I would now like to ask about any health conditions [you/(name)] may have that have lasted, or are likely to last, for six months or more.

Go to DIS_Q01

You told me that you [WS15DIS: have/have not] been told by a doctor or nurse that you have a health condition.

I would like to know about any health conditions you have now that have lasted, or are likely to last, for six months or more, even if a doctor or nurse has not told you about them.

Please include any conditions you have already told me about.

^

[Do/Does] [you/(name)] have any of these [conditions/health problems] (that have lasted, or are likely to last, for six months or more)?

Prompt Card 24 (more than one response is allowed):

Non-remote

1. Shortness of breath
2. Chronic or recurring pain
3. A nervous or emotional condition
4. Long term effects as a result of head injury, stoke or other brain damage
5. Any other long term condition that requires treatment or medication
6. Any other long term condition such as arthritis, asthma, heart disease, Alzheimer’s disease, dementia etc.
7. No, none of these

Remote

1. Trouble breathing that makes doing things hard
2. Pain that is always there or pain that keeps coming back in the same place that makes doing things hard
3. Fears or any emotional problems such as depression that makes doing things hard
4. Problems doing things now because of a knock to the head or a stroke
5. Any other long term health problem that means you have to see the doctor or take medicine
6. A long-term condition such as arthritis, asthma, heart disease, diabetes/sugar problems, kidney problems.
7. No, none of these

1 to 6 - Go to DIS_Q03

7 - Go to DIS_Q04

Do you have any of these conditions?

Green prompt card K1:

Non-remote

1. Shortness of breath, or difficulty breathing
2. Chronic or recurring pain
3. A nervous or emotional condition
4. Long term effects as a result of head injury, stoke or other brain damage
5. A long term condition that requires treatment or medication
6. Any other long term condition such as arthritis, asthma, heart disease, Alzheimer’s disease, dementia etc

Remote

1. Trouble breathing that makes doing things hard
2. Pain that is always there or pain that keeps coming back in the same place that makes doing things hard
3. Fears or any emotional problems such as depression that makes doing things hard
4. Problems doing things now because of a knock to the head or a stroke
5. Going to the (Doctor/Clinic) or taking any medicine for any other health problems
6. Any other long term condition such as arthritis, asthma, heart disease, Alzheimer’s disease, dementia, etc

1. Yes
5. No

1 - Go to Q03DIS

5 - Go to Q04DIS

^

Which ones?

Green prompt card K1

More than one response is allowed

[WS1DIS:

Non-remote

1. Shortness of breath, or difficulty breathing
2. Chronic or recurring pain
3. A nervous or emotional condition
4. Long term effects as a result of head injury, stoke or other brain damage
5. A long term condition that requires treatment or medication
6. Any other long term condition such as arthritis, asthma, heart disease, Alzheimer’s disease, dementia etc

Remote

1. Trouble breathing that makes doing things hard
2. Pain that is always there or pain that keeps coming back in the same place that makes doing things hard
3. Fears or any emotional problems such as depression that makes doing things hard
4. Problems doing things now because of a knock to the head or a stroke
5. Going to the (Doctor/Clinic) or taking any medicine for any other health problems
6. Any other long term condition such as arthritis, asthma, heart disease, Alzheimer’s disease, dementia, etc]

1 to 6 - Go to Q03ADIS

^

[Are/is] [you/he/she] restricted in everyday activities because of [this/these] [condition/conditions]?

[Insert conditions (1 to 6) identified at DIS_Q01]

1. Yes
5. No

1 - Go to DIS_Q03_SG

5 - Go to DIS_Q04

^

Are you restricted in everyday activities because of [WS2DIS: these /this] [WS3DIS: conditions/condition]?

1. Yes
5. No

1 - Go to SG3DIS

5 - Go to Q04DIS

1. If more than one condition reported in DIS_Q01
2. Otherwise (only one condition)

1 - Go to DIS_Q03A

2 - Go to DIS_Q04

1. If more than one condition reported in Q03DIS
2. Otherwise (only one condition selected)

1 - Go to Q03BDIS

2 - Go to Q04DIS

^

Which ones?

[Insert conditions (1 to 6) identified at DIS_Q01]

All - Go to DIS_Q04

Which ones?

More than one response is allowed.

[Insert conditions (1-6) identified at Q03DIS]

All - Go to Q04DIS

^

I would now like to ask about any other conditions [you/(name)] may have that have lasted, or are likely to last, for six months or more.

[Do/Does] [you/he/she] have any of these conditions?

Which ones?

