HA. Health Assessment

Module HA. Health Assessment of TILDA 2014

item label type description
HA001 Question READ OUT There are two parts to this survey. You have just helped us with the first part. We hope you will also help us with the second part, which is a visit to a health centre to collect more medical information and carry out some physical measurements. (IWER Inform respondent about the location of the health centre in Dublin) With your permission, I would like to make an appointment for you with the nurse at the health assessment centre
HA002 Question IWER: Phone health centre executive officer to arrange a visit to the health centre at a time and date that suits the respondent.
HA003 Question IWER: Record reason why respondent refused visit to health centre
HA004 Question Would you be happy for a nurse to visit your home to carry out a health assessment?
HA005 Question IWER: Phone health centre executive officer and inform her that a respondent has agreed to a HOME assessment. PLEASE CLEARLY INDICATE THAT THE RESPONDENT IS UNDECIDED.
HA006 Question IWER: Record reason why respondent refused visit by a nurse to the home.
HA007 Question With your permission, we would like to make an appointment for (Rname) with the nurse at the health assessment centre.
HA008 Question IWER: Phone health centre executive officer to arrange a visit to the health centre at a time and date that suits the proxy and TILDA respondent. (NOTE: proxy respondent must accompany TILDA respondent).
HA009 Question IWER: Record reason why proxy respondent refused visit to health centre
HA010 Question Would you be happy for a nurse to visit (Rname) home to carry out a health assessment?
HA011 Question IWER: Phone health centre executive officer and inform her that a proxy respondent has agreed to a TILDA participant having a home assessment.
HA012 Question IWER: Record reason why proxy respondent refused visit by a nurse to the TILDA participant's home.
HA013 Question Would you be happy for a nurse to visit (Rname) home to carry out a home health assessment?
HA014 Question IWER: Phone health centre executive officer and inform her that a proxy respondent has agreed to a TILDA participant having a home assessment. PLEASE CLEARLY INDICATE THAT THE RESPONDENT IS UNDECIDED.
HA015 Question IWER: Record reason why proxy respondent refused visit by a nurse to the TILDA participant's home.
Start of HA. Health Assessment
 
If HH005 = 1 »
 
   
 
HA001

READ OUT There are two parts to this survey. You have just helped us with the first part. We hope you will also help us with the second part, which is a visit to a health centre to collect more medical information and carry out some physical measurements. (IWER Inform respondent about the location of the health centre in Dublin) With your permission, I would like to make an appointment for you with the nurse at the health assessment centre

READ OUT THERE ARE TWO PARTS TO THIS SURVEY. YOU HAVE JUST HELPED US WITH THE FIRST PART. WE HOPE YOU WILL ALSO HELP US WITH THE SECOND PART, WHICH IS A VISIT TO A HEALTH CENTRE TO COLLECT MORE MEDICAL INFORMATION AND CARRY OUT SOME PHYSICAL MEASUREMENTS. (IWER INFORM RESPONDENT ABOUT THE LOCATION OF THE HEALTH CENTRE IN DUBLIN) WITH YOUR PERMISSION, I WOULD LIKE TO MAKE AN APPOINTMENT FOR YOU WITH THE NURSE AT THE HEALTH ASSESSMENT CENTRE
expand
   
 
If READ OUT There are two parts to this survey. You have just helped us with the first part. We hope you will also help us with the second part, which is a visit to a health centre to collect more medical information and carry out some physical measurements. (IWER Inform respondent about the location of the health centre in Dublin) With your permission, I would like to make an appointment for you with the nurse at the health assessment centre = 1 Yes to visit to health assessment centre 2 No to visit to health assessment centre 3 Undecided, nurse to phone to discuss health assessment in more detail or READ OUT There are two parts to this survey. You have just helped us with the first part. We hope you will also help us with the second part, which is a visit to a health centre to collect more medical information and carry out some physical measurements. (IWER Inform respondent about the location of the health centre in Dublin) With your permission, I would like to make an appointment for you with the nurse at the health assessment centre = 3 »
 
     
   
HA002

IWER: Phone health centre executive officer to arrange a visit to the health centre at a time and date that suits the respondent.

IWER: PHONE HEALTH CENTRE EXECUTIVE OFFICER TO ARRANGE A VISIT TO THE HEALTH CENTRE AT A TIME AND DATE THAT SUITS THE RESPONDENT.
expand
     
 
Else
 
     
   
HA003

IWER: Record reason why respondent refused visit to health centre

IWER: RECORD REASON WHY RESPONDENT REFUSED VISIT TO HEALTH CENTRE
expand
     
   
HA004

Would you be happy for a nurse to visit your home to carry out a health assessment?

