Innovation Panel Questionnaire Module
scasf12_ip10
Self-Completion SF12 Module
Questions 15
scasf12_ip10.gridsf12w10
Random allocation to static or dynamic grid SF12
Type: choice
Source: UKHLS
| Option | Label |
|---|---|
| 1 | Static grid |
| 2 | Dynamic grid |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_gridsf12w10 (j_indresp_ip) Random allocation to static or dynamic grid SF12
scasf12_ip10.scsf1
General health
Type: choice
Source: Quality Metric Inc., 2007
Text: In general, would you say your health is...
| Option | Label |
|---|---|
| 1 | Excellent |
| 2 | Very good |
| 3 | Good |
| 4 | Fair |
| 5 | Poor |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf1 (j_indresp_ip) General health
scasf12_ip10.scsf2a
Health limits moderate activities
Type: choice
Source: Quality Metric Inc., 2007
Text: The following questions are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much? Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling or playing golf
| Option | Label |
|---|---|
| 1 | Yes, limited a lot |
| 2 | Yes, limited a little |
| 3 | No, not limited at all |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf2a (j_indresp_ip) Health limits moderate activities
scasf12_ip10.scsf2b
Health limits several flights of stairs
Type: choice
Source: Quality Metric Inc., 2007
Text: Climbing several flights of stairs
| Option | Label |
|---|---|
| 1 | Yes, limited a lot |
| 2 | Yes, limited a little |
| 3 | No, not limited at all |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf2b (j_indresp_ip) Health limits several flights of stairs
scasf12_ip10.scsf3a
Last 4 weeks: Physical health limits amount of work
Type: choice
Source: Quality Metric Inc., 2007
Text: During the past 4 weeks, how much of the time have you had any of the following problems with your work or other regular daily activities as a result of your physical health? Accomplished less than you would like
| Option | Label |
|---|---|
| 1 | All of the time |
| 2 | Most of the time |
| 3 | Some of the time |
| 4 | A little of the time |
| 5 | None of the time |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf3a (j_indresp_ip) Last 4 weeks: Physical health limits amount of work
scasf12_ip10.scsf3b
Last 4 weeks: Physical health limits kind of work
Type: choice
Source: Quality Metric Inc., 2007
Text: Were limited in the kind of work or other activities
| Option | Label |
|---|---|
| 1 | All of the time |
| 2 | Most of the time |
| 3 | Some of the time |
| 4 | A little of the time |
| 5 | None of the time |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf3b (j_indresp_ip) Last 4 weeks: Physical health limits kind of work
scasf12_ip10.scsf4a
Last 4 weeks: Mental health meant accomplished less
Type: choice
Source: Quality Metric Inc., 2007
Text: During the past 4 weeks, how much of the time have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)? Accomplished less than you would like
| Option | Label |
|---|---|
| 1 | All of the time |
| 2 | Most of the time |
| 3 | Some of the time |
| 4 | A little of the time |
| 5 | None of the time |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf4a (j_indresp_ip) Last 4 weeks: Mental health meant accomplished less
scasf12_ip10.scsf4b
Last 4 weeks: Mental health meant worked less carefully
Type: choice
Source: Quality Metric Inc., 2007
Text: Did work or other activities less carefully than usual
| Option | Label |
|---|---|
| 1 | All of the time |
| 2 | Most of the time |
| 3 | Some of the time |
| 4 | A little of the time |
| 5 | None of the time |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf4b (j_indresp_ip) Last 4 weeks: Mental health meant worked less carefully
scasf12_ip10.scsf5
Last 4 weeks: Pain interfered with work
Type: choice
Source: Quality Metric Inc., 2007
Text: During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?
| Option | Label |
|---|---|
| 1 | Not at all |
| 2 | A little bit |
| 3 | Moderately |
| 4 | Quite a bit |
| 5 | Extremely |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf5 (j_indresp_ip) Last 4 weeks: Pain interfered with work
scasf12_ip10.scsf6a
Last 4 weeks: Felt calm and peaceful
Type: choice
Source: Quality Metric Inc., 2007
Text: These questions are about how you feel and how things have been with you during the past 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 felt calm and peaceful?
| Option | Label |
|---|---|
| 1 | All of the time |
| 2 | Most of the time |
| 3 | Some of the time |
| 4 | A little of the time |
| 5 | None of the time |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf6a (j_indresp_ip) Last 4 weeks: Felt calm and peaceful
scasf12_ip10.scsf6b
Last 4 weeks: Had a lot of energy
Type: choice
Source: Quality Metric Inc., 2007
Text: Did you have a lot of energy?
| Option | Label |
|---|---|
| 1 | All of the time |
| 2 | Most of the time |
| 3 | Some of the time |
| 4 | A little of the time |
| 5 | None of the time |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf6b (j_indresp_ip) Last 4 weeks: Had a lot of energy
scasf12_ip10.scsf6c
Last 4 weeks: Felt downhearted and depressed
Type: choice
Source: Quality Metric Inc., 2007
Text: Have you felt downhearted and depressed?
| Option | Label |
|---|---|
| 1 | All of the time |
| 2 | Most of the time |
| 3 | Some of the time |
| 4 | A little of the time |
| 5 | None of the time |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf6c (j_indresp_ip) Last 4 weeks: Felt downhearted and depressed
scasf12_ip10.scsf7
Last 4 weeks: Physical or mental health interfered with social life
Type: choice
Source: Quality Metric Inc., 2007
Text: During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting friends, relatives)?
| Option | Label |
|---|---|
| 1 | All of the time |
| 2 | Most of the time |
| 3 | Some of the time |
| 4 | A little of the time |
| 5 | None of the time |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_scsf7 (j_indresp_ip) Last 4 weeks: Physical or mental health interfered with social life
scasf12_ip10.sfgriddif1
Difficulty with grid responding in SF-12
Type: choice
Source: UKHLS
Text: The last set of questions asked you about your health. How easy or difficult did you find it to select your responses based on the format that was used for these questions? Please answer just based on how easy or difficult it was to select the responses you wanted to - and not based on how easy or difficult you found it to understand the questions.
| Option | Label |
|---|---|
| 1 | Very easy |
| 2 | Fairly easy |
| 3 | Fairly difficult |
| 4 | Very difficult |
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
- j_sfgriddif1 (j_indresp_ip) Difficulty with grid responding in SF-12
scasf12_ip10.sfgriddif2
Reasons for difficulty with grid responding in SF-12
Type: text
Source: UKHLS
Text: You said that you found it difficult to select your responses. Why do you say that?
Universe:
if (GRIDVARIABLES.ModeType = 1 & CASISTART.scac = 1 thru 3) | (GRIDVARIABLES.ModeType = 2 | 3) (Mode is face-to-face and has agreed to self-completion OR mode is telephone or web)
and if sfgriddif1 = 3|4 (Difficulty with grid responding in SF-12 is fairly or very difficult)
- j_sfgriddif2_code (j_indresp_ip) reason for grid response difficulty