Prompt Card 24

More than one response is allowed:

Non-Remote

10. Sight problems not corrected by glasses or contact lenses
11. Hearing problems
12. Speech problems
13. Blackouts, fits or loss of consciousness
14. Difficulty learning or understanding things
15. Limited use of arms or fingers
16. Difficulty gripping things
17. Limited use of legs or feet
18. Any condition that restricts physical activity or physical work (e.g. back problems, migraines)
19. Any disfigurement or deformity
20. Any mental illness for which help or supervision is required
21. No, none of these

Remote

10. Problems with sight or seeing things
11. Can’t hear/Any problems hearing
12. Can’t speak/ Any problems speaking
13. Blackouts, fits or loss of consciousness
14. Problems learning or understanding things because of any conditions
15. Problems using your arms or fingers
16. Problems holding things or picking things up
17. Problems using your legs or feet
18. Any condition such as back problems or bad headaches, that stops you being able to do any physical activity or work
19. Any scars, loss of limbs or other conditions that affect your appearance
20. Any mental illness for which help or supervision is required
21. No, none of these

All - Go to DIS_Q05_SG

^

I would now like to ask about any other conditions you may have that are likely to last or have lasted, for six months or more.

Do you have any of these conditions?

Green Prompt Card K2:

Non-Remote

10. Sight problems not corrected by glasses or contact lenses
11. Hearing problems
12. Speech problems
13. Blackouts, fits or loss of consciousness
14. Difficulty learning or understanding things
15. Limited use of arms or fingers
16. Difficulty gripping things
17. Limited use of legs or feet
18. A condition that restricts physical activity or physical work (e.g. back problems, migraines)
19. A disfigurement or deformity
20. A mental illness for which help or supervision is required

Remote

10. Problems with sight or seeing things
11. Any problems hearing
12. Any problems speaking
13. Blackouts or fits
14. Problems learning or understanding things because of any conditions
15. Problems using your arms or fingers
16. Problems holding things or picking things up
17. Problems using your legs or feet
18. Any condition such as back problems or bad headaches, that stops you being able to do any physical activity or work
19. Any scars, loss of limbs or other conditions that affect your appearance
20. A mental illness for which help is required

1. Yes
5. No

1 - Go to Q05DIS

5 - Go to SG1DIS

1. If DIS_Q03A = 1 to 6 or DIS_Q04 = 10 to 20
2. Otherwise

1 - Go to DIS_Q06

2 - Go to DIS_Q06_SG

^

1. IF Q02DIS = 5 or Q03ADIS = 5
2. ELSE

1 - End of module

2 - Go to Q25DIS

[Is this health conditions/Are any of these health conditions] a result of an accident or injury?

1. Yes
5. No
6. Don’t know

All - Go to DIS_Q06_SG

^

Which ones?

Green Prompt Card K2

More than one response is allowed

[WS4DIS:

Non-Remote

10. Sight problems not corrected by glasses or contact lenses
11. Hearing problems
12. Speech problems
13. Blackouts, fits or loss of consciousness
14. Difficulty learning or understanding things
15. Limited use of arms or fingers
16. Difficulty gripping things
17. Limited use of legs or feet
18. A condition that restricts physical activity or physical work (e.g. back problems, migraines)
19. A disfigurement or deformity
20. A mental illness for which help or supervision is required

Remote

10. Problems with sight or seeing things
11. Any problems hearing
12. Any problems speaking
13. Blackouts or fits
14. Problems learning or understanding things because of any conditions
15. Problems using your arms or fingers
16. Problems holding things or picking things up
17. Problems using your legs or feet
18. Any condition such as back problems or bad headaches, that stops you being able to do any physical activity or work
19. Any scars, loss of limbs or other conditions that affect your appearance
20. A mental illness for which help is required]

All - Go to Q25DIS

^

No restrictive conditions

1. If DIS_Q03 = 5 and DIS_Q04 = 21
Multiple restrictive conditions

2. If DIS_Q03A has more than one response
3. If DIS_Q04 has more than one response
4. If DIS_Q03A = one response from 1 to 6 and DIS_Q04 = one response from 10 to 20

One restrictive condition only

5. If DIS_Q03A = one response from 1 to 6 and DIS_Q04 = 21
6. If DIS_Q01 = 7 and DIS_Q04 = one response from 10 to 20

1 - End of module

2 to 4 - Go to DIS_Q07

5 or 6 - Go to DIS_Q08

^

You told me that [you/(name)] [have/has] [these conditions].

Which one of these health conditions causes [you/him/her] the most problems?

(List conditions reported in DIS_Q03A and DIS_Q04)

All - Go to DIS_Q08

I now have some questions about times that [you/(name)] may need somebody to help or look after [you/him/her] because of the condition(s) you have told me about.

Non-Remote

[Do/Does] [you/(name)] ever need help or supervision with any of these tasks?

Remote

[Do/Does] [you/(name)] ever need somebody to help or look after [you/him/her] when [you/he/she] [do/does] any of these things?

Prompt card 26:

Non-Remote and Remote

Personal needs

For example:

Bathing or showering

Dressing and/or undressing

Eating and/or feeding

Going to toilet

Bladder/bowel control

Moving around

For example:

Moving around away from home

Moving around at home

Getting in or out of a bed or chair

Talking with people

For example:

Understanding and/or being understood by friends or family, strangers (including use of sign language/lip reading)

1. Yes
5. No

1 - Go to DIS_Q09

5 - Go to DIS_Q10

I now have some questions about times that you may need somebody to help or look after you because of the condition(s) you have told me about.

