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ID
41594
Descripción
The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS) is a public data repository which contains information on the physical and mental health and wellbeing of older persons and informal caregivers across the Netherlands. The database was developed in part to ensure uniform collection of outcomes measures, thus promoting comparability between studies. To date, 53 different research projects have contributed data to this initiative, resulting in a pooled dataset >44,000 older persons and >9,000 informal caregivers. Early 2021, the database will be updated with new data, specifically from older persons with dementia and their informal caregivers. More information can be found at https://topics-mds.eu This form contains the English and Dutch version of TOPICS-MDS 2017 questionnaire for the care receiver for the Baseline and Follow-up measurement. For follow-up, please note that for each follow-up measurement separately, all questions containing ‘12 months’ / ‘12 maanden’, the 12 needs to be replaced by the actual follow-up period. For example, when follow-up takes place after 3 months, the 12 is replaced by ‘3’. Additionally some questions are not needed for follow-up: From "Personal Information" only the marital status is needed. From "Health and Disease" the questions about the diseases are optional. They are recommended, if you want to use the frailty index. English Instructions for the participant (Dutch version below): Your experiences as a care receiver are valuable. You receive care. This list contains questions about what this care means for you as a care receiver. Your answers will be used in research to improve care for the elderly. The more information there is about care for elderly people, the more this can be taken into consideration. For example, when changing the facilities, regulations or legislation for care and wellbeing. Therefore, your experiences are also valuable for other elderly people. Instructions for this questionnaire: - Completing this questionnaire will take approximately half an hour. - Read each question through completely before selecting an answer. - If you find it difficult to understand or answer the questions, ask your partner, a family member or a friend to help you. - Some questions may appear to be ‘repeated’, but please answer all questions. They are intended to view your situation again from a different angle. - When you are done, please check that you have not forgotten any questions. Nederlandse aanwijzingen: Uw ervaringen als zorgvrager zijn waardevol. In deze lijst staan vragen over uw lichamelijke en geestelijke gezondheid, kwaliteit van leven en zorggebruik. Uw antwoorden worden gebruikt in onderzoek naar verbetering van de zorg voor ouderen. Want hoe meer er bekend is over wat ouderen zelf vinden, hoe beter er rekening mee gehouden kan worden. Bijvoorbeeld bij het veranderen van voorzieningen, regelingen of wetten voor zorg en welzijn. Uw ervaringen zijn dus waardevol, ook voor andere ouderen. Aanwijzingen bij deze vragenlijst: Het invullen van de vragenlijst kost u ongeveer een half uur. Lees elke vraag eerst helemaal door voordat u een antwoord geeft. Als u het moeilijk vindt om de vragen te begrijpen of in te vullen, vraag dan hulp aan uw partner, een familielid of vriendof vriendin. Sommige vragen lijken ‘dubbel’, maar we verzoeken u ze toch in te vullen. Ze zijn bedoeld om uw situatie nog eens van een andere kant te bekijken. Bent u klaar? Kijk dan of u geen vragen vergeten bent.
Link
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Versiones (5)
- 12/5/20 12/5/20 -
- 19/11/20 19/11/20 -
- 30/1/21 30/1/21 -
- 11/2/21 11/2/21 - Sarah Riepenhausen
- 27/9/21 27/9/21 -
Titular de derechos de autor
Radboud University Medical Center, Department of Geriatric Medicine
Subido en
19 de noviembre de 2020
DOI
Para solicitar uno, por favor iniciar sesión.
Licencia
Creative Commons BY-NC 4.0
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TOPICS-MDS
TOPICS-MDS Care Receiver Baseline + Follow-up (Zorgvrager Basismeting + Vervolgmeting)
Similar models
TOPICS-MDS Care Receiver Baseline + Follow-up (Zorgvrager Basismeting + Vervolgmeting)
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Distinction if this form is filled in at baseline or follow-up.
C1522577 (UMLS CUI-1)
C1442488 (UMLS CUI-2)
C1442488 (UMLS CUI-2)
Item
Please tick, if you fill in this form at baseline or follow-up.
integer
C1522577 (UMLS CUI [1,1])
C1442488 (UMLS CUI [1,2])
C1442488 (UMLS CUI [1,2])
CL Item
Baseline (1)
CL Item
Follow-up (2)
Assessment date
Item
Date of filling in the questionnaire
date
C2985720 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
Postal code
Item
Postal code (four numbers)
integer
C0421454 (UMLS CUI [1])
CL Item
The Netherlands (1)
CL Item
Another country (2)
Other country of origin
Item
If you ticked "Another country", in which country were you born?
text
C0205394 (UMLS CUI [1,1])
C1300001 (UMLS CUI [1,2])
C1300001 (UMLS CUI [1,2])
Item
In which country was your father born?
integer
C1300001 (UMLS CUI [1,1])
C0015671 (UMLS CUI [1,2])
C0015671 (UMLS CUI [1,2])
CL Item
The Netherlands (1)
CL Item
Another country (2)
Other father's country of origin
Item
If you ticked "Another country", in which country was your father born?
text
C0205394 (UMLS CUI [1,1])
C0015671 (UMLS CUI [1,2])
C1300001 (UMLS CUI [1,3])
C0015671 (UMLS CUI [1,2])
C1300001 (UMLS CUI [1,3])
Item
In which country was your mother born?
integer
C1300001 (UMLS CUI [1,1])
C0026591 (UMLS CUI [1,2])
C0026591 (UMLS CUI [1,2])
CL Item
The Netherlands (1)
CL Item
Another country (2)
Other mother's country of origin
Item
If you ticked "Another country", in which country was your mother born?
text
C0205394 (UMLS CUI [1,1])
C1300001 (UMLS CUI [1,2])
C0026591 (UMLS CUI [1,3])
C1300001 (UMLS CUI [1,2])
C0026591 (UMLS CUI [1,3])
Item
What is the highest level of education that you have completed?
integer
C4264309 (UMLS CUI [1])
CL Item
Fewer than 6 classes of primary school (1)
(Comment:nl)
CL Item
6 Primary school classes / lom-school / mlk-school (2)
(Comment:nl)
CL Item
More than primary school / primary school with uncompleted further (3)
(Comment:nl)
CL Item
(Pre-)vocational secondary education (Ambachtsschool, vmbo) (4)
(Comment:nl)
CL Item
Secondary vocational education (Mulo / mms / mavo / mbo) (5)
(Comment:nl)
CL Item
University entrance level (Hbs / gymnasium / atheneum) (6)
(Comment:nl)
CL Item
University / tertiary education / higher professional education (hbo) (7)
(Comment:nl)
CL Item
Married (1)
CL Item
Unmarried, no partner (2)
CL Item
Long-term cohabitation, unmarried (3)
CL Item
Divorced (4)
CL Item
Widow / widower / partner deceased (5)
Children
Item
Do you have children?
boolean
C0008059 (UMLS CUI [1])
CL Item
Independent, alone (1)
CL Item
Independent, with others (partner, children, etc.) (2)
CL Item
Care facility (nursing home / residential care centre) (3)
CL Item
Another (4)
Other Living situation
Item
If you ticked "Another", please specify:
text
C0205394 (UMLS CUI [1,1])
C2184149 (UMLS CUI [1,2])
C2184149 (UMLS CUI [1,2])
Health in general
Item
On a scale of 0 to 10: how do you rate your health in general TODAY? 0 indicates ‘completely unhealthy’ and 10 ‘completely healthy’.
