questionnaire date
Item
Date when the questions were answered
date
C0034394 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
1. Where are you living currently?
integer
C2184149 (UMLS CUI [1])
Code List
1. Where are you living currently?
CL Item
own accommodation (live at home) (1)
CL Item
service house / apartment (2)
CL Item
group residence (3)
CL Item
retirement home (4)
CL Item
emergency hospital (eg medicine, neurologist, surgeon clinic). (6)
CL Item
Geriatric / Rehab Clinic (7)
living alone
Item
2. Do you live alone?
boolean
C2184149 (UMLS CUI [1,1])
C0439044 (UMLS CUI [1,2])
Item
3. Do you need help from someone eating and drinking?
integer
C0559899 (UMLS CUI [1,1])
C1521721 (UMLS CUI [1,2])
Code List
3. Do you need help from someone eating and drinking?
CL Item
No, I eat and drink on my own. (1)
CL Item
Yes, I get help with eating and drinking. (2)
Item
4. Do you need help from someone to visit the toilet?
integer
C0562816 (UMLS CUI [1])
Code List
4. Do you need help from someone to visit the toilet?
CL Item
I can manage to visit the toilet by myself (1)
CL Item
I need help to visit the toilet (2)
Item
5. How is your mobility now?
integer
C0449580 (UMLS CUI [1])
Code List
5. How is your mobility now?
CL Item
I move myself, with or without aids, both indoors and outdoors. (1)
CL Item
I am moving myself, with or without aids indoors, but not outdoors. (2)
CL Item
I get help from another person when moving. (3)
Item
6. Do you need help getting dressed and undressed?
integer
C0518459 (UMLS CUI [1,1])
C1521721 (UMLS CUI [1,2])
Code List
6. Do you need help getting dressed and undressed?
CL Item
I can manage to get dressed and undressed by myself (1)
CL Item
I need help to get dressed and undressed (2)
Item
7. Do you get help with your daily hygiene?
integer
C0564673 (UMLS CUI [1,1])
C1521721 (UMLS CUI [1,2])
Code List
7. Do you get help with your daily hygiene?
CL Item
No, I take care of my daily hygiene. (1)
CL Item
Yes, I get help with my daily hygiene. (2)
Item
8. Do you need help with cooking?
integer
C1511504 (UMLS CUI [1,1])
C1521721 (UMLS CUI [1,2])
Code List
8. Do you need help with cooking?
CL Item
No, I cook for myself. (1)
CL Item
Yes, I get help with cooking. (2)
Item
9. Do you need help with cleaning?
integer
C0001288 (UMLS CUI [1,1])
C1521721 (UMLS CUI [1,2])
Code List
9. Do you need help with cleaning?
CL Item
No, I'm cleaning myself. (1)
CL Item
Yes, I get help with cleaning. (2)
Item
10. Do you get help with food purchases?
integer
C4055547 (UMLS CUI [1,1])
C1521721 (UMLS CUI [1,2])
Code List
10. Do you get help with food purchases?
CL Item
No, I do food purchases on my own. (1)
CL Item
Yes, I get help with food purchases. (2)
Item
11. Is your need for support / assistance fulfilled?
integer
C1521721 (UMLS CUI [1,1])
C3840284 (UMLS CUI [1,2])
Code List
11. Is your need for support / assistance fulfilled?
CL Item
I do not need any support / help. (1)
CL Item
Yes, my support / help needs are met. (2)
CL Item
no, not enough (3)
CL Item
no, but I would like support / help. (4)
Item
12. If no, why have you not received support / assistance needs?
integer
C1521721 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
Code List
12. If no, why have you not received support / assistance needs?
CL Item
I do not know who to contact. (1)
CL Item
I refrain from support / help because it costs too much. (2)
CL Item
I refrain from support / help because I think the help is of poor quality. (3)
CL Item
There is no support / help available. (4)
CL Item
Other reasons, which? (5)
Item
13. Who or what fulfills your need for support / help? You can check multiple options.
integer
C1521721 (UMLS CUI [1,1])
C0027361 (UMLS CUI [1,2])
