SHARE:
le_hrs001a_rel_previous
General information
| Question text: | PREVIOUS MONTH
Please click the relevant box if any of the events below occurred to your close relative in the last month (^FLMonth). |
| Answer type: | Check boxes |
| Answer options: | 1 He/she fell down 2 He/she was injured in an accident at home 3 He/she was injured in an accident at work 4 He/she was injured due to an accident elsewhere (not at home or work) 5 He/she was assaulted 6 He/she suffered a heart attack, or was diagnosed with coronary heart disease, angina, congestive heart failure, or other heart problems 7 He/she was diagnosed with heart disease 8 He/she was diagnosed with cancer or a malignant tumor 9 He/she was diagnosed with dementia senility or any other serious memory impairment 10 He/she was diagnosed with diabetes 11 He/she contracted influenza 12 He/she contracted pneumonia 13 He/she was diagnosed with kidney disease 14 He/she was diagnosed with a chronic lung disease such as chronic bronchitis or emphysema 15 He/she was diagnosed with arthritis or rheumatism 16 A doctor told him/her he/she has osteoporosis 17 He/she had surgery or any joint replacement because of arthritis 18 A doctor told him/her that he/she has high blood pressure or hypertension 19 He/she contracted shingles 20 A doctor told him/her that he/she has an emotional, nervous, or psychiatric problem 21 A doctor or other health professional told him/her that he/she has a sleep disorder 22 He/she was diagnosed with an illness not listed above |
| Label: | previous relative which illnesses |
| Empty allowed: | One-time warning |
| Error allowed: | Not allowed |
| Multiple instances: | No |