integer
C0424575 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
C0750526 (UMLS CUI [1,3])
C0449438 (UMLS CUI [1,2])
C0750526 (UMLS CUI [1,3])
Item
Please tick the one box that best describes your health TODAY. Mobility:
integer
C0547136 (UMLS CUI [1,1])
C0750526 (UMLS CUI [1,2])
C0750526 (UMLS CUI [1,2])
CL Item
I have no problems washing or dressing myself (1)
CL Item
I have slight problems washing or dressing myself (2)
CL Item
I have moderate problems washing or dressing myself (3)
CL Item
I have severe problems washing or dressing myself (4)
CL Item
I am unable to wash or dress myself (5)
Item
Please tick the one box that best describes your health TODAY. Self-care:
integer
C0750526 (UMLS CUI [1,1])
C0474417 (UMLS CUI [1,2])
C0474417 (UMLS CUI [1,2])
CL Item
I have no problems washing or dressing myself (1)
CL Item
I have slight problems washing or dressing myself (2)
CL Item
I have moderate problems washing or dressing myself (3)
CL Item
I have severe problems washing or dressing myself (4)
CL Item
I am unable to wash or dress myself (5)
Item
Please tick the one box that best describes your health TODAY. Usual activities (e.g. work, study, housework, family or leisure activities):
integer
C0001288 (UMLS CUI [1,1])
C0750526 (UMLS CUI [1,2])
C0750526 (UMLS CUI [1,2])
Code List
Please tick the one box that best describes your health TODAY. Usual activities (e.g. work, study, housework, family or leisure activities):
CL Item
I have no problems doing my usual activities (1)
CL Item
I have slight problems doing my usual activities (2)
CL Item
I have moderate problems doing my usual activities (3)
CL Item
I have severe problems doing my usual activities (4)
CL Item
I am unable to do my usual activities (5)
Item
Please tick the one box that best describes your health TODAY. Pain / discomfort:
integer
C0030193 (UMLS CUI [1,1])
C0750526 (UMLS CUI [1,2])
C2364135 (UMLS CUI [2,1])
C0750526 (UMLS CUI [2,2])
C0750526 (UMLS CUI [1,2])
C2364135 (UMLS CUI [2,1])
C0750526 (UMLS CUI [2,2])
Code List
Please tick the one box that best describes your health TODAY. Pain / discomfort:
CL Item
I have no pain or discomfort (1)
CL Item
I have slight pain or discomfort (2)
CL Item
I have moderate pain or discomfort (3)
CL Item
I have severe pain or discomfort (4)
CL Item
I have extreme pain or discomfort (5)
Item
Please tick the one box that best describes your health TODAY. Anxiety / depression:
integer
C0003467 (UMLS CUI [1,1])
C0750526 (UMLS CUI [1,2])
C0011581 (UMLS CUI [2,1])
C0750526 (UMLS CUI [2,2])
C0750526 (UMLS CUI [1,2])
C0011581 (UMLS CUI [2,1])
C0750526 (UMLS CUI [2,2])
Code List
Please tick the one box that best describes your health TODAY. Anxiety / depression:
CL Item
I am not anxious or depressed (1)
CL Item
I am slightly anxious or depressed (2)
CL Item
I am moderately anxious or depressed (3)
CL Item
I am severely anxious or depressed (4)
CL Item
I am extremely anxious or depressed (5)
Item
Do you have complaints about your memory?
integer
C0233794 (UMLS CUI [1,1])
C1254481 (UMLS CUI [1,2])
C1254481 (UMLS CUI [1,2])
CL Item
No (1)
CL Item
Yes (2)
Item
Did you consult a doctor about your memory problems?
integer
C0233794 (UMLS CUI [1,1])
C3826021 (UMLS CUI [1,2])
C3826021 (UMLS CUI [1,2])
CL Item
No (1)
CL Item
Yes (2)
Item
Did you fall in the past 12 months?
integer
C0085639 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Diabetes:
integer
C0011849 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Diabetes:
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Stroke, cerebral haemorrhage (bleed in the brain), cerebral infarction (blocked bloodvessel in the brain) or TIA:
integer
C0038454 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C0007787 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C0007785 (UMLS CUI [3,1])
C3887293 (UMLS CUI [3,2])
C2937358 (UMLS CUI [4,1])
C3887293 (UMLS CUI [4,2])
C3887293 (UMLS CUI [1,2])
C0007787 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C0007785 (UMLS CUI [3,1])
C3887293 (UMLS CUI [3,2])
C2937358 (UMLS CUI [4,1])
C3887293 (UMLS CUI [4,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Stroke, cerebral haemorrhage (bleed in the brain), cerebral infarction (blocked bloodvessel in the brain) or TIA:
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Heart failure, myocardial infarction (heart attack) or other heart condition:
integer
C0018801 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C0027051 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C0205394 (UMLS CUI [3,1])
C3842523 (UMLS CUI [3,2])
C3887293 (UMLS CUI [3,3])
C3887293 (UMLS CUI [1,2])
C0027051 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C0205394 (UMLS CUI [3,1])
C3842523 (UMLS CUI [3,2])
C3887293 (UMLS CUI [3,3])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Heart failure, myocardial infarction (heart attack) or other heart condition:
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. A type of cancer (malignant disease):
integer
C0006826 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. A type of cancer (malignant disease):
CL Item
No (1)
CL Item
Yes (2)
Cancer type within past year
Item
Please specify the type of cancer you have have or have had:
text
C0006826 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
C0332307 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Asthma, chronic bronchitis, pulmonary emphysema or COPD:
integer
C0004096 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C0008677 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C0034067 (UMLS CUI [3,1])
C3887293 (UMLS CUI [3,2])
C0024117 (UMLS CUI [4,1])
C3887293 (UMLS CUI [4,2])
C3887293 (UMLS CUI [1,2])
C0008677 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C0034067 (UMLS CUI [3,1])
C3887293 (UMLS CUI [3,2])
C0024117 (UMLS CUI [4,1])
C3887293 (UMLS CUI [4,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Asthma, chronic bronchitis, pulmonary emphysema or COPD:
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Involuntary urinary loss (incontinence):
integer
C0021167 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Involuntary urinary loss (incontinence):
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Wearing of the joints (arthrosis, osteoarthritis / degenerative arthritis):
integer
C0029408 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Wearing of the joints (arthrosis, osteoarthritis / degenerative arthritis):
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Chronic joint inflammation (arthritis):
integer
C0003864 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Chronic joint inflammation (arthritis):
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Loss of bone tissue (osteoporosis):
integer
C0029456 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Loss of bone tissue (osteoporosis):
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Hip fracture or other bone fractures:
integer
C0019557 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C0205394 (UMLS CUI [2,1])
C0016658 (UMLS CUI [2,2])
C3887293 (UMLS CUI [2,3])
C3887293 (UMLS CUI [1,2])
C0205394 (UMLS CUI [2,1])
C0016658 (UMLS CUI [2,2])
C3887293 (UMLS CUI [2,3])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Hip fracture or other bone fractures:
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Dizziness:
integer
C0012833 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Dizziness:
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Neurological disease (Parkinson’s disease, multiple sclerosis, epilepsy):
integer
C0027765 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C0030567 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C0026769 (UMLS CUI [3,1])
C3887293 (UMLS CUI [3,2])
C0014544 (UMLS CUI [4,1])
C3887293 (UMLS CUI [4,2])
C3887293 (UMLS CUI [1,2])
C0030567 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C0026769 (UMLS CUI [3,1])
C3887293 (UMLS CUI [3,2])
C0014544 (UMLS CUI [4,1])
C3887293 (UMLS CUI [4,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Neurological disease (Parkinson’s disease, multiple sclerosis, epilepsy):
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Depression:
integer
C0011581 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Depression:
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Anxiety / panic disorder:
integer
C0003467 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C0030319 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C3887293 (UMLS CUI [1,2])
C0030319 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Anxiety / panic disorder:
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Dementia:
integer
C0497327 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Dementia:
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Hearing problems (despite hearing aid):
integer
C0521116 (UMLS CUI [1,1])
C3898940 (UMLS CUI [1,2])
C3641650 (UMLS CUI [1,3])
C0542459 (UMLS CUI [1,4])
C3898940 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C3641650 (UMLS CUI [2,3])
C0542459 (UMLS CUI [2,4])
C3898940 (UMLS CUI [1,2])
C3641650 (UMLS CUI [1,3])
C0542459 (UMLS CUI [1,4])
C3898940 (UMLS CUI [2,1])
C3887293 (UMLS CUI [2,2])
C3641650 (UMLS CUI [2,3])
C0542459 (UMLS CUI [2,4])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Hearing problems (despite hearing aid):
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Problems with vision (despite glasses / contact lenses):
integer
C3665347 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3641650 (UMLS CUI [1,3])
C3843284 (UMLS CUI [1,4])
C3887293 (UMLS CUI [1,2])
C3641650 (UMLS CUI [1,3])
C3843284 (UMLS CUI [1,4])
Code List
The following questions are about the diseases and conditions that you have or have had. Do you have or have you had one or more of the following diseases and conditions in the past 12 months? Tick “yes”or “no” for all diseases and conditions mentioned. Problems with vision (despite glasses / contact lenses):
CL Item
No (1)
CL Item
Yes (2)
Item Group
Tasks and activities of daily life
C0001288 (UMLS CUI-1)
Item
The following questions refer to daily activities which should be performed frequently, such as walking a flight of stairs or cooking. In each question it is asked whether you are able to perform the activity at this moment. It is not intended to assess whether you are actually performing the activities, but if you can do them if necessary. Can you, fully independently, dress yourself?
