» THIS QUESTION REFERS TO CIGARETTE SMOKING ONLY. IF R SMOKES CIGARS OR PIPES,
ENTER THE TYPE AND AMOUNT SMOKED IN AN F2 COMMENT.
CIGARETTES PER DAY:
OR
PACKS PER DAY:
0..100
|
| |
|
|
| |
|
If NUM CIGS PER DAY- WHEN SMOKED MOST was assigned an EMPTY value »
|
|
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|
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OC124
NUM PACKS PER DAY- WHEN SMOKED MOST
(WHEN YOU WERE SMOKING THE MOST, ABOUT HOW MANY CIGARETTES OR PACKS DID
YOU USUALLY SMOKE IN A DAY?)
» PROBE A RANGE. THERE ARE 20 CIGARETTES IN A PACK.
» THIS QUESTION REFERS TO CIGARETTE SMOKING ONLY. IF R SMOKES CIGARS OR PIPES, ENTER THE TYPE AND
AMOUNT SMOKED IN AN F2 COMMENT.
CIGARETTES PER DAY:
OR
PACKS PER DAY:
1..5
|
| |
|
|
|
| |
|
If NUM CIGS PER DAY- WHEN SMOKED MOST != 995 »
|
|
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|
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OC125
YRS AGO STOP SMOKING
ABOUT HOW MANY YEARS AGO DID YOU STOP SMOKING?
» ENTER ‘95Â’ IF R SAYS NEVER SMOKED
» ENTER '96' IF LESS THAN ONE YEAR
YEARS AGO:
OR
YEAR STOPPED SMOKING:
OR
AGE WHEN STOPPED SMOKING:
1..96
|
| |
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|
|
If YRS AGO STOP SMOKING was assigned an EMPTY value »
|
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|
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OC126
YR STOP SMOKING
(ABOUT HOW MANY YEARS AGO DID YOU STOP SMOKING?)
» ENTER '96' IF LESS THAN ONE YEAR
YEARS AGO:
OR
YEAR STOPPED SMOKING:
OR
AGE WHEN STOPPED SMOKING:
1880..2014
|
| |
|
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|
|
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If YR STOP SMOKING was assigned an EMPTY value »
|
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OC127
AGE STOP SMOKING
(ABOUT HOW MANY YEARS AGO DID YOU STOP SMOKING?)
» ENTER '96' IF LESS THAN ONE YEAR
YEARS AGO:
OR
YEAR STOPPED SMOKING:
OR
AGE WHEN STOPPED SMOKING:
0..96
|
| |
|
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OC128
EVER DRINK ALCOHOL
[F1]--HELP
DO YOU EVER DRINK ANY ALCOHOLIC BEVERAGES SUCH AS BEER, WINE, OR LIQUOR?
1 Yes
3 [Vol] never have used alcohol
5 No
|
| |
If EVER DRINK ALCOHOL = 1 Yes »
|
|
| |
|
| |
OC129
NUMBER DAYS PER WEEK- DRINK ALCOHOL
IN THE LAST THREE MONTHS, ON AVERAGE, HOW MANY DAYS PER WEEK HAVE YOU HAD
ANY ALCOHOL TO DRINK? (FOR EXAMPLE, BEER, WINE, OR ANY DRINK CONTAINING LIQUOR.)
» USE 0 FOR NONE OR LESS THAN ONCE A WEEK
1 - 6
7 EVERY DAY
DAYS:
0..7
|
| |
|
| |
If NUMBER DAYS PER WEEK- DRINK ALCOHOL != 0 or NUMBER DAYS PER WEEK- DRINK ALCOHOL was not answered »
|
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OC130
NUMBER DRINKS- PER DAY
[F1]--HELP
IN THE LAST THREE MONTHS, ON THE DAYS YOU DRINK, ABOUT HOW MANY DRINKS DO YOU HAVE?
# DRINKS:
0..15
|
| |
|
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OC131
BINGE DRINKING
[F1]--HELP
IN THE LAST THREE MONTHS, ON HOW MANY DAYS HAVE YOU HAD FOUR OR MORE DRINKS
ON ONE OCCASION?