WOULD YOU BE HAPPY FOR A NURSE TO VISIT YOUR HOME TO CARRY OUT A HEALTH ASSESSMENT?
expand
     
   
If Would you be happy for a nurse to visit your home to carry out a health assessment? != 2 »
 
       
     
HA006

IWER: Record reason why respondent refused visit by a nurse to the home.

IWER: RECORD REASON WHY RESPONDENT REFUSED VISIT BY A NURSE TO THE HOME.
expand
       
   
Else
 
       
     
HA005

IWER: Phone health centre executive officer and inform her that a respondent has agreed to a HOME assessment. PLEASE CLEARLY INDICATE THAT THE RESPONDENT IS UNDECIDED.

IWER: PHONE HEALTH CENTRE EXECUTIVE OFFICER AND INFORM HER THAT A RESPONDENT HAS AGREED TO A HOME ASSESSMENT. PLEASE CLEARLY INDICATE THAT THE RESPONDENT IS UNDECIDED.
expand
       
Else If W1 = 1 »
 
   
 
HA007

With your permission, we would like to make an appointment for (Rname) with the nurse at the health assessment centre.

WITH YOUR PERMISSION, WE WOULD LIKE TO MAKE AN APPOINTMENT FOR (RNAME) WITH THE NURSE AT THE HEALTH ASSESSMENT CENTRE.
expand
   
 
If With your permission, we would like to make an appointment for (Rname) with the nurse at the health assessment centre. != 2 »
 
     
   
HA009

IWER: Record reason why proxy respondent refused visit to health centre

IWER: RECORD REASON WHY PROXY RESPONDENT REFUSED VISIT TO HEALTH CENTRE
expand
     
   
HA010

Would you be happy for a nurse to visit (Rname) home to carry out a health assessment?

WOULD YOU BE HAPPY FOR A NURSE TO VISIT (RNAME) HOME TO CARRY OUT A HEALTH ASSESSMENT?
expand
     
   
If Would you be happy for a nurse to visit (Rname) home to carry out a health assessment? = 2 »
 
       
     
HA012

IWER: Record reason why proxy respondent refused visit by a nurse to the TILDA participant's home.

IWER: RECORD REASON WHY PROXY RESPONDENT REFUSED VISIT BY A NURSE TO THE TILDA PARTICIPANT'S HOME.
expand
       
   
Else
 
       
     
H011
       
 
Else
 
     
   
HA008

IWER: Phone health centre executive officer to arrange a visit to the health centre at a time and date that suits the proxy and TILDA respondent. (NOTE: proxy respondent must accompany TILDA respondent).

IWER: PHONE HEALTH CENTRE EXECUTIVE OFFICER TO ARRANGE A VISIT TO THE HEALTH CENTRE AT A TIME AND DATE THAT SUITS THE PROXY AND TILDA RESPONDENT. (NOTE: PROXY RESPONDENT MUST ACCOMPANY TILDA RESPONDENT).
expand
     
Else If W1 = 2 »
 
   
 
HA013

Would you be happy for a nurse to visit (Rname) home to carry out a home health assessment?

WOULD YOU BE HAPPY FOR A NURSE TO VISIT (RNAME) HOME TO CARRY OUT A HOME HEALTH ASSESSMENT?
expand
   
 
If Would you be happy for a nurse to visit (Rname) home to carry out a home health assessment? != 2 »
 
     
   
HA014

IWER: Phone health centre executive officer and inform her that a proxy respondent has agreed to a TILDA participant having a home assessment. PLEASE CLEARLY INDICATE THAT THE RESPONDENT IS UNDECIDED.

IWER: PHONE HEALTH CENTRE EXECUTIVE OFFICER AND INFORM HER THAT A PROXY RESPONDENT HAS AGREED TO A TILDA PARTICIPANT HAVING A HOME ASSESSMENT. PLEASE CLEARLY INDICATE THAT THE RESPONDENT IS UNDECIDED.
expand
     
 
Else
 
     
   
HA015

IWER: Record reason why proxy respondent refused visit by a nurse to the TILDA participant's home.

IWER: RECORD REASON WHY PROXY RESPONDENT REFUSED VISIT BY A NURSE TO THE TILDA PARTICIPANT'S HOME.
expand
     
End of HA. Health Assessment
Start of HA. Health Assessment

If HH005 = 1 »

|  ========================================================================
HA001
READ OUT There are two parts to this survey. You have just helped us with the first part. We hope you will also help us with the second part, which is a visit to a health centre to collect more medical information and carry out some physical measurements. (IWER Inform respondent about the location of the health centre in Dublin) With your permission, I would like to make an appointment for you with the nurse at the health assessment centre