integer
C0429966 (UMLS CUI [1])
Code List
The following questions refer to daily activities which should be performed frequently, such as walking a flight of stairs or cooking. In each question it is asked whether you are able to perform the activity at this moment. It is not intended to assess whether you are actually performing the activities, but if you can do them if necessary. Can you, fully independently, dress yourself?
CL Item
Yes, I can do it fully independently without any difficulty (1)
CL Item
Yes, I can do it fully independently but with some difficulty (2)
CL Item
Yes, I can do it fully independently but with great difficulty (3)
CL Item
No, I cannot do it fully independently, I can only do it with someone's help (4)
Item
Can you, fully independently, stand up from sitting in a chair?
integer
C0560792 (UMLS CUI [1,1])
C1299583 (UMLS CUI [1,2])
C1299583 (UMLS CUI [1,2])
CL Item
Yes, I can do it fully independently without any difficulty (1)
CL Item
Yes, I can do it fully independently but with some difficulty (2)
CL Item
Yes, I can do it fully independently but with great difficulty (3)
CL Item
No, I cannot do it fully independently, I can only do it with someone's help (4)
Item
Can you, fully independently, wash and dry your whole body?
integer
C4055522 (UMLS CUI [1,1])
C1299583 (UMLS CUI [1,2])
C1299583 (UMLS CUI [1,2])
CL Item
Yes, I can do it fully independently without any difficulty (1)
CL Item
Yes, I can do it fully independently but with some difficulty (2)
CL Item
Yes, I can do it fully independently but with great difficulty (3)
CL Item
No, I cannot do it fully independently, I can only do it with someone's help (4)
Item
Can you, fully independently, go up and down the stairs?
integer
C0560077 (UMLS CUI [1,1])
C1299583 (UMLS CUI [1,2])
C0560081 (UMLS CUI [2,1])
C1299583 (UMLS CUI [2,2])
C1299583 (UMLS CUI [1,2])
C0560081 (UMLS CUI [2,1])
C1299583 (UMLS CUI [2,2])
CL Item
Yes, I can do it fully independently without any difficulty (1)
CL Item
Yes, I can do it fully independently but with some difficulty (2)
CL Item
Yes, I can do it fully independently but with great difficulty (3)
CL Item
No, I cannot do it fully independently, I can only do it with someone's help (4)
Item
Can you, fully independently, walk outdoors (if necessary with a cane or wheel rollator)?
integer
C4722228 (UMLS CUI [1,1])
C4283770 (UMLS CUI [1,2])
C1299583 (UMLS CUI [1,3])
C0750377 (UMLS CUI [2,1])
C4283770 (UMLS CUI [2,2])
C1299583 (UMLS CUI [2,3])
C1524063 (UMLS CUI [3,1])
C0184339 (UMLS CUI [3,2])
C4283770 (UMLS CUI [3,3])
C1299583 (UMLS CUI [3,4])
C4283770 (UMLS CUI [1,2])
C1299583 (UMLS CUI [1,3])
C0750377 (UMLS CUI [2,1])
C4283770 (UMLS CUI [2,2])
C1299583 (UMLS CUI [2,3])
C1524063 (UMLS CUI [3,1])
C0184339 (UMLS CUI [3,2])
C4283770 (UMLS CUI [3,3])
C1299583 (UMLS CUI [3,4])
Code List
Can you, fully independently, walk outdoors (if necessary with a cane or wheel rollator)?
CL Item
Yes, I can do it fully independently without any difficulty (1)
CL Item
Yes, I can do it fully independently but with some difficulty (2)
CL Item
Yes, I can do it fully independently but with great difficulty (3)
CL Item
No, I cannot do it fully independently, I can only do it with someone's help (4)
Item
Can you, fully independently, take care of your feet and toenails?
integer
C3873451 (UMLS CUI [1,1])
C1299583 (UMLS CUI [1,2])
C0749563 (UMLS CUI [2,1])
C1299583 (UMLS CUI [2,2])
C1299583 (UMLS CUI [1,2])
C0749563 (UMLS CUI [2,1])
C1299583 (UMLS CUI [2,2])
CL Item
Yes, I can do it fully independently without any difficulty (1)
CL Item
Yes, I can do it fully independently but with some difficulty (2)
CL Item
Yes, I can do it fully independently but with great difficulty (3)
CL Item
No, I cannot do it fully independently, I can only do it with someone's help (4)
Item
Can you, fully independently, do “light” household activities (for example, dusting and tidying up)?
integer
C4055557 (UMLS CUI [1,1])
C1299583 (UMLS CUI [1,2])
C1299583 (UMLS CUI [1,2])
Code List
Can you, fully independently, do “light” household activities (for example, dusting and tidying up)?
CL Item
Yes, I can do it fully independently without any difficulty (1)
CL Item
Yes, I can do it fully independently but with some difficulty (2)
CL Item
Yes, I can do it fully independently but with great difficulty (3)
CL Item
No, I cannot do it fully independently, I can only do it with someone's help (4)
Item
Can you, fully independently, do the shopping?
integer
C4055547 (UMLS CUI [1,1])
C1299583 (UMLS CUI [1,2])
C1299583 (UMLS CUI [1,2])
CL Item
Yes, I can do it fully independently without any difficulty (1)
CL Item
Yes, I can do it fully independently but with some difficulty (2)
CL Item
Yes, I can do it fully independently but with great difficulty (3)
CL Item
No, I cannot do it fully independently, I can only do it with someone's help (4)
Item
Can you, fully independently, take your medicines?
integer
C4075001 (UMLS CUI [1,1])
C1299583 (UMLS CUI [1,2])
C1299583 (UMLS CUI [1,2])
CL Item
Yes, I can do it fully independently without any difficulty (1)
CL Item
Yes, I can do it fully independently but with some difficulty (2)
CL Item
Yes, I can do it fully independently but with great difficulty (3)
CL Item
No, I cannot do it fully independently, I can only do it with someone's help (4)
Item
Can you, fully independently, use your own or public transportation?
integer
C0871194 (UMLS CUI [1,1])
C1299583 (UMLS CUI [1,2])
C4274917 (UMLS CUI [2,1])
C1299583 (UMLS CUI [2,2])
C1299583 (UMLS CUI [1,2])
C4274917 (UMLS CUI [2,1])
C1299583 (UMLS CUI [2,2])
CL Item
Yes, I can do it fully independently without any difficulty (1)
CL Item
Yes, I can do it fully independently but with some difficulty (2)
CL Item
Yes, I can do it fully independently but with great difficulty (3)
CL Item
No, I cannot do it fully independently, I can only do it with someone's help (4)
Item Group
Do you experience complaints with your mouth, jaws or temples?