» USE ZERO FOR NONE
AMOUNT:
0..92
|
| |
|
|
If EVER DRINK ALCOHOL != 1 Yes »
|
|
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|
| |
OC134
HAD 12+ DRINKS OF ALCOHOL OVER ENTIRE LIFE
IN YOUR ENTIRE LIFE, HAVE YOU HAD AT LEAST 12 DRINKS OF ANY TYPE OF ALCOHOLIC BEVERAGE?
1 Yes
2 Yes assigned prior wave
5 No
6 No assigned prior wave
|
| |
|
| |
If HAD 12+ DRINKS OF ALCOHOL OVER ENTIRE LIFE = 1 Yes »
|
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|
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OC135
R FELT NEED TO CUT DOWN DRINKING
[F1]--HELP
HAVE YOU EVER FELT THAT YOU SHOULD CUT DOWN ON DRINKING?
1 Yes
5 No
|
| |
|
|
If EVER DRINK ALCOHOL = 1 Yes or HAD 12+ DRINKS OF ALCOHOL OVER ENTIRE LIFE = 1 Yes »
|
|
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|
| |
OC136
FELT ANNOYED BY CRITICISM ABOUT DRINKING
[F1]--HELP
HAVE PEOPLE EVER ANNOYED YOU BY CRITICIZING YOUR DRINKING?
1 Yes
5 No
|
| |
|
| |
OC137
GUILT OVER DRINKING
[F1]--HELP
HAVE YOU EVER FELT BAD OR GUILTY ABOUT DRINKING?
1 Yes
5 No
|
| |
|
| |
OC138
EVER DRINK IN THE MORNING
[F1]--HELP
HAVE YOU EVER TAKEN A DRINK FIRST THING IN THE MORNING TO STEADY YOUR NERVES OR GET
RID OF A HANGOVER?
1 Yes
5 No
|
| |
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OC139
WEIGHT IN POUNDS
[F1]--HELP
ABOUT HOW MUCH DO YOU WEIGH?
»ENTER 400 IF R REPORTS A WEIGHT OF 400 OR MORE
POUNDS:
50..400
|
| |
OC140
WEIGHT GAIN/LOSS 10 LBS. SINCE PREV WAVE
HAVE YOU GAINED OR LOST TEN OR MORE POUNDS IN THE LAST 2 YEARS?
» IF R ANSWERS 'YES', PROBE FOR WHETHER R GAINED, LOST OR BOTH GAINED AND LOST 10 OR MORE POUNDS.
1 Yes, gained
2 Yes, lost
3 Yes, gained and lost
5 No
|
| |
OC226
MOST EVER WEIGH- POUNDS
UP TO THE PRESENT TIME, WHAT IS THE MOST YOU HAVE EVER WEIGHED?
^FLC226
» ENTER WEIGHT IN POUNDS
»ENTER 400 IF R REPORTS A WEIGHT OF 400 OR MORE
NUMBER OF POUNDS:
50..400
|
| |
If MOST EVER WEIGH- POUNDS was answered »
|
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OC228
MOST EVER WEIGH- WHAT AGE
[F1]--HELP
HOW OLD WERE YOU THEN? (IF YOU DON'T KNOW YOUR EXACT AGE, PLEASE MAKE YOUR BEST GUESS.)
0..120
|
| |
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OC141
HEIGHT FEET
[F1]--HELP
ABOUT HOW TALL ARE YOU?
FEET:
3..7
|
| |
If HEIGHT FEET was answered »
|
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|
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OC142
HEIGHT INCHES
(ABOUT HOW TALL ARE YOU?)
» RECORD TO THE QUARTER OF AN INCH. FOR EXAMPLE, RECORD 7 1/4 INCHES AS 7.25. RECORD 7 INCHES AS 7.00
INCHES:
0..12
|
| |
|
OC143
SWELLING FEET/ANKLES
[F1]--HELP
^FLC143 PERSISTENT SWELLING IN YOUR FEET OR ANKLES?
1 Yes
5 No
|
| |
OC144
SHORTNESS OF BREATH
[F1]--HELP
( ^FLC143) SHORTNESS OF BREATH WHILE AWAKE?
1 Yes
5 No
|
| |
OC145
EVER BEEN DIZZY
[F1]--HELP
( ^FLC143) PERSISTENT DIZZINESS OR LIGHTHEADEDNESS?
1 Yes
5 No
|
| |
OC146
BACK PAIN OR PROBLEMS
[F1]--HELP
( ^FLC143) BACK PAIN OR PROBLEMS?