Code List
13. Who or what fulfills your need for support / help? You can check multiple options.
CL Item
No, I have no need for support / help. (2)
CL Item
relative / relatives (3)
CL Item
municipal housing service (4)
CL Item
care staff in special housing (5)
Item
14. Are you currently dependent on help / support from your relative / close relative?
integer
C0581904 (UMLS CUI [1])
Code List
14. Are you currently dependent on help / support from your relative / close relative?
CL Item
I do not depend on support / help or supervision of relative / close relative. (1)
CL Item
I am partly dependent on support / help or supervision of relative / close relative. (2)
CL Item
I am completely dependent on support / help or supervision of relative / close relative. (3)
Item
15. Are there any plans for your continued care and rehabilitation / training today?
integer
C0017313 (UMLS CUI [1,1])
C0034991 (UMLS CUI [1,2])
C0038454 (UMLS CUI [1,3])
Code List
15. Are there any plans for your continued care and rehabilitation / training today?
CL Item
not applicable (3)
CL Item
do not know / do not remember (4)
Item
16. Do you receive rehabilitation / exercise today?
integer
C0034991 (UMLS CUI [1])
Code List
16. Do you receive rehabilitation / exercise today?
CL Item
ja, jag får rehabilitering/träning. (1)
CL Item
ja, jag får rehabilitering/träning, men inte tillräckligt. (2)
CL Item
nej, men jag skulle behöva rehabilitering/träning. (3)
CL Item
nej, jag behöver inte rehabilitering/träning. (4)
Item
17. If yes, by whom do you get rehabilitation / exercise? You can check multiple options.
integer
C0034991 (UMLS CUI [1,1])
C0680379 (UMLS CUI [1,2])
Code List
17. If yes, by whom do you get rehabilitation / exercise? You can check multiple options.
CL Item
physiotherapist (1)
CL Item
occupational therapist (2)
CL Item
speech therapist (3)
Item
18. Have you received municipal rehabilitation outside the home during the past six months (day rehabilitation) or have you received rehabilitation at home (home rehabilitation)? You can check multiple options.
integer
C0034991 (UMLS CUI [1,1])
C0442519 (UMLS CUI [1,2])
Code List
18. Have you received municipal rehabilitation outside the home during the past six months (day rehabilitation) or have you received rehabilitation at home (home rehabilitation)? You can check multiple options.
CL Item
Yes, day rehabilitation, outside the home. (2)
CL Item
Yes, home rehabilitation, at home. (3)
contact for Rehabilitation
Item
19. Do you know who you can contact today if you would like any of the following: a. Rehabilitation / exercise?
boolean
C0034991 (UMLS CUI [1,1])
C0332158 (UMLS CUI [1,2])
contact for Medical treatment
Item
19. Do you know who you can contact today if you would like any of the following: b. Medical treatment?
boolean
C0418981 (UMLS CUI [1,1])
C0332158 (UMLS CUI [1,2])
contact Municipal home servant
Item
19. Do you know who you can contact today if you would like any of the following: c. Municipal home servantt?
boolean
C0028697 (UMLS CUI [1,1])
C0442673 (UMLS CUI [1,2])
C0332158 (UMLS CUI [1,3])
contact other accommodation
Item
19. Do you know who you can contact today if you would like any of the following: d. other accommodation?
boolean
C0595920 (UMLS CUI [1,1])
C0332158 (UMLS CUI [1,2])
contact nurse
Item
19. Do you know who you can contact today if you would like any of the following: Nurse?
boolean
C0028661 (UMLS CUI [1,1])
C0332158 (UMLS CUI [1,2])
contact doctor
Item
19. Do you know who you can contact today if you would like any of the following: f. Doctor?
boolean
C0031831 (UMLS CUI [1,1])
C0332158 (UMLS CUI [1,2])
Item
20. Do you have or have had contact with any local patient association within ex. National Association against Brain's Disease Disorders (Strokeförbundet / Association), Aphasia Federation in Sweden, Neurologically Disabled Disability Federation?
integer
C0006111 (UMLS CUI [1,1])
C0036606 (UMLS CUI [1,2])
Code List
20. Do you have or have had contact with any local patient association within ex. National Association against Brain's Disease Disorders (Strokeförbundet / Association), Aphasia Federation in Sweden, Neurologically Disabled Disability Federation?