C1161186 (UMLS CUI-1)
C0848667 (UMLS CUI-2)
C2108445 (UMLS CUI-3)
C0935456 (UMLS CUI-4)
C1457887 (UMLS CUI-5)
C0848667 (UMLS CUI-2)
C2108445 (UMLS CUI-3)
C0935456 (UMLS CUI-4)
C1457887 (UMLS CUI-5)
Item
I experience pain
integer
C0221776 (UMLS CUI [1])
C0236000 (UMLS CUI [2])
C0935456 (UMLS CUI [3,1])
C0030193 (UMLS CUI [3,2])
C0236000 (UMLS CUI [2])
C0935456 (UMLS CUI [3,1])
C0030193 (UMLS CUI [3,2])
CL Item
No (1)
CL Item
Yes (2)
CL Item
No (1)
CL Item
Yes (2)
CL Item
No (1)
CL Item
Yes (2)
CL Item
No (1)
CL Item
Yes (2)
Item
The following questions are about how you feel and how things have been with you during thepast 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks have you been a very nervous person?
integer
C0849963 (UMLS CUI [1,1])
C3828653 (UMLS CUI [1,2])
C3828653 (UMLS CUI [1,2])
Code List
The following questions are about how you feel and how things have been with you during thepast 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks have you been a very nervous person?
CL Item
All of the time (1)
CL Item
Most of the time (2)
CL Item
A good bit of the time (3)
CL Item
Some of the time (4)
CL Item
A little of the time (5)
CL Item
None of the time (6)
Item
How much of the time during the past 4 weeks have you felt calm and peaceful?
integer
C3829745 (UMLS CUI [1,1])
C3828653 (UMLS CUI [1,2])
C3828653 (UMLS CUI [1,2])
CL Item
All of the time (1)
CL Item
Most of the time (2)
CL Item
A good bit of the time (3)
CL Item
Some of the time (4)
CL Item
A little of the time (5)
CL Item
None of the time (6)
Item
How much of the time during the past 4 weeks have you felt downhearted and blue?
integer
C3828653 (UMLS CUI [1,1])
C3829743 (UMLS CUI [1,2])
C3829743 (UMLS CUI [1,2])
CL Item
All of the time (1)
CL Item
Most of the time (2)
CL Item
A good bit of the time (3)
CL Item
Some of the time (4)
CL Item
A little of the time (5)
CL Item
None of the time (6)
Item
How much of the time during the past 4 weeks have you been a happy person?
integer
C3828653 (UMLS CUI [1,1])
C3829752 (UMLS CUI [1,2])
C3829752 (UMLS CUI [1,2])
CL Item
All of the time (1)
CL Item
Most of the time (2)
CL Item
A good bit of the time (3)
CL Item
Some of the time (4)
CL Item
A little of the time (5)
CL Item
None of the time (6)
Item
How much of the time during the past 4 weeks have you felt so down in the dumps that nothing could cheer you up?
integer
C3828653 (UMLS CUI [1,1])
C3829738 (UMLS CUI [1,2])
C3829738 (UMLS CUI [1,2])
Code List
How much of the time during the past 4 weeks have you felt so down in the dumps that nothing could cheer you up?
CL Item
All of the time (1)
CL Item
Most of the time (2)
CL Item
A good bit of the time (3)
CL Item
Some of the time (4)
CL Item
A little of the time (5)
CL Item
None of the time (6)
Item
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?
integer
C3484327 (UMLS CUI [1])
Code List
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?
CL Item
All of the time (1)
CL Item
Most of the time (2)
CL Item
Some of the time (3)
CL Item
A little of the time (4)
CL Item
None of the time (5)
Quality of life at this moment
Item
The following question is about your ‘quality of life’. This refers to what you think about your life. For example, whether you are satisfied with your life, whether you have enjoyment in your life and whether your life gives you satisfaction. On a scale of 0 to 10: how do you rate your life at this moment? 0 indicates ‘completely unsatisfied’ and 10 ‘completely satisfied’.
integer
C3476431 (UMLS CUI [1,1])
C0521116 (UMLS CUI [1,2])
C0521116 (UMLS CUI [1,2])
Item
Have you been admitted to the hospital in the past 12 months? You had to stay overnight, for example because you had surgery and could not go home the same day. Did you tick “Yes”? Please answer the following question. If not, go to question after next.
integer
C0184666 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
Have you been admitted to the hospital in the past 12 months? You had to stay overnight, for example because you had surgery and could not go home the same day. Did you tick “Yes”? Please answer the following question. If not, go to question after next.
CL Item
No (1)
CL Item
Yes (2)
Admission quantity to hospital past year
Item
If you ticked "Yes", namely:
integer
C0184666 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C1265611 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,2])
C1265611 (UMLS CUI [1,3])
Days in hospital past year
Item
How many days did you stay in hospital in total? If you stayed in hospital more than once in the past 12 months, then please sum up the number of days you stayed during each of the admissions. Fill in this item only if you selected "Yes" in the prior question.
integer
C3694481 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Item
Have you visited the emergency department of a hospital for yourself in the past 12 months? Other names for emergency department are: emergency room (ER), emergency ward, accident & emergency department (A&E) or casualty department.
integer
C0586082 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
Have you visited the emergency department of a hospital for yourself in the past 12 months? Other names for emergency department are: emergency room (ER), emergency ward, accident & emergency department (A&E) or casualty department.
CL Item
No (1)
CL Item
Yes (2)
Visit quantity of emergency department past year
Item
If you ticked "Yes", how many times have you visited the emergency department of a hospital for yourself in the past 12 months?
integer
C0586082 (UMLS CUI [1,1])
C1265611 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
C1265611 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
Item
Have you visited an out-of-office hours GP service or had a visit from a general practitioner in the evening, night or on the weekend for yourself in the past 12 months?
integer
C0017319 (UMLS CUI [1,1])
C0498340 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
C0017319 (UMLS CUI [2,1])
C1947978 (UMLS CUI [2,2])
C0587117 (UMLS CUI [2,3])
C3887293 (UMLS CUI [2,4])
C0017319 (UMLS CUI [3,1])
C1947978 (UMLS CUI [3,2])
C0240526 (UMLS CUI [3,3])
C3887293 (UMLS CUI [3,4])
C0017319 (UMLS CUI [4,1])
C0581045 (UMLS CUI [4,2])
C3887293 (UMLS CUI [4,3])
C0498340 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
C0017319 (UMLS CUI [2,1])
C1947978 (UMLS CUI [2,2])
C0587117 (UMLS CUI [2,3])
C3887293 (UMLS CUI [2,4])
C0017319 (UMLS CUI [3,1])
C1947978 (UMLS CUI [3,2])
C0240526 (UMLS CUI [3,3])
C3887293 (UMLS CUI [3,4])
C0017319 (UMLS CUI [4,1])
C0581045 (UMLS CUI [4,2])
C3887293 (UMLS CUI [4,3])
Code List
Have you visited an out-of-office hours GP service or had a visit from a general practitioner in the evening, night or on the weekend for yourself in the past 12 months?