READ OUT THERE ARE TWO PARTS TO THIS SURVEY. YOU HAVE JUST HELPED US WITH THE FIRST PART. WE HOPE YOU WILL ALSO HELP US WITH THE SECOND PART, WHICH IS A VISIT TO A HEALTH CENTRE TO COLLECT MORE MEDICAL INFORMATION AND CARRY OUT SOME PHYSICAL MEASUREMENTS. (IWER INFORM RESPONDENT ABOUT THE LOCATION OF THE HEALTH CENTRE IN DUBLIN) WITH YOUR PERMISSION, I WOULD LIKE TO MAKE AN APPOINTMENT FOR YOU WITH THE NURSE AT THE HEALTH ASSESSMENT CENTRE
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes to visit to health assessment centre
2 No to visit to health assessment centre
3 Undecided, nurse to phone to discuss health assessment in more detail


If READ OUT There are two parts to this survey. You have just helped us with the first part. We hope you will also help us with the second part, which is a visit to a health centre to collect more medical information and carry out some physical measurements. (IWER Inform respondent about the location of the health centre in Dublin) With your permission, I would like to make an appointment for you with the nurse at the health assessment centre (HA001) = 1 Yes to visit to health assessment centre 2 No to visit to health assessment centre 3 Undecided, nurse to phone to discuss health assessment in more detail or READ OUT There are two parts to this survey. You have just helped us with the first part. We hope you will also help us with the second part, which is a visit to a health centre to collect more medical information and carry out some physical measurements. (IWER Inform respondent about the location of the health centre in Dublin) With your permission, I would like to make an appointment for you with the nurse at the health assessment centre (HA001) = 3 »

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HA002
IWER: Phone health centre executive officer to arrange a visit to the health centre at a time and date that suits the respondent.

IWER: PHONE HEALTH CENTRE EXECUTIVE OFFICER TO ARRANGE A VISIT TO THE HEALTH CENTRE AT A TIME AND DATE THAT SUITS THE RESPONDENT.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Health assessment appointment arranged by you
2 Health assessment appointment to be arranged by executive officer on following day
3 Respondent to be phoned back by nurse to discuss health assessment further


Else

| |  ========================================================================
| | 
HA003
IWER: Record reason why respondent refused visit to health centre

IWER: RECORD REASON WHY RESPONDENT REFUSED VISIT TO HEALTH CENTRE
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Own doctor already has information
2 Given enough time already to this survey/expecting too much
3 Too busy, cannot spare the time
4 Had enough of medical tests/medical profession at present time
5 Worried about what nurse may find out/'might tempt fate'
6 Scared/of medical profession/ particular medical procedures (e.g. blood sample)
7 Not interested/Can't be bothered
8 Unable to attend due to mobility problems
9 Health assessment centre is too far away
95 Other reason (specify)


| |  ========================================================================
| | 
HA004
Would you be happy for a nurse to visit your home to carry out a health assessment?

WOULD YOU BE HAPPY FOR A NURSE TO VISIT YOUR HOME TO CARRY OUT A HEALTH ASSESSMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes to home health assessment
2 No to home health assessment
3 Undecided, nurse to phone to discuss health assessment in more detail


| |  If Would you be happy for a nurse to visit your home to carry out a health assessment? (HA004) != 2 »

| | |  ========================================================================
| | | 
HA006
IWER: Record reason why respondent refused visit by a nurse to the home.

IWER: RECORD REASON WHY RESPONDENT REFUSED VISIT BY A NURSE TO THE HOME.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Own doctor already has information
2 Given enough time already to this survey/expecting too much
3 Too busy, cannot spare the time
4 Had enough of medical tests/medical profession at present time
5 Worried about what nurse may find out/'might tempt fate'
6 Scared/of medical profession/ particular medical procedures
7 Not interested/Can't be bothered
8 Unable to attend due to mobility problems
95 Other reason (specify)


| |  Else

| | |  ========================================================================
| | | 
HA005
IWER: Phone health centre executive officer and inform her that a respondent has agreed to a HOME assessment. PLEASE CLEARLY INDICATE THAT THE RESPONDENT IS UNDECIDED.

IWER: PHONE HEALTH CENTRE EXECUTIVE OFFICER AND INFORM HER THAT A RESPONDENT HAS AGREED TO A HOME ASSESSMENT. PLEASE CLEARLY INDICATE THAT THE RESPONDENT IS UNDECIDED.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Spoke to executive officer about home assessment
2 Left a message for executive officer about home assessment
3 Respondent to be phoned back by nurse to discuss health assessment further


Else If W1 = 1 »

|  ========================================================================
HA007
With your permission, we would like to make an appointment for (Rname) with the nurse at the health assessment centre.