1 Yes
5 No
|
| |
OC147
PERSISTENT HEADACHE
[F1]--HELP
( ^FLC143) HAVE YOU HAD PERSISTENT HEADACHES?
1 Yes
5 No
|
| |
OC148
SEVERE FATIGUE
[F1]--HELP
( ^FLC143) SEVERE FATIGUE OR EXHAUSTION?
1 Yes
5 No
|
| |
OC149
PERSISTENT COUGH/WHEEZE/PHLEGM
[F1]--HELP
( ^FLC143) PERSISTENT WHEEZING, COUGH, OR BRINGING UP PHLEGM?
1 Yes
5 No
|
| |
OC229
DAYS IN BED
[F1]--HELP
ASIDE FROM ANY HOSPITAL OR NURSING HOME STAYS, ABOUT HOW MANY DAYS DID YOU STAY IN BED MORE THAN HALF THE DAY BECAUSE OF ILLNESS OR INJURY DURING THE LAST MONTH?
» USE ZERO FOR NONE
0..31
|
| |
OC150
FELT DEPRESSED IN PAST YR
[F1]--HELP
DURING THE LAST 12 MONTHS, WAS THERE EVER A TIME WHEN YOU FELT SAD, BLUE,
OR DEPRESSED FOR TWO WEEKS OR MORE IN A ROW?
1 Yes
3 [Vol] did not feel depressed because on anti-depressant medication
5 No
|
| |
If FELT DEPRESSED IN PAST YR = 1 Yes »
|
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OC151
DEPRESSED WHAT PORTION OF DAY
[F1]--HELP
PLEASE THINK OF THE TWO-WEEK PERIOD DURING THE LAST 12 MONTHS WHEN THESE
FEELINGS WERE WORST. DURING THAT TIME DID THE FEELINGS OF BEING SAD, BLUE,
OR DEPRESSED USUALLY LAST ALL DAY LONG, MOST OF THE DAY, ABOUT HALF THE DAY,
OR LESS THAN HALF THE DAY?
1 All day long
2 Most of the day
3 About half the day
4 Less than half the day
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If DEPRESSED WHAT PORTION OF DAY = 1 All day long or DEPRESSED WHAT PORTION OF DAY = 2 Most of the day »
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OC152
DEPRESSED EVERY DAY
[F1]--HELP
DURING THOSE TWO WEEKS, DID YOU FEEL THIS WAY EVERY DAY, ALMOST EVERY DAY,
OR LESS OFTEN THAN THAT?
1 Every day
2 Almost every day
3 Less often
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If DEPRESSED EVERY DAY = 1 Every day or DEPRESSED EVERY DAY = 2 Almost every day »
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OC153
LOSS OF INTEREST
[F1]--HELP
DURING THOSE TWO WEEKS, DID YOU LOSE INTEREST IN MOST THINGS?
» IF R SAYS USUALLY NO INTEREST IN THINGS, REPEAT Q ADDING: '...MORE THAN
IS USUAL FOR YOU.'
1 Yes
5 No
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OC154
FEELING TIRED
[F1]--HELP
THINKING ABOUT THOSE SAME TWO WEEKS, DID YOU EVER FEEL MORE TIRED OUT OR
LOW IN ENERGY THAN IS USUAL FOR YOU?
1 Yes
5 No
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OC155
LOSE APPETITE
[F1]--HELP
DURING THOSE SAME TWO WEEKS, DID YOU LOSE YOUR APPETITE?
1 Yes
5 No
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If LOSE APPETITE != 1 Yes »
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OC156
APPETITE INCREASE
DID YOUR APPETITE INCREASE DURING THOSE SAME TWO WEEKS?
1 Yes
5 No
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OC157
TROUBLE FALL ASLEEP
DID YOU HAVE MORE TROUBLE FALLING ASLEEP THAN YOU USUALLY DO DURING THOSE TWO WEEKS?
1 Yes
5 No
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If TROUBLE FALL ASLEEP = 1 Yes »
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OC158
FREQ OF TROUBLE FALLING ASLEEP
DID THAT HAPPEN EVERY NIGHT, NEARLY EVERY NIGHT, OR LESS OFTEN DURING THOSE TWO WEEKS?