CL Item
No (1)
CL Item
Yes (2)
Visit quantity of out-of-office hours GP service
Item
If you ticked "Yes", how many times in total have you visited an out-of-office hours GP service or had a visit from a general practitioner in the evening, night or on the weekend for yourself in the past 12 months?
integer
C0017319 (UMLS CUI [1,1])
C0498340 (UMLS CUI [1,2])
C1265611 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C0017319 (UMLS CUI [2,1])
C1947978 (UMLS CUI [2,2])
C1265611 (UMLS CUI [2,3])
C0587117 (UMLS CUI [2,4])
C3887293 (UMLS CUI [2,5])
C0017319 (UMLS CUI [3,1])
C1947978 (UMLS CUI [3,2])
C1265611 (UMLS CUI [3,3])
C0240526 (UMLS CUI [3,4])
C3887293 (UMLS CUI [3,5])
C0017319 (UMLS CUI [4,1])
C0581045 (UMLS CUI [4,2])
C1265611 (UMLS CUI [4,3])
C3887293 (UMLS CUI [4,4])
C0498340 (UMLS CUI [1,2])
C1265611 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C0017319 (UMLS CUI [2,1])
C1947978 (UMLS CUI [2,2])
C1265611 (UMLS CUI [2,3])
C0587117 (UMLS CUI [2,4])
C3887293 (UMLS CUI [2,5])
C0017319 (UMLS CUI [3,1])
C1947978 (UMLS CUI [3,2])
C1265611 (UMLS CUI [3,3])
C0240526 (UMLS CUI [3,4])
C3887293 (UMLS CUI [3,5])
C0017319 (UMLS CUI [4,1])
C0581045 (UMLS CUI [4,2])
C1265611 (UMLS CUI [4,3])
C3887293 (UMLS CUI [4,4])
Item
How many appointments (office hours and house calls) have you had with a general practitioner for yourself in the past 12 months?
text
C0017319 (UMLS CUI [1,1])
C1512346 (UMLS CUI [1,2])
C1265611 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C1512346 (UMLS CUI [1,2])
C1265611 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
Code List
How many appointments (office hours and house calls) have you had with a general practitioner for yourself in the past 12 months?
CL Item
Not a single appointment (1)
CL Item
One or more appointments (2)
GP visit past year
Item
If you ticked "One or more appointments", how many appointments (office hours and house calls) have you had with a general practitioner for yourself in the past 12 months in total?
integer
C0017319 (UMLS CUI [1,1])
C1512346 (UMLS CUI [1,2])
C1265611 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C1512346 (UMLS CUI [1,2])
C1265611 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
Item
Did you receive home care in the past 12 months?
integer
C0204977 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
CL Item
No (1)
CL Item
Yes (2)
Item
Have you had help with household chores (for example: vacuuming, making the bed, grocery shopping) in the past 12 months? Answer this question only, if you have ticked "Yes" in the question about receiving home care.
integer
C1514756 (UMLS CUI [1,1])
C3273800 (UMLS CUI [1,2])
C0557036 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C3273800 (UMLS CUI [1,2])
C0557036 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
Code List
Have you had help with household chores (for example: vacuuming, making the bed, grocery shopping) in the past 12 months? Answer this question only, if you have ticked "Yes" in the question about receiving home care.
CL Item
No (1)
CL Item
Yes (2)
Item
Have you received home care in the form of help with personal care (for example: help with bathing/showering or dressing) in the past 12 months? Answer this question only, if you have ticked "Yes" in the question about receiving home care.
integer
C1514756 (UMLS CUI [1,1])
C0686948 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
C0686948 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
Code List
Have you received home care in the form of help with personal care (for example: help with bathing/showering or dressing) in the past 12 months? Answer this question only, if you have ticked "Yes" in the question about receiving home care.
CL Item
No (1)
CL Item
Yes (2)
Item
Have you received home care in the form of nursing care (for example: changing dressings, administering medications, measuring blood pressure) in the past 12 months? Answer this question only, if you have ticked "Yes" in the question about receiving home care.
integer
C0028682 (UMLS CUI [1,1])
C1553498 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
C1553498 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
Code List
Have you received home care in the form of nursing care (for example: changing dressings, administering medications, measuring blood pressure) in the past 12 months? Answer this question only, if you have ticked "Yes" in the question about receiving home care.
CL Item
No (1)
CL Item
Yes (2)
Quantity of weeks of help with household past year
Item
How many weeks did you receive help with household chores? Please, sum up all weeks in the past 12 months. Answer this question only, if you have ticked "Yes" in the question about receiving help with household chores. Please note: a period of 12 months concerns 52 weeks.
integer
C3273800 (UMLS CUI [1,1])
C1514756 (UMLS CUI [1,2])
C0557036 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C0557840 (UMLS CUI [1,5])
C1514756 (UMLS CUI [1,2])
C0557036 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C0557840 (UMLS CUI [1,5])
Quantity of weeks of help with personal care
Item
How many weeks did you receive help with personal care? Please, sum up all weeks in the past 12 months. Answer this question only, if you have ticked "Yes" in the question about receiving personal care. Please note: a period of 12 months concerns 52 weeks.
integer
C1514756 (UMLS CUI [1,1])
C0686948 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
C0557840 (UMLS CUI [1,4])
C0686948 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
C0557840 (UMLS CUI [1,4])
Quantity of weeks of nursing care past year
Item
How many weeks did you receive home care in the form of nursing care? Please, sum up all weeks in the past 12 months. Answer this question only, if you have ticked "Yes" in the question about receiving nursing care. Please note: a period of 12 months concerns 52 weeks.
integer
C0028682 (UMLS CUI [1,1])
C1553498 (UMLS CUI [1,2])
C1948053 (UMLS CUI [1,3])
C0557840 (UMLS CUI [1,4])
C3887293 (UMLS CUI [1,5])
C1553498 (UMLS CUI [1,2])
C1948053 (UMLS CUI [1,3])
C0557840 (UMLS CUI [1,4])
C3887293 (UMLS CUI [1,5])
Quantity of hours of help with household past year
Item
How many hours of help with household chores did you receive during these weeks on average? Answer this question only, if you have ticked "Yes" in the question about receiving help with household chores.
integer
C3273800 (UMLS CUI [1,1])
C1514756 (UMLS CUI [1,2])
C0557036 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C4289948 (UMLS CUI [1,5])
C1514756 (UMLS CUI [1,2])
C0557036 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C4289948 (UMLS CUI [1,5])
Quantity of hours of help with personal care
Item
How many hours of help with personal care did you receive during these weeks on average? Answer this question only, if you have ticked "Yes" in the question about receiving personal care. Please note: a period of 12 months concerns 52 weeks.
integer
C1514756 (UMLS CUI [1,1])
C0686948 (UMLS CUI [1,2])
C4289948 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C0686948 (UMLS CUI [1,2])
C4289948 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
Quantity of hours of nursing care past year
Item
How many hours of home care in the form of nursing care did you receive during these weeks on average? Answer this question only, if you have ticked "Yes" in the question about receiving nursing care.
integer
C0028682 (UMLS CUI [1,1])
C1553498 (UMLS CUI [1,2])
C4289948 (UMLS CUI [1,3])
C1553498 (UMLS CUI [1,2])
C4289948 (UMLS CUI [1,3])
Item
In the past 12 months, did you have to stay overnight somewhere else than your own home because of your health? For example, in a nursing home, residential care center, psychiatric hospital or rehabilitation center?
integer
C0018704 (UMLS CUI [1,1])
C0439583 (UMLS CUI [1,2])
C3177049 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C0439583 (UMLS CUI [2,1])
C0028688 (UMLS CUI [2,2])
C0439583 (UMLS CUI [3,1])
C0237680 (UMLS CUI [3,2])
C0439583 (UMLS CUI [4,1])
C0259948 (UMLS CUI [4,2])
C0439583 (UMLS CUI [5,1])
C1550688 (UMLS CUI [5,2])
C0439583 (UMLS CUI [1,2])
C3177049 (UMLS CUI [1,3])
C3887293 (UMLS CUI [1,4])
C0439583 (UMLS CUI [2,1])
C0028688 (UMLS CUI [2,2])
C0439583 (UMLS CUI [3,1])
C0237680 (UMLS CUI [3,2])
C0439583 (UMLS CUI [4,1])
C0259948 (UMLS CUI [4,2])
C0439583 (UMLS CUI [5,1])
C1550688 (UMLS CUI [5,2])
Code List
In the past 12 months, did you have to stay overnight somewhere else than your own home because of your health? For example, in a nursing home, residential care center, psychiatric hospital or rehabilitation center?
