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Innovation Panel Questionnaire Module

scareqol10early_ip14

Self Completion SCA Reqol-10 Early module

Questions 11

scareqol10early_ip14.reqol1ear

Task difficulty early

Type: choice

Source: ReQoL-10

Text: For each of the following statements, please tick ONE box that best describes your thoughts, feelings and activities over the LAST WEEK: I found it difficult to get started with everyday tasks.

OptionLabel
1None of the time
2Only occasionally
3Sometimes
4Often
5Most or all of the time

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

scareqol10early_ip14.reqol2ear

Trust early

Type: choice

Source: ReQoL-10

Text: (For each of the following statements, please tick ONE box that best describes your thoughts, feelings and activities over the LAST WEEK:) I felt able to trust others.

OptionLabel
1None of the time
2Only occasionally
3Sometimes
4Often
5Most or all of the time

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

scareqol10early_ip14.reqol3ear

Cope early

Type: choice

Source: ReQoL-10

Text: (For each of the following statements, please tick ONE box that best describes your thoughts, feelings and activities over the LAST WEEK:) I felt unable to cope.

OptionLabel
1None of the time
2Only occasionally
3Sometimes
4Often
5Most or all of the time

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

scareqol10early_ip14.reqol4ear

Do things early

Type: choice

Source: ReQoL-10

Text: (For each of the following statements, please tick ONE box that best describes your thoughts, feelings and activities over the LAST WEEK:) I could do the things I wanted to do.

OptionLabel
1None of the time
2Only occasionally
3Sometimes
4Often
5Most or all of the time

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

scareqol10early_ip14.reqol5ear

Happy early

Type: choice

Source: ReQoL-10

Text: (For each of the following statements, please tick ONE box that best describes your thoughts, feelings and activities over the LAST WEEK:) I felt happy.

OptionLabel
1None of the time
2Only occasionally
3Sometimes
4Often
5Most or all of the time

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

scareqol10early_ip14.reqol6ear

Not worth living early

Type: choice

Source: ReQoL-10

Text: (For each of the following statements, please tick ONE box that best describes your thoughts, feelings and activities over the LAST WEEK:) I thought my life was not worth living.

OptionLabel
4Often
1None of the time
2Only occasionally
3Sometimes
5Most or all of the time

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

scareqol10early_ip14.reqol7ear

Enjoyed early

Type: choice

Source: ReQoL-10

Text: (For each of the following statements, please tick ONE box that best describes your thoughts, feelings and activities over the LAST WEEK:) I enjoyed what I did.

OptionLabel
1None of the time
2Only occasionally
3Sometimes
4Often
5Most or all of the time

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

scareqol10early_ip14.reqol8ear

Hopeful early

Type: choice

Source: ReQoL-10

Text: (For each of the following statements, please tick ONE box that best describes your thoughts, feelings and activities over the LAST WEEK:) I felt hopeful about my future.

OptionLabel
1None of the time
2Only occasionally
3Sometimes
4Often
5Most or all of the time

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

scareqol10early_ip14.reqol9ear

Lonely early

Type: choice

Source: ReQoL-10

Text: (For each of the following statements, please tick ONE box that best describes your thoughts, feelings and activities over the LAST WEEK:) I felt lonely.

OptionLabel
1None of the time
2Only occasionally
3Sometimes
4Often
5Most or all of the time

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

scareqol10early_ip14.reqol10ear

Confident early

Type: choice

Source: ReQoL-10

Text: (For each of the following statements, please tick ONE box that best describes your thoughts, feelings and activities over the LAST WEEK:) I felt confident in myself.

OptionLabel
1None of the time
2Only occasionally
3Sometimes
4Often
5Most or all of the time

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

scareqol10early_ip14.reqphysear

Physical Health early

Type: choice

Source: ReQoL-10

Text: Please describe your physical health (problems with pain, mobility, difficulties caring for yourself or feeling physically unwell) over the LAST WEEK:

OptionLabel
1No problems
2Slight problems
3Moderate problems
4Severe problems
5Very severe problems

Universe:
if (GRIDVARIABLES.modetype = 1 & CASIEARLYSTART.SCACEARLY = 1 | 2 | 3) | GRIDVARIABLES.modetype = 2 | 3 (Mode is face to face and has agreed to self-completion OR Mode is telephone or web)
and if EXPERIMENTALVARIABLES.REQ10COND = 1 (ReQoL condition is ASK ReQoL and EQ5D early and GHQ late.)

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