Conceptual Variable Group

Label
Physical/Functional Limitations
Conceptual Variables
Name Label
506 Does the condition involve asthma?
507 Does the condition involve breathing difficulties?
508 Has a doctor, nurse or other health care provider ever told you that you have or had: asthma, chronic bronchitis or emphysema?
519 Do you have a condition involving a heart problem?
802 Do you use a brace, cane, crutches, walker, medically prescribed shoes, wheelchair, or scooter because of a physical condition?
803 Do you use a brace for your hand, arm, leg, or foot because of a permanent physical condition?
804 Do you use an artificial hand, arm, leg, or foot?
805 By yourself and not using aids, do you have difficulty walking up 10 steps without resting?
806 How much difficulty do you have?
807 By yourself and not using aids, do you have difficulty walking one-quarter of a mile, or about three city blocks?
808 How much difficulty do you have walking one-quarter of a mile, or about three city blocks?
809 By yourself and not using aids, do you have difficulty standing for about 20 minutes?
810 How much difficulty do you have standing for about 20 minutes?
811 By yourself and not using aids, do you have difficulty reaching up over your head, or reaching out as if to shake someone's hand?
812 How much difficulty do you have reaching up over your head, or reaching out as if to shake someone's hand?
813 By yourself and not using aids, do you have difficulty using your fingers to grasp or handle something, for example, picking up a glass?
814 How much difficulty do you have using your fingers to grasp or handle something, for example, picking up a glass?
815 By yourself and not using aids, do you have difficulty holding a pen or pencil?
816 How much difficulty do you have holding a pen or pencil?
817 Do you need help from another person when eating?
818 Do you need help from another person when bathing?
819 Do you need help from another person when dressing?
820 Do you need help from another person when getting on or off the toilet?
821 Do you need help from another person when shopping?
822 Do you use special equipment in eating, dressing, or getting on or off the toilet?
823 Do you use special equipment in bathing?
824 Do you use special equipment in shopping?
825 Do you use a cane?
826 Do you use crutches or a walker?
827 Do you use medically prescribed shoes?
828 Do you use a manual wheelchair, a powered wheelchair, or a scooter?
829 Do you consider yourself to have a disability?
830 Do you think other people consider you to have a disability?
6191 Do you have difficulty using your hands, arms, legs, or feet because of a physical condition?
6192 Do you have difficulty using your hands, arms, legs, or feet because of a physical condition that has lasted for the past twelve months or more? Does that condition involve: a heart problem?
6193 Do you have difficulty using your hands, arms, legs, or feet because of a physical condition that has lasted for the past twelve months or more? Does that condition involve: asthma?
6194 Do you have difficulty using your hands, arms, legs, or feet because of a physical condition that has lasted for the past twelve months or more? Does that condition involve: other breathing difficulties?
6195 Do you have difficulty using your hands, arms, legs, or feet because of a physical condition that has lasted for the past twelve months or more? Does that condition involve: some other problem?
6196 Have you used a brace on your arms, hands, legs, or feet for the past twelve months or more?
6201 In the last month, how often did a health or emotional problem cause you to have trouble walking?
6202 In the last month, how often did a health or emotional problem cause you to have trouble running?
6203 In the last month, how often did a health or emotional problem cause you to have trouble bending or lifting?
6204 In the last month, how often did a health or emotional problem cause you to have trouble using your hands or fingers?
6525 Does {NAME} have difficulty using (his/her) hands or arms?
6526 Does (he/she) have difficulty using (his/her) feet or legs?
6529 Are (his/her) difficulties caused by a physical condition?
6530 Did the condition result from an accident, or from a disease, or was it present at birth?
6531 How old was {NAME} when this condition first occurred?
6532 What parts of the body are affected by this condition? entire right hand
6533 What parts of the body are affected by this condition? fingers of right hand
6534 What parts of the body are affected by this condition? entire left hand
6535 What parts of the body are affected by this condition? fingers of left hand
6536 What parts of the body are affected by this condition? upper right arm
6537 What parts of the body are affected by this condition? lower right arm
6538 What parts of the body are affected by this condition? upper left arm
6539 What parts of the body are affected by this condition? lower left arm
6540 What parts of the body are affected by this condition? entire right foot
6541 What parts of the body are affected by this condition? toes of right foot
6542 What parts of the body are affected by this condition? entire left foot
6543 What parts of the body are affected by this condition? toes of left foot
6544 What parts of the body are affected by this condition? upper right leg
6545 What parts of the body are affected by this condition? lower right leg
6546 What parts of the body are affected by this condition? upper left leg
6547 What parts of the body are affected by this condition? lower left leg
6548 What parts of the body are affected by this condition? Back
6549 What parts of the body are affected by this condition? Other
6550 Because of this condition, does {NAME} get help from another person in eating?
6551 Because of this condition, does {NAME} get help from another person in bathing?
6552 Because of this condition, does {NAME} get help from another person in dressing?
6553 Because of this condition, does {NAME} get help from another person in getting on or off the toilet?
6554 What special equipment must {NAME} use as a result of this condition? cane
6555 What special equipment must {NAME} use as a result of this condition? crutches/walker
6556 What special equipment must {NAME} use as a result of this condition? medically prescribed shoes
6557 What special equipment must {NAME} use as a result of this condition? manual wheelchair/powered wheelchair/scooter
6558 What special equipment must {NAME} use as a result of this condition? brace (arm, hand, foot, or leg)
6559 What special equipment must {NAME} use as a result of this condition? other
6560 What special equipment must {NAME} use as a result of this condition? none