CL Item
No (1)
CL Item
Yes (2)
Quantity of overnight stays past year
Item
If you have stayed somewhere else overnight in the past 12 months, how many times in total?
integer
C0018704 (UMLS CUI [1,1])
C0439583 (UMLS CUI [1,2])
C3177049 (UMLS CUI [1,3])
C0439603 (UMLS CUI [1,4])
C3887293 (UMLS CUI [1,5])
C0439583 (UMLS CUI [1,2])
C3177049 (UMLS CUI [1,3])
C0439603 (UMLS CUI [1,4])
C3887293 (UMLS CUI [1,5])
Length of overnight stays past year
Item
If you have stayed somewhere else overnight in the past 12 months, how long did you stay in this care facility? If you stayed more than once in a care facility in the past 12 months, please sum up the number of days of all stays together.
integer
C0018704 (UMLS CUI [1,1])
C0439583 (UMLS CUI [1,2])
C3177049 (UMLS CUI [1,3])
C0023303 (UMLS CUI [1,4])
C3887293 (UMLS CUI [1,5])
C0439583 (UMLS CUI [1,2])
C3177049 (UMLS CUI [1,3])
C0023303 (UMLS CUI [1,4])
C3887293 (UMLS CUI [1,5])
Item
In the past 12 months, did you stay somewhere else than your own home during the day for treatment? So, you did not stay overnight. For example, you went to day care or day treatment.
integer
C0002423 (UMLS CUI [1,1])
C3887293 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,2])
Code List
In the past 12 months, did you stay somewhere else than your own home during the day for treatment? So, you did not stay overnight. For example, you went to day care or day treatment.
CL Item
No (1)
CL Item
Yes (2)
Quantity of outpatient day care past year
Item
If you ticked "Yes", how many times per week did you stay somewhere else than your own home during the day for treatment in the past 12 months? So, you did not stay overnight. For example, you went to day care or day treatment.
integer
C0002423 (UMLS CUI [1,1])
C0456698 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
C0456698 (UMLS CUI [1,2])
C3887293 (UMLS CUI [1,3])
Item
Because of your health problems, did you receive help from your family or friends in the past week with household chores such as preparing food, cleaning your house, doing the laundry, ironing or mending your cloths, grocery shopping or do odd jobs in and around the house?
integer
C0001288 (UMLS CUI [1,1])
C0581904 (UMLS CUI [1,2])
C2987125 (UMLS CUI [1,3])
C0001288 (UMLS CUI [2,1])
C4708444 (UMLS CUI [2,2])
C2987125 (UMLS CUI [2,3])
C0581904 (UMLS CUI [1,2])
C2987125 (UMLS CUI [1,3])
C0001288 (UMLS CUI [2,1])
C4708444 (UMLS CUI [2,2])
C2987125 (UMLS CUI [2,3])
Code List
Because of your health problems, did you receive help from your family or friends in the past week with household chores such as preparing food, cleaning your house, doing the laundry, ironing or mending your cloths, grocery shopping or do odd jobs in and around the house?
CL Item
No (1)
CL Item
Yes (2)
Quantity of hours of support with household chores past week
Item
If you ticked "Yes", how many hours did you receive help from your family or friends in the past week?
integer
C0001288 (UMLS CUI [1,1])
C0581904 (UMLS CUI [1,2])
C0556976 (UMLS CUI [1,3])
C0001288 (UMLS CUI [2,1])
C4708444 (UMLS CUI [2,2])
C0556976 (UMLS CUI [2,3])
C0581904 (UMLS CUI [1,2])
C0556976 (UMLS CUI [1,3])
C0001288 (UMLS CUI [2,1])
C4708444 (UMLS CUI [2,2])
C0556976 (UMLS CUI [2,3])
Item
Because of your health problems, did you receive help from your family or friends in the past week with personal care (dressing, washing your body, combing your hair, shaving), toileting, transferring in the house, eating, drinken or taking medications?
integer
C0563471 (UMLS CUI [1,1])
C0581904 (UMLS CUI [1,2])
C2987125 (UMLS CUI [1,3])
C0563471 (UMLS CUI [2,1])
C4708444 (UMLS CUI [2,2])
C2987125 (UMLS CUI [2,3])
C0150810 (UMLS CUI [3,1])
C0581904 (UMLS CUI [3,2])
C2987125 (UMLS CUI [3,3])
C0150810 (UMLS CUI [4,1])
C4708444 (UMLS CUI [4,2])
C2987125 (UMLS CUI [4,3])
C2371389 (UMLS CUI [5,1])
C0581904 (UMLS CUI [5,2])
C2987125 (UMLS CUI [5,3])
C2371389 (UMLS CUI [6,1])
C4708444 (UMLS CUI [6,2])
C2987125 (UMLS CUI [6,3])
C1279813 (UMLS CUI [7,1])
C4708444 (UMLS CUI [7,2])
C2987125 (UMLS CUI [7,3])
C1279813 (UMLS CUI [8,1])
C0581904 (UMLS CUI [8,2])
C2987125 (UMLS CUI [8,3])
C1290952 (UMLS CUI [9,1])
C0581904 (UMLS CUI [9,2])
C2987125 (UMLS CUI [9,3])
C1290952 (UMLS CUI [10,1])
C4708444 (UMLS CUI [10,2])
C2987125 (UMLS CUI [10,3])
C0581904 (UMLS CUI [1,2])
C2987125 (UMLS CUI [1,3])
C0563471 (UMLS CUI [2,1])
C4708444 (UMLS CUI [2,2])
C2987125 (UMLS CUI [2,3])
C0150810 (UMLS CUI [3,1])
C0581904 (UMLS CUI [3,2])
C2987125 (UMLS CUI [3,3])
C0150810 (UMLS CUI [4,1])
C4708444 (UMLS CUI [4,2])
C2987125 (UMLS CUI [4,3])
C2371389 (UMLS CUI [5,1])
C0581904 (UMLS CUI [5,2])
C2987125 (UMLS CUI [5,3])
C2371389 (UMLS CUI [6,1])
C4708444 (UMLS CUI [6,2])
C2987125 (UMLS CUI [6,3])
C1279813 (UMLS CUI [7,1])
C4708444 (UMLS CUI [7,2])
C2987125 (UMLS CUI [7,3])
C1279813 (UMLS CUI [8,1])
C0581904 (UMLS CUI [8,2])
C2987125 (UMLS CUI [8,3])
C1290952 (UMLS CUI [9,1])
C0581904 (UMLS CUI [9,2])
C2987125 (UMLS CUI [9,3])
C1290952 (UMLS CUI [10,1])
C4708444 (UMLS CUI [10,2])
C2987125 (UMLS CUI [10,3])
Code List
Because of your health problems, did you receive help from your family or friends in the past week with personal care (dressing, washing your body, combing your hair, shaving), toileting, transferring in the house, eating, drinken or taking medications?