WITH YOUR PERMISSION, WE WOULD LIKE TO MAKE AN APPOINTMENT FOR (RNAME) WITH THE NURSE AT THE HEALTH ASSESSMENT CENTRE.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes to visit to health assessment centre
2 No to visit to health assessment centre
3 Undecided, nurse to phone to discuss health assessment in more detail


If With your permission, we would like to make an appointment for (Rname) with the nurse at the health assessment centre. (HA007) != 2 »

| |  ========================================================================
| | 
HA009
IWER: Record reason why proxy respondent refused visit to health centre

IWER: RECORD REASON WHY PROXY RESPONDENT REFUSED VISIT TO HEALTH CENTRE
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Own doctor already has information
2 Given enough time already to this survey/expecting too much
3 Too busy, cannot spare the time
4 Had enough of medical tests/medical profession at present time
5 Worried about what nurse may find out/'might tempt fate'
6 Scared/of medical profession/ particular medical procedures
7 Not interested/Can't be bothered
8 Unable to attend due to mobility problems
9 Health assessment centre is too far away
10 Proxy respondent does not think the TILDA participant is well enough
95 Other reason (specify)


| |  ========================================================================
| | 
HA010
Would you be happy for a nurse to visit (Rname) home to carry out a health assessment?

WOULD YOU BE HAPPY FOR A NURSE TO VISIT (RNAME) HOME TO CARRY OUT A HEALTH ASSESSMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes to home health assessment
2 No to home health assessment
3 Undecided, nurse to phone to discuss health assessment in more detail


| |  If Would you be happy for a nurse to visit (Rname) home to carry out a health assessment? (HA010) = 2 »

| | |  ========================================================================
| | | 
HA012
IWER: Record reason why proxy respondent refused visit by a nurse to the TILDA participant's home.

IWER: RECORD REASON WHY PROXY RESPONDENT REFUSED VISIT BY A NURSE TO THE TILDA PARTICIPANT'S HOME.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Own doctor already has information
2 Given enough time already to this survey/expecting too much
3 Too busy, cannot spare the time
4 Had enough of medical tests/medical profession at present time
5 Worried about what nurse may find out/'might tempt fate'
6 Scared/of medical profession/ particular medical procedures
7 Not interested/Can't be bothered/
8 Unable to attend due to mobility problems
9 Proxy respondent does not think the TILDA participant is well enough
95 Other reason (specify)


| |  Else

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| | | 
H011
H011

Else

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| | 
HA008
IWER: Phone health centre executive officer to arrange a visit to the health centre at a time and date that suits the proxy and TILDA respondent. (NOTE: proxy respondent must accompany TILDA respondent).

IWER: PHONE HEALTH CENTRE EXECUTIVE OFFICER TO ARRANGE A VISIT TO THE HEALTH CENTRE AT A TIME AND DATE THAT SUITS THE PROXY AND TILDA RESPONDENT. (NOTE: PROXY RESPONDENT MUST ACCOMPANY TILDA RESPONDENT).
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Health assessment appointment arranged by you
2 Health assessment appointment to be arranged by executive officer on following day
3 Respondent to be phoned back by nurse to discuss health assessment further


Else If W1 = 2 »

|  ========================================================================
HA013
Would you be happy for a nurse to visit (Rname) home to carry out a home health assessment?

WOULD YOU BE HAPPY FOR A NURSE TO VISIT (RNAME) HOME TO CARRY OUT A HOME HEALTH ASSESSMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes to home health assessment
2 No to home health assessment
3 Undecided, nurse to phone to discuss health assessment in more detail


If Would you be happy for a nurse to visit (Rname) home to carry out a home health assessment? (HA013) != 2 »

| |  ========================================================================
| | 
HA014
IWER: Phone health centre executive officer and inform her that a proxy respondent has agreed to a TILDA participant having a home assessment. PLEASE CLEARLY INDICATE THAT THE RESPONDENT IS UNDECIDED.

IWER: PHONE HEALTH CENTRE EXECUTIVE OFFICER AND INFORM HER THAT A PROXY RESPONDENT HAS AGREED TO A TILDA PARTICIPANT HAVING A HOME ASSESSMENT. PLEASE CLEARLY INDICATE THAT THE RESPONDENT IS UNDECIDED.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Spoke to executive officer about home assessment
2 Left a message for executive officer about home assessment
3 Respondent to be phoned back by nurse to discuss health assessment further


Else

| |  ========================================================================
| | 
HA015
IWER: Record reason why proxy respondent refused visit by a nurse to the TILDA participant's home.

IWER: RECORD REASON WHY PROXY RESPONDENT REFUSED VISIT BY A NURSE TO THE TILDA PARTICIPANT'S HOME.
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Own doctor already has information
2 Given enough time already to this survey/expecting too much
3 Too busy, cannot spare the time (if Code 2 does not apply)
4 Had enough of medical tests/medical profession at present time
5 Worried about what nurse may find out/'might tempt fate'
6 Scared/of medical profession/ particular medical procedures
7 Not interested/Can't be bothered
8 Unable to attend due to mobility problems
9 Proxy respondent does not think the TILDA participant is well enough


End of HA. Health Assessment