1 Every night
2 Nearly every night
3 Less often
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OC159
TROUBLE CONCENTRATING
DURING THAT SAME TWO-WEEK PERIOD, DID YOU HAVE A LOT MORE TROUBLE CONCENTRATING
THAN USUAL?
1 Yes
5 No
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OC160
FEELING DOWN ON YOURSELF
PEOPLE SOMETIMES FEEL DOWN ON THEMSELVES, AND NO GOOD OR WORTHLESS. DURING THAT
TWO-WEEK PERIOD, DID YOU FEEL THIS WAY?
1 Yes
5 No
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OC161
THOUGHTS ABOUT DEATH
DID YOU THINK A LOT ABOUT DEATH -- EITHER YOUR OWN, SOMEONE ELSE'S, OR DEATH IN
GENERAL -- DURING THOSE TWO WEEKS?
1 Yes
5 No
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If CHECKPOINT DEPRESSION = 1 »
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OC163
DEPRESSION EPISODE LASTED-WEEKS
[F1]--HELP
TO REVIEW, YOU HAD TWO WEEKS IN A ROW DURING THE LAST 12 MONTHS WHEN YOU WERE
SAD, BLUE, OR DEPRESSED AND ALSO HAD SOME OTHER FEELINGS OR PROBLEMS LIKE -
» READ UP TO THE FIRST 3 'YES' RESPONSES TO C153 - C161
^FLC153PROB
^FLC154PROB
^FLC155PROB
^FLC156PROB
^FLC157PROB
^FLC159PROB
^FLC160PROB
^FLC161PROB
ABOUT HOW MANY WEEKS ALTOGETHER -- OUT OF 52 -- DID YOU FEEL THIS WAY DURING THE
LAST 12 MONTHS?
WEEKS:
OR
MONTHS:
OR
ENTIRE YEAR:
0..52
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OC164
DEPRESSION EPISODE LASTED-MONTHS
(TO REVIEW, YOU HAD TWO WEEKS IN A ROW DURING THE LAST 12 MONTHS WHEN YOU WERE SAD,
BLUE, OR DEPRESSED AND ALSO HAD SOME OTHER FEELINGS OR PROBLEMS LIKE -
» READ UP TO THE FIRST 3 'YES' RESPONSES TO C153 - C161
^FLC153PROB
^FLC154PROB
^FLC155PROB
^FLC156PROB
^FLC157PROB
^FLC159PROB
^FLC160PROB
^FLC161PROB
ABOUT HOW MANY WEEKS ALTOGETHER -- OUT OF 52 -- DID YOU FEEL THIS WAY DURING THE LAST 12 MONTHS?)
WEEKS:
OR
MONTHS:
OR
ENTIRE YEAR:
0..12
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OC165
DEPRESSION EPISODE LASTED-ENTIRE YEAR
(TO REVIEW, YOU HAD TWO WEEKS IN A ROW DURING THE LAST 12 MONTHS WHEN YOU WERE SAD,
BLUE, OR DEPRESSED AND ALSO HAD SOME OTHER FEELINGS OR PROBLEMS LIKE -
» READ UP TO THE FIRST 3 'YES' RESPONSES TO C153 - C161
^FLC153PROB
^FLC154PROB
^FLC155PROB
^FLC156PROB
^FLC157PROB
^FLC159PROB
^FLC160PROB
^FLC161PROB
ABOUT HOW MANY WEEKS ALTOGETHER -- OUT OF 52 -- DID YOU FEEL THIS WAY DURING THE
LAST 12 MONTHS?)
WEEKS:
OR
MONTHS:
OR
ENTIRE YEAR:
1 Entire year
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If DEPRESSION EPISODE LASTED-WEEKS != 52 and DEPRESSION EPISODE LASTED-MONTHS != 12 and DEPRESSION EPISODE LASTED-ENTIRE YEAR != 1 Entire year »
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OC166
MOST RECENT MO- SAD/DEPRESSED
[F1]--HELP
THINK ABOUT THE MOST RECENT TIME WHEN YOU HAD TWO WEEKS IN A ROW WHEN YOU FELT THIS
WAY. IN WHAT MONTH WAS THIS (DURING THE LAST 12 MONTHS)?