CL Item
No (1)
CL Item
Yes (2)
Quantity of hours per week of support with personal care
Item
If you ticked "Yes", how many hours per week did you receive help from your family or friends in the past week with personal care?
integer
C0563471 (UMLS CUI [1,1])
C0581904 (UMLS CUI [1,2])
C0556976 (UMLS CUI [1,3])
C0563471 (UMLS CUI [2,1])
C4708444 (UMLS CUI [2,2])
C0556976 (UMLS CUI [2,3])
C0581904 (UMLS CUI [1,2])
C0556976 (UMLS CUI [1,3])
C0563471 (UMLS CUI [2,1])
C4708444 (UMLS CUI [2,2])
C0556976 (UMLS CUI [2,3])
Item
Because of your health problems, did you receive help from your family or friends in the past week with getting around outside the house, making trips, visiting family or friends, dealings with health care (attending your visits to the GP, hospital or treatment), arranging for help, aids or home adjustments, or arranging your finances or paper work?
integer
C3842571 (UMLS CUI [1,1])
C0581904 (UMLS CUI [1,2])
C2987125 (UMLS CUI [1,3])
C4708444 (UMLS CUI [2,1])
C2987125 (UMLS CUI [2,2])
C0086388 (UMLS CUI [3,1])
C0581904 (UMLS CUI [3,2])
C2987125 (UMLS CUI [3,3])
C0086388 (UMLS CUI [4,1])
C4708444 (UMLS CUI [4,2])
C2987125 (UMLS CUI [4,3])
C1300196 (UMLS CUI [5,1])
C0557036 (UMLS CUI [5,2])
C0581904 (UMLS CUI [5,3])
C2987125 (UMLS CUI [5,4])
C1300196 (UMLS CUI [6,1])
C0557036 (UMLS CUI [6,2])
C4708444 (UMLS CUI [6,3])
C2987125 (UMLS CUI [6,4])
C1300196 (UMLS CUI [7,1])
C0449435 (UMLS CUI [7,2])
C0581904 (UMLS CUI [7,3])
C2987125 (UMLS CUI [7,4])
C1300196 (UMLS CUI [8,1])
C0449435 (UMLS CUI [8,2])
C4708444 (UMLS CUI [8,3])
C2987125 (UMLS CUI [8,4])
C1300196 (UMLS CUI [9,1])
C0850398 (UMLS CUI [9,2])
C0581904 (UMLS CUI [9,3])
C2987125 (UMLS CUI [9,4])
C1300196 (UMLS CUI [10,1])
C0850398 (UMLS CUI [10,2])
C4708444 (UMLS CUI [10,3])
C2987125 (UMLS CUI [10,4])
C0149692 (UMLS CUI [11,1])
C4708444 (UMLS CUI [11,2])
C2987125 (UMLS CUI [11,3])
C0149692 (UMLS CUI [12,1])
C0581904 (UMLS CUI [12,2])
C2987125 (UMLS CUI [12,3])
C2986711 (UMLS CUI [13,1])
C4708444 (UMLS CUI [13,2])
C2987125 (UMLS CUI [13,3])
C2986711 (UMLS CUI [14,1])
C0581904 (UMLS CUI [14,2])
C2987125 (UMLS CUI [14,3])
C2371431 (UMLS CUI [15,1])
C0581904 (UMLS CUI [15,2])
C2987125 (UMLS CUI [15,3])
C2371431 (UMLS CUI [16,1])
C4708444 (UMLS CUI [16,2])
C2987125 (UMLS CUI [16,3])
C0577328 (UMLS CUI [17,1])
C0581904 (UMLS CUI [17,2])
C2987125 (UMLS CUI [17,3])
C0577328 (UMLS CUI [18,1])
C4708444 (UMLS CUI [18,2])
C2987125 (UMLS CUI [18,3])
C0581904 (UMLS CUI [1,2])
C2987125 (UMLS CUI [1,3])
C4708444 (UMLS CUI [2,1])
C2987125 (UMLS CUI [2,2])
C0086388 (UMLS CUI [3,1])
C0581904 (UMLS CUI [3,2])
C2987125 (UMLS CUI [3,3])
C0086388 (UMLS CUI [4,1])
C4708444 (UMLS CUI [4,2])
C2987125 (UMLS CUI [4,3])
C1300196 (UMLS CUI [5,1])
C0557036 (UMLS CUI [5,2])
C0581904 (UMLS CUI [5,3])
C2987125 (UMLS CUI [5,4])
C1300196 (UMLS CUI [6,1])
C0557036 (UMLS CUI [6,2])
C4708444 (UMLS CUI [6,3])
C2987125 (UMLS CUI [6,4])
C1300196 (UMLS CUI [7,1])
C0449435 (UMLS CUI [7,2])
C0581904 (UMLS CUI [7,3])
C2987125 (UMLS CUI [7,4])
C1300196 (UMLS CUI [8,1])
C0449435 (UMLS CUI [8,2])
C4708444 (UMLS CUI [8,3])
C2987125 (UMLS CUI [8,4])
C1300196 (UMLS CUI [9,1])
C0850398 (UMLS CUI [9,2])
C0581904 (UMLS CUI [9,3])
C2987125 (UMLS CUI [9,4])
C1300196 (UMLS CUI [10,1])
C0850398 (UMLS CUI [10,2])
C4708444 (UMLS CUI [10,3])
C2987125 (UMLS CUI [10,4])
C0149692 (UMLS CUI [11,1])
C4708444 (UMLS CUI [11,2])
C2987125 (UMLS CUI [11,3])
C0149692 (UMLS CUI [12,1])
C0581904 (UMLS CUI [12,2])
C2987125 (UMLS CUI [12,3])
C2986711 (UMLS CUI [13,1])
C4708444 (UMLS CUI [13,2])
C2987125 (UMLS CUI [13,3])
C2986711 (UMLS CUI [14,1])
C0581904 (UMLS CUI [14,2])
C2987125 (UMLS CUI [14,3])
C2371431 (UMLS CUI [15,1])
C0581904 (UMLS CUI [15,2])
C2987125 (UMLS CUI [15,3])
C2371431 (UMLS CUI [16,1])
C4708444 (UMLS CUI [16,2])
C2987125 (UMLS CUI [16,3])
C0577328 (UMLS CUI [17,1])
C0581904 (UMLS CUI [17,2])
C2987125 (UMLS CUI [17,3])
C0577328 (UMLS CUI [18,1])
C4708444 (UMLS CUI [18,2])
C2987125 (UMLS CUI [18,3])
Code List
Because of your health problems, did you receive help from your family or friends in the past week with getting around outside the house, making trips, visiting family or friends, dealings with health care (attending your visits to the GP, hospital or treatment), arranging for help, aids or home adjustments, or arranging your finances or paper work?
