H1
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Because of a health problem, do you have difficulty walking several blocks? |
H2
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Because of a health problem, do you have difficulty running or jogging one kilometer? |
H3
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Because of a health problem, do you have difficulty walking one block? |
H4
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Because of a health problem, do you have difficulty staying seated for about 2 hours? |
H5
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Because of a health problem, do you have difficulty getting up from a chair after sitting for long periods? |
H6
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Because of a health problem, do you have difficulty climbing several flights of stairs without resting? |
H7
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Because of a health problem, do you have difficulty climbing one flight of stairs without resting? |
H8
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Because of a health problem, do you have difficulty stooping, kneeling, or crouching? |
H9
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Because of a health problem, do you have difficulty reaching or extending your arms above shoulder level? |
H10
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Because of a health problem, do you have difficulty pulling or pushing large objects like a living-room chair? |
H11
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Because of a health problem, do you have difficulty lifting or carrying objects that weigh more than 5 kg, like a heavy bag of groceries? |
H12
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Because of a health problem, do you have difficulty picking up a 1-peso coin from the table? |
H13
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Because of a health problem, do you have difficulty dressing, including putting on shoes and socks? |
H14
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Does anyone ever help you get dressed? |
H15a
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Because of a health problem, do you have any difficulty walking across a room? |
H15b
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Do you ever use equipment or devices such as a cane, walker or wheelchair to walk across a room? |
H15c
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What equipment do you use? |
H15d
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Does someone help you? |
H16a
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Because of a health problem, do you have difficulty bathing or showering? |
H16d
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Does someone help you? |
H17a
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Because of a health problem, do you have difficulty eating or cutting food? |
H17d
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Does someone help you? |
H18a
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Because of a health problem, do you have difficulty getting into or out of bed? |
H18b
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Do you ever use equipment or devices such as a cane, walker or wheelchair to get into or out of bed? |
H18c
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What equipment do you use? |
H18d
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Does someone help you? |
H19a
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Because of a health problem, do you have difficulty going to the bathroom? |
H19d
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Does someone help you? |
H21
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Please tell me who helps you the most with these activities. Enter name |
H22
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What relationship does (NAME OF PERSON WHO HELPS) have with this respondent? |
H23
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If the person is on any registration roster, enter the roster number. In previous month, how many days did (NAME) help you? |
H24
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If the person is on any registration roster, enter the roster number. In previous month, how many days did (NAME) help you? |
H25
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On those days that (NAME) helps you, about how many hours does he/she help you? |
H26a
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Because of a health problem, do you have difficulty preparing a hot meal? |
H26b
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Is this because of a health problem? |
H26c
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Does someone help you? |
H27a
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Because of a health problem, do you have difficulty shopping? |
H27b
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Is this because of a health problem? |
H27c
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Does someone help you? |
H28a
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Because of a health problem, do you have difficulty taking medicine? |
H28b
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Is this because of a health problem? |
H28c
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Does someone help you? |
H29a
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Because of a health problem, do you have difficulty managing money? |
H29b
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Is this because of a health problem? |
H29c
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Does someone help you? |
H31
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Enter name |
H32
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What relationship does (NAME OF PERSON WHO HELPS) have with this respondent? |
H33
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If the person is on any registration roster, enter the roster number. If child- in-law/grandchild, enter the registration number of the child to whom he/she is related. If person is not on any roster, enter 666. |
H34
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During the last month, about how many days did (NAME) help you? |
H35
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On those days that (NAME) helps you, about how many hours does he/she help you? |
H36
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INTERVIEWER: How frequently did the respondent need help to answer Section H. Functionality and Help? |