CL Item
no, but I would like to get in touch with any patient association. (3)
CL Item
I did not know there were any associations. (4)
Item
21. How do you rate your general health condition?
integer
C0516984 (UMLS CUI [1])
Code List
21. How do you rate your general health condition?
Item
22. Do you feel tired?
integer
C0849970 (UMLS CUI [1])
Code List
22. Do you feel tired?
Item
23. Do you feel depressed?
integer
C0497307 (UMLS CUI [1])
Code List
23. Do you feel depressed?
Item
24. Do you feel anxiety and fear?
integer
C0003467 (UMLS CUI [1,1])
C1288289 (UMLS CUI [1,2])
Code List
24. Do you feel anxiety and fear?
Item
25. Do you have pain?
integer
C0030193 (UMLS CUI [1])
Code List
25. Do you have pain?
Item
26. Is there any particular person who you feel can really support you?
integer
C1521721 (UMLS CUI [1,1])
C0027361 (UMLS CUI [1,2])
Code List
26. Is there any particular person who you feel can really support you?
CL Item
Yes, but I do not need it. (2)
Item
27. Can you exercise the interests you had before you got stroke?
integer
C0023292 (UMLS CUI [1])
C0038454 (UMLS CUI [2])
Code List
27. Can you exercise the interests you had before you got stroke?
CL Item
yes, as before. (1)
CL Item
Yes, but not really as before. (2)
CL Item
no, almost not at all or never. (3)
Item
28. Do you have difficulty speaking?
integer
C1527347 (UMLS CUI [1])
Code List
28. Do you have difficulty speaking?
CL Item
No, I have no difficulty speaking. (1)
CL Item
Yes, I have difficulty speaking. (2)
Item
29. Do you have trouble reading? (even with glasses)
integer
C0586742 (UMLS CUI [1])
Code List
29. Do you have trouble reading? (even with glasses)
CL Item
No, I have no difficulty reading. (1)
CL Item
Yes, I have difficulty reading. (2)
Item
30. Do you have difficulty writing?
integer
C0584995 (UMLS CUI [1])
Code List
30. Do you have difficulty writing?
CL Item
No, I have no difficulty writing. (1)
CL Item
Yes, I have difficulty writing. (2)
Item
31. Do you use general means of transportation? (bus, train etc)
integer
C0577341 (UMLS CUI [1])
Code List
31. Do you use general means of transportation? (bus, train etc)
CL Item
Yes, I use public means of transportation. (1)
CL Item
no, I do not use public transportation. (2)
Item
32. Do you drive?
integer
C0577353 (UMLS CUI [1])
Code List
32. Do you drive?
CL Item
yes, I drive a car. (1)
CL Item
No, but I drove a car before stroke, but do not do it now. (2)
CL Item
no and I did not drive a car before the stroke accident. (3)
Item
33. Do you have a travel service?
integer
C2003850 (UMLS CUI [1])
Code List
33. Do you have a travel service?
CL Item
no, I do not have a travel service. (1)
CL Item
Yes, I have a travel service. (2)
Item
33. Who has answered this questionnaire?
integer
C0034394 (UMLS CUI [1,1])
C0508431 (UMLS CUI [1,2])
C0027361 (UMLS CUI [1,3])
Code List
33. Who has answered this questionnaire?
CL Item
myself, with the help of another (2)
CL Item
relative / close relative (3)
CL Item
healthcare staff (4)
stroke information
Item
Is there something we forgot to touch as discussion strokes and which you feel anxious to add. Or is there something that you think we should know more about? Please tell us more with your own words, continue on back or on a separate paper if the lines are insufficient.
text
C0038454 (UMLS CUI [1,1])
C2584313 (UMLS CUI [1,2])
C1533716 (UMLS CUI [1,3])