CL Item
No (1)
CL Item
Yes (2)
Quantity of hours of Help from family or friends in past week with getting around outside the house, making trips, visiting family or friends, dealings with health care (attending your visits to the GP, hospital or treatment), arranging for help, aids or home adjustments, or arranging your finances or paper work
Item
If you ticked "Yes", how many hours per week did you receive help from your family or friends in the past week with getting around outside the house, making trips, visiting family or friends, dealings with health care (attending your visits to the GP, hospital or treatment), arranging for help, aids or home adjustments, or arranging your finances or paper work?
integer
C3842571 (UMLS CUI [1,1])
C0581904 (UMLS CUI [1,2])
C2987125 (UMLS CUI [1,3])
C0556976 (UMLS CUI [1,4])
C4708444 (UMLS CUI [2,1])
C2987125 (UMLS CUI [2,2])
C0556976 (UMLS CUI [2,3])
C0086388 (UMLS CUI [3,1])
C0581904 (UMLS CUI [3,2])
C2987125 (UMLS CUI [3,3])
C0556976 (UMLS CUI [3,4])
C0086388 (UMLS CUI [4,1])
C4708444 (UMLS CUI [4,2])
C2987125 (UMLS CUI [4,3])
C0556976 (UMLS CUI [4,4])
C1300196 (UMLS CUI [5,1])
C0557036 (UMLS CUI [5,2])
C0581904 (UMLS CUI [5,3])
C2987125 (UMLS CUI [5,4])
C0556976 (UMLS CUI [5,5])
C1300196 (UMLS CUI [6,1])
C0557036 (UMLS CUI [6,2])
C4708444 (UMLS CUI [6,3])
C2987125 (UMLS CUI [6,4])
C0556976 (UMLS CUI [6,5])
C1300196 (UMLS CUI [7,1])
C0449435 (UMLS CUI [7,2])
C0581904 (UMLS CUI [7,3])
C2987125 (UMLS CUI [7,4])
C0556976 (UMLS CUI [7,5])
C1300196 (UMLS CUI [8,1])
C0449435 (UMLS CUI [8,2])
C4708444 (UMLS CUI [8,3])
C2987125 (UMLS CUI [8,4])
C0556976 (UMLS CUI [8,5])
C1300196 (UMLS CUI [9,1])
C0850398 (UMLS CUI [9,2])
C0581904 (UMLS CUI [9,3])
C2987125 (UMLS CUI [9,4])
C0556976 (UMLS CUI [9,5])
C1300196 (UMLS CUI [10,1])
C0850398 (UMLS CUI [10,2])
C4708444 (UMLS CUI [10,3])
C2987125 (UMLS CUI [10,4])
C0556976 (UMLS CUI [10,5])
C0149692 (UMLS CUI [11,1])
C4708444 (UMLS CUI [11,2])
C2987125 (UMLS CUI [11,3])
C0556976 (UMLS CUI [11,4])
C0149692 (UMLS CUI [12,1])
C0581904 (UMLS CUI [12,2])
C2987125 (UMLS CUI [12,3])
C0556976 (UMLS CUI [12,4])
C2986711 (UMLS CUI [13,1])
C4708444 (UMLS CUI [13,2])
C2987125 (UMLS CUI [13,3])
C0556976 (UMLS CUI [13,4])
C2986711 (UMLS CUI [14,1])
C0581904 (UMLS CUI [14,2])
C2987125 (UMLS CUI [14,3])
C0556976 (UMLS CUI [14,4])
C2371431 (UMLS CUI [15,1])
C0581904 (UMLS CUI [15,2])
C2987125 (UMLS CUI [15,3])
C0556976 (UMLS CUI [15,4])
C2371431 (UMLS CUI [16,1])
C4708444 (UMLS CUI [16,2])
C2987125 (UMLS CUI [16,3])
C0556976 (UMLS CUI [16,4])
C0577328 (UMLS CUI [17,1])
C0581904 (UMLS CUI [17,2])
C2987125 (UMLS CUI [17,3])
C0556976 (UMLS CUI [17,4])
C0577328 (UMLS CUI [18,1])
C4708444 (UMLS CUI [18,2])
C2987125 (UMLS CUI [18,3])
C0556976 (UMLS CUI [18,4])
C0581904 (UMLS CUI [1,2])
C2987125 (UMLS CUI [1,3])
C0556976 (UMLS CUI [1,4])
C4708444 (UMLS CUI [2,1])
C2987125 (UMLS CUI [2,2])
C0556976 (UMLS CUI [2,3])
C0086388 (UMLS CUI [3,1])
C0581904 (UMLS CUI [3,2])
C2987125 (UMLS CUI [3,3])
C0556976 (UMLS CUI [3,4])
C0086388 (UMLS CUI [4,1])
C4708444 (UMLS CUI [4,2])
C2987125 (UMLS CUI [4,3])
C0556976 (UMLS CUI [4,4])
C1300196 (UMLS CUI [5,1])
C0557036 (UMLS CUI [5,2])
C0581904 (UMLS CUI [5,3])
C2987125 (UMLS CUI [5,4])
C0556976 (UMLS CUI [5,5])
C1300196 (UMLS CUI [6,1])
C0557036 (UMLS CUI [6,2])
C4708444 (UMLS CUI [6,3])
C2987125 (UMLS CUI [6,4])
C0556976 (UMLS CUI [6,5])
C1300196 (UMLS CUI [7,1])
C0449435 (UMLS CUI [7,2])
C0581904 (UMLS CUI [7,3])
C2987125 (UMLS CUI [7,4])
C0556976 (UMLS CUI [7,5])
C1300196 (UMLS CUI [8,1])
C0449435 (UMLS CUI [8,2])
C4708444 (UMLS CUI [8,3])
C2987125 (UMLS CUI [8,4])
C0556976 (UMLS CUI [8,5])
C1300196 (UMLS CUI [9,1])
C0850398 (UMLS CUI [9,2])
C0581904 (UMLS CUI [9,3])
C2987125 (UMLS CUI [9,4])
C0556976 (UMLS CUI [9,5])
C1300196 (UMLS CUI [10,1])
C0850398 (UMLS CUI [10,2])
C4708444 (UMLS CUI [10,3])
C2987125 (UMLS CUI [10,4])
C0556976 (UMLS CUI [10,5])
C0149692 (UMLS CUI [11,1])
C4708444 (UMLS CUI [11,2])
C2987125 (UMLS CUI [11,3])
C0556976 (UMLS CUI [11,4])
C0149692 (UMLS CUI [12,1])
C0581904 (UMLS CUI [12,2])
C2987125 (UMLS CUI [12,3])
C0556976 (UMLS CUI [12,4])
C2986711 (UMLS CUI [13,1])
C4708444 (UMLS CUI [13,2])
C2987125 (UMLS CUI [13,3])
C0556976 (UMLS CUI [13,4])
C2986711 (UMLS CUI [14,1])
C0581904 (UMLS CUI [14,2])
C2987125 (UMLS CUI [14,3])
C0556976 (UMLS CUI [14,4])
C2371431 (UMLS CUI [15,1])
C0581904 (UMLS CUI [15,2])
C2987125 (UMLS CUI [15,3])
C0556976 (UMLS CUI [15,4])
C2371431 (UMLS CUI [16,1])
C4708444 (UMLS CUI [16,2])
C2987125 (UMLS CUI [16,3])
C0556976 (UMLS CUI [16,4])
C0577328 (UMLS CUI [17,1])
C0581904 (UMLS CUI [17,2])
C2987125 (UMLS CUI [17,3])
C0556976 (UMLS CUI [17,4])
C0577328 (UMLS CUI [18,1])
C4708444 (UMLS CUI [18,2])
C2987125 (UMLS CUI [18,3])
C0556976 (UMLS CUI [18,4])
Item
Has somebody helped you to complete this questionnaire?
integer
C3828841 (UMLS CUI [1,1])
C0034394 (UMLS CUI [1,2])
C0034394 (UMLS CUI [1,2])
Code List
Has somebody helped you to complete this questionnaire?
CL Item
No, I completed the list alone (1)
CL Item
Yes, somebody helped me to complete the list (2)
Item
If yes, what did the help consist of?
integer
C0332307 (UMLS CUI [1,1])
C3828841 (UMLS CUI [1,2])
C0034394 (UMLS CUI [1,3])
C3828841 (UMLS CUI [1,2])
C0034394 (UMLS CUI [1,3])
CL Item
Someone else has written down the answers, I have chosen the answers myself (1)
CL Item
Someone else helped me to choose and write down the answers (2)
CL Item
Someone else has chosen and written down the answers for me (3)
Comment
Item
If you have any comments, please write them down in the space below. This is the end of the questionnaire. Thank you very much for completing the questionnaire.
text
C0947611 (UMLS CUI [1])
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