Disability and Quality of Life Module
| Questions and Risk Factor |
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2002 |
2003 |
2004 |
2005 |
2006 |
| Q1: Are you limited in any way in any activities because of physical, mental, or emotional problems? | ||||||
| Q2: Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone? | ||||||
| Q3: What is your major impairment or health problem? |
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| Q4: For how long have your activities been limited because of your major impairment or health problem? |
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| Q5: Because of any impairment or health problem, do you need the help of other persons with your personal care needs, such as eating, bathing, dressing, or getting around the house? |
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| Q6: Because of any impairment or health problem, do you need the help of other persons in handling your routine needs, such as everyday household chores, doing necessary business, shopping or getting around for other purposes? |
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| Q7: During the past 30 days, for about how many days did pain make it hard for you to do your usual activities? |
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| Q8: During the past 30 days, for about how many days have you felt sad, blue or depressed? |
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| Q9: During the past 30 days, for about how many days have you felt worried, tense or anxious? |
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| Q10: During the past 30 days, for about how many days have you felt you did not get enough rest or sleep? |
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| Q11: During the past 30 days, for about how many days have you felt very healthy and full of energy? |
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| R1: At risk for disability: Persons reporting being limited in any activities because of health problems | ||||||
| R2: At risk for pain limitation: Persons who report that pain limited their activities for one or more days out of the last 30 days |
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| R3: At risk for worried, tense or anxious: Persons who reported 14 or more days out of the last 30 days feeling worried tense our anxious. |
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| R4: At risk for sad, blue or depressed: Persons who reported 14 or more days out of the last 30 days feeling sad, blue or depressed. |
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