» RECORD MOST RECENT MONTH
MONTH:
1 Jan
2 Feb
3 Mar
4 Apr
5 May
6 Jun
7 Jul
8 Aug
9 Sep
10 Oct
11 Nov
12 Dec
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If DEPRESSION EPISODE LASTED-WEEKS != 52 and DEPRESSION EPISODE LASTED-MONTHS != 12 and DEPRESSION EPISODE LASTED-ENTIRE YEAR != 1 Entire year and DEPRESSED EVERY DAY != 1 Every day and DEPRESSED EVERY DAY != 2 Almost every day and DEPRESSED WHAT PORTION OF DAY != 1 All day long and DEPRESSED WHAT PORTION OF DAY != 2 Most of the day »
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OC167
LOSE INTEREST- CIDI
[F1]--HELP
DURING THE LAST 12 MONTHS, WAS THERE EVER A TIME LASTING TWO WEEKS OR MORE
WHEN YOU LOST INTEREST IN MOST THINGS LIKE HOBBIES, WORK, OR ACTIVITIES THAT
USUALLY GIVE YOU PLEASURE?
1 Yes
3 [Vol] Not feel loss of interest because on anti-depressant medication
5 No
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If LOSE INTEREST- CIDI = 1 Yes »
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OC168
LOSE INTEREST OFTEN- CIDI
[F1]--HELP
PLEASE THINK OF THE TWO-WEEK PERIOD DURING THE LAST 12 MONTHS WHEN YOU HAD THE
MOST COMPLETE LOSS OF INTEREST IN THINGS. DURING THAT TWO-WEEK PERIOD, DID THE
LOSS OF INTEREST USUALLY LAST ALL DAY LONG, MOST OF THE DAY, ABOUT HALF THE DAY,
OR LESS THAN HALF THE DAY?
1 All day long
2 Most of the day
3 About half the day
4 Less than half the day
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If LOSE INTEREST OFTEN- CIDI = 1 All day long or LOSE INTEREST OFTEN- CIDI = 2 Most of the day »
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OC169
LOSE INTEREST DYSFUNCTION- CIDI
[F1]--HELP
DID YOU FEEL THIS WAY EVERY DAY, ALMOST EVERY DAY, OR LESS OFTEN DURING THE
TWO WEEKS?
1 Every day
2 Almost every day
3 Less often
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If LOSE INTEREST DYSFUNCTION- CIDI = 1 Every day or LOSE INTEREST DYSFUNCTION- CIDI = 2 Almost every day »
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OC170
FEELING TIRED- CIDI
[F1]--HELP
DURING THOSE TWO WEEKS, DID YOU FEEL TIRED OUT OR LOW ON ENERGY ALL THE TIME?
1 Yes
5 No
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OC171
LOST APPETITE- CIDI
[F1]--HELP
DURING THOSE SAME TWO WEEKS, DID YOU LOSE YOUR APPETITE?
1 Yes
5 No
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If LOST APPETITE- CIDI != 1 Yes »
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OC172
APPETITE INCREASE- CIDI
[F1]--HELP
DID YOUR APPETITE INCREASE DURING THOSE SAME TWO WEEKS?
1 Yes
5 No
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OC173
TROUBLE FALLING ASLEEP- CIDI
[F1]--HELP
DURING THOSE SAME TWO WEEKS, DID YOU HAVE MORE TROUBLE FALLING ASLEEP THAN
YOU USUALLY DO?
1 Yes
5 No
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If TROUBLE FALLING ASLEEP- CIDI = 1 Yes »
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OC174
FREQUENCY OF SLEEP TROUBLE- CIDI
[F1]--HELP
DID THAT HAPPEN EVERY NIGHT, NEARLY EVERY NIGHT, OR LESS OFTEN DURING THOSE
TWO WEEKS?
1 Every night
2 Nearly every night
3 Less often
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OC175
TROUBLE CONCENTRATE- CIDI
[F1]--HELP
DURING THOSE TWO WEEKS, DID YOU HAVE MORE TROUBLE CONCENTRATING THAN USUAL?
1 Yes
5 No
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OC176
FEELING DOWN ON ONESELF- CIDI
[F1]--HELP
PEOPLE SOMETIMES FEEL DOWN ON THEMSELVES, NO GOOD OR WORTHLESS. DID YOU FEEL
THIS WAY DURING THAT TWO-WEEK PERIOD?