[WS5DIS

Non-Remote

Do you ever need help or supervision with any of these tasks?

Remote

Do you ever need somebody to help or look after you with any of these tasks?]

Green Prompt Card K3:

Non-Remote and Remote

Personal needs

For example:

Bathing or showering

Dressing and/or undressing

Eating and/or feeding

Going to toilet

Bladder/bowel control

Moving around

For example:

Moving around away from home

Moving around at home

Getting in or out of a bed or chair

Talking with people

For example:

Understanding and/or being understood by friends or family, strangers (including use of sign language/lip reading)

1. Yes
5. No

1 - Go to Q26DIS

5 - Go to Q27DIS

^

[Do/does] [you/(name)] always need help with any of these tasks?

Show prompt card 26

1. Yes
5. No

1 - Go to DIS_Q11_SG

5 - Go to DIS_Q10

[WS7DIS

Non-Remote

Do you always need help with any of these tasks?

Remote

Do you always need help doing any of these things?]

Show Green Prompt card K3

1. Yes
5. No

1 - Go to SG2DIS

5 - Go to Q27DIS

^

[Do/Does] [you/(name)] ever have difficulty with any of these tasks?

Show prompt card 26

1. Yes
5. No

All - Go to DIS_Q11_SG

^

[WS6DIS, WS7DIS, WS8DIS:

Non-Remote

Because of the condition/conditions you have told me about, do you ever have difficulty with any of these tasks?

Remote

Because of the condition/conditions you have told me about, do you ever have problems doing any of these things?]

Show Green prompt card K3

1. Yes
5. No

1 - Go to SG2DIS

5 - Go to Q28DIS

^

1. If Non-Remote and aged 5 years or over
2. If Remote and aged 5 years or over
3. Otherwise

1 - DIS_Q11

2 - DIS_Q13_SG

3 - End of module

Even though (you/(name)] can do these self-care, mobility and communication tasks without difficulty [do/does] [you/he/she] use any aids to assist with these tasks?

1. Yes
5. No

All - DIS_Q12

[WS9DIS, WS10DIS,WS11DIS:

Non-remote

Even though you can do these self-care, mobility and communication tasks without difficulty do you use any aids to assist with these tasks?

Remote

Even though you can do these things without problems do you use anything to help you do them? (Examples might include a walking stick, wheelchair, hearing aid, or a ramp)]

Show Green prompt card K3

1. Yes
5. No

All - Q29DIS

^

Can [you/he/she]:

(Read each response, more than one response is allowed)

1. Easily walk 200 metres
2. Walk up and down stairs without a handrail
3. Easily bend to pick up an object from the floor
4. Use public transport without difficulty, help or supervision
5. None of the above

All - DIS_Q13_SG

Can you:

(Read each response, more than one response is allowed)

[WS12DIS:

Non-remote

1. Easily walk 200 metres
2. Walk up and down stairs without a handrail
3. Easily bend to pick up an object from the floor
4. Use public transport without difficulty, help or supervision
5. None of the above (do not read out)

Remote

1. Easily walk 200 metres
2. Walk up and down stairs without a handrail
3. Easily bend to pick up an object from the floor
5. None of the above (do not read out)]

All - SG2DIS

^

1. If the respondent is aged 5 to 14 years or aged 15 years or over and currently studying
2. Otherwise

1 - DIS_Q14

2 - DIS_Q15_SG

1. If age >64
2. Else

1 - SGENDDIS

2 - Q36DIS

Is [your/(name’s) schooling/study affected (because of the conditions you told me about), in any of the following ways?

More than one response is allowed

1. Not attending school/further study due to condition
2. Need time off school/study
3. Attend special classes/school
4. Other related difficulties
5. None of the above

All - DIS_Q15_SG

^

[WS6DIS, WS13DIS:

Non-remote

Because of the condition/s you have told me about, do you have any difficulties with education such as these?

Remote

Because of the condition/s you have told me about, do you have any problems with schooling such as these?]

Prompt card K4

1. Not attending school/further study due to condition
2. Need time off school/study
3. Attend special classes/school
4. Other related difficulties

1. Yes
5. No

All - Q37DIS

^

1. If respondent is aged 0 to 14 years or aged 65 years and over
2. Otherwise

1 - End of module

2 - DIS_Q16

Because of the [condition/conditions] you have told me about, [do/does] [you/(name)] have any difficulties with employment such as these?

Prompt card 28:

(more than one response is allowed)

1. Can’t do some types of jobs
2. Have to lower the number of hours worked
3. Can’t find suitable work
4. Need time off work
5. Not able to work at all
6. No difficulties
7. Not currently working

END OF MODULE

[WS6DIS, WS14DIS:

Non-remote

Because of the condition/s you have told me about, do you have any difficulties with employment such as these?

Remote

Because of the condition/s you have told me about, do you have any problems with work such as these?]

Prompt card K5:

1. Type of job you can do
2. Number of hours you can work
3. Finding suitable work
4. Needing time off work
5. Permanently unable to work due of condition

1. Yes
5. No

END OF MODULE