Innovation Panel Questionnaire Module
scareqol10late_ip14
Self Completion SCA Reqol-10 Late module
Questions 11
scareqol10late_ip14.reqol1lat
Task difficulty late
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:
| Option | Label |
|---|---|
| 1 | None of the time |
| 2 | Only occasionally |
| 3 | Sometimes |
| 4 | Often |
| 5 | Most or all of the time |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scareqol10late_ip14.reqol2lat
Trust late
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:)
| Option | Label |
|---|---|
| 1 | None of the time |
| 2 | Only occasionally |
| 3 | Sometimes |
| 4 | Often |
| 5 | Most or all of the time |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scareqol10late_ip14.reqol3lat
Cope late
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:)
| Option | Label |
|---|---|
| 1 | None of the time |
| 2 | Only occasionally |
| 3 | Sometimes |
| 4 | Often |
| 5 | Most or all of the time |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scareqol10late_ip14.reqol4lat
Do things late
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:)
| Option | Label |
|---|---|
| 1 | None of the time |
| 2 | Only occasionally |
| 3 | Sometimes |
| 4 | Often |
| 5 | Most or all of the time |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scareqol10late_ip14.reqol5lat
Happy late
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:)
| Option | Label |
|---|---|
| 1 | None of the time |
| 2 | Only occasionally |
| 3 | Sometimes |
| 4 | Often |
| 5 | Most or all of the time |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scareqol10late_ip14.reqol6lat
Not worth living late
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:)
| Option | Label |
|---|---|
| 1 | None of the time |
| 2 | Only occasionally |
| 3 | Sometimes |
| 4 | Often |
| 5 | Most or all of the time |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scareqol10late_ip14.reqol7lat
Enjoyed late
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:)
| Option | Label |
|---|---|
| 1 | None of the time |
| 2 | Only occasionally |
| 3 | Sometimes |
| 4 | Often |
| 5 | Most or all of the time |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scareqol10late_ip14.reqol8lat
Hopeful late
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:)
| Option | Label |
|---|---|
| 1 | None of the time |
| 2 | Only occasionally |
| 3 | Sometimes |
| 4 | Often |
| 5 | Most or all of the time |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scareqol10late_ip14.reqol9lat
Lonely late
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:)
| Option | Label |
|---|---|
| 1 | None of the time |
| 2 | Only occasionally |
| 3 | Sometimes |
| 4 | Often |
| 5 | Most or all of the time |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scareqol10late_ip14.reqol10lat
Confident late
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:)
| Option | Label |
|---|---|
| 1 | None of the time |
| 2 | Only occasionally |
| 3 | Sometimes |
| 4 | Often |
| 5 | Most or all of the time |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
scareqol10late_ip14.reqphyslat
Physical Health late
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:
| Option | Label |
|---|---|
| 1 | No problems |
| 2 | Slight problems |
| 3 | Moderate problems |
| 4 | Severe problems |
| 5 | Very severe problems |
Universe:
if (GRIDVARIABLES.modetype = 1 & CASISTART.SCAC = 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 = 2 (ReQoL condition is ASK ReQoL and EQ5D late and GHQ early.)