1 Yes
5 No
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OC177
INTEREST IN DEATH- CIDI
DID YOU THINK A LOT ABOUT DEATH DURING THOSE TWO WEEKS --EITHER YOUR OWN,
SOMEONE ELSE'S, OR DEATH IN GENERAL?
1 Yes
5 No
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If REVIEW CHECKPOINT- SECTION C = 1 »
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OC179
DEPRESSION EPISODE LASTED-WEEKS-CIDI
[F1]--HELP
TO REVIEW, YOU HAD TWO WEEKS IN A ROW DURING THE LAST 12 MONTHS WHEN YOU
LOST INTEREST IN MOST THINGS LIKE HOBBIES, WORK, OR ACTIVITIES THAT USUALLY
GIVE YOU PLEASURE, AND ALSO HAD SOME OTHER FEELINGS OR PROBLEMS LIKE -
» READ UP TO THE FIRST 3 'YES' RESPONSES TO C170 - C177
^FLC170PROB
^FLC171PROB
^FLC172PROB
^FLC173PROB
^FLC175PROB
^FLC176PROB
^FLC177PROB
ABOUT HOW MANY WEEKS ALTOGETHER--OUT OF 52--DID YOU FEEL THIS WAY DURING THE LAST 12 MONTHS?
WEEKS:
OR
MONTHS:
OR
ENTIRE YEAR:
0..52
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OC180
DEPRESSION EPISODE LASTED-MONTHS-CIDI
(TO REVIEW, YOU HAD TWO WEEKS IN A ROW DURING THE LAST 12 MONTHS WHEN YOU LOST INTEREST
IN MOST THINGS LIKE HOBBIES, WORK, OR ACTIVITIES THAT USUALLY GIVE YOU PLEASURE, AND ALSO
HAD SOME OTHER FEELINGS OR PROBLEMS LIKE -
» READ UP TO THE FIRST 3 'YES' RESPONSES TO C170 - C177
^FLC170PROB
^FLC171PROB
^FLC172PROB
^FLC173PROB
^FLC175PROB
^FLC176PROB
^FLC177PROB
ABOUT HOW MANY WEEKS ALTOGETHER--OUT OF 52--DID YOU FEEL THIS WAY DURING THE LAST 12 MONTHS?)
WEEKS:
OR
MONTHS:
OR
ENTIRE YEAR:
0..12
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OC181
DEPRESSION EPISODE LASTED-ENTIRE YR-CIDI
(TO REVIEW, YOU HAD TWO WEEKS IN A ROW DURING THE LAST 12 MONTHS WHEN YOU LOST INTEREST
IN MOST THINGS LIKE HOBBIES, WORK, OR ACTIVITIES THAT USUALLY GIVE YOU PLEASURE, AND ALSO
HAD SOME OTHER FEELINGS OR PROBLEMS LIKE -
» READ UP TO THE FIRST 3 'YES' RESPONSES TO C170 - C177
^FLC170PROB
^FLC171PROB
^FLC172PROB
^FLC173PROB
^FLC175PROB
^FLC176PROB
^FLC177PROB
ABOUT HOW MANY WEEKS ALTOGETHER--OUT OF 52--DID YOU FEEL THIS WAY DURING THE LAST 12 MONTHS?)
WEEKS:
OR
MONTHS:
OR
ENTIRE YEAR:
1 Entire year
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If DEPRESSION EPISODE LASTED-WEEKS-CIDI != 52 and DEPRESSION EPISODE LASTED-MONTHS-CIDI != 12 and DEPRESSION EPISODE LASTED-ENTIRE YR-CIDI != 1 Entire year »
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OC182
REVIEW LOSS OF INTEREST- MOST RECENT MO
[F1]--HELP
THINK ABOUT THE MOST RECENT TIME WHEN YOU HAD TWO WEEKS IN A ROW WHEN YOU
FELT THIS WAY. IN WHAT MONTH WAS THIS (DURING THE LAST 12 MONTHS)?
MONTH:
1 Jan
2 Feb
3 Mar
4 Apr
5 May
6 Jun
7 Jul
8 Aug
9 Sep
10 Oct
11 Nov
12 Dec
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OC183
ASSIST SECTION C - HEALTH
» HOW OFTEN DID R RECEIVE ASSISTANCE WITH ANSWERS IN SECTION C - HEALTH?
1 Never
2 A few times
3 Most or all of the time
4 The section was done by a proxy reporter
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End of C. Physical Health
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