WORLD HEALTH ORGANIZATIONapps.who.int/iris/bitstream/10665/68350/1/a80933.pdfWORLD HEALTH ORGANIZATION DISABILITY ASSESSMENT SCHEDULE WHODAS II Phase 2 Field Trials – Health Services

WORLD HEALTH ORGANIZATION

DISABILITY ASSESSMENT SCHEDULE

WHODAS II

Phase 2 Field Trials – Health Services Research12 +24 Interviewer Administered, Days Version

February 2000

2

This instrument was developed by the WHO’s Assessment, Classification and Epidemiology Groupwithin the framework of the WHO/NIH Joint Project on Assessment and Classification ofDisablements. The International Task Force members who contributed to the development of thisinstrument include:Elizabeth Badley Canada Ron Kessler USAKaren Ritchie France Robert Trotter USASrinivasa Murthy India Michael Von Korff USACharles Pull Luxembourg Robert Battjes NIDAHans Hoek Netherlands Bennett Fletcher NIDADurk Wiersma Netherlands Bridget Grant NIAAAMartin Prince UK Cille Kennedy NIMHThe WHO team:

Somnath Chatterji Jayne Lux Shekhar SaxenaPatrick Doyle Christopher Nelson T. Bedirhan ÜstünJoAnne Epping-Jordan Jurgen RehmMatilde Leonardi Ritu Sadana

Field Trial Centers:

Thomas Kugener Austria Hans Hoek NetherlandsKruy Kim Hourn Cambodia Bisi Odejide NigeriaYao Guizhong China José Luis Segura García PeruJesús Saíz Cuba Radu Vrasti RomaniaVenos Mavreas Greece José Luis Vazquez Barquero SpainSrinivasa Murthy India, Bangalore Adel Chaker TunisiaHemraj Pal India, Delhi Berna Ulug TurkeyUgo Nocentini Italy Martin Prince UKMiyako Tazaki Japan Ron Kessler USAElie Karam Lebanon Katherine McGonagle USACharles Pull Luxembourg Michael Von Korff USA

The proper use of this instrument requires appropriate training of interviewers including use of theWHO-DAS II Interviewer’s Training Manual and Interview Guide. The computerized version of theinterview (I shell) is available for computer assisted interviews or for data entry. Informant (proxy)and self-administered versions of this instrument are available for field testing.

Permission to translate this instrument into any language should be obtained from WHO. Alltranslations should be prepared according to the WHO translation guidelines.

For additional information, please contact:Dr T. Bedirhan ÜstünGroup LeaderAssessment, Classification and Epidemiology GroupWorld Health OrganizationCH – 1211 Geneva 27

Switzerland

Tel: + + 41 22 791 3609Fax: + + 41 22 791 4885Email: [email protected]

3

SECTION 1. Face Sheet

ITEMS F1- F6 ARE TO BE COMPLETED BY INTERVIEWERS PRIOR TOSTARTING EACH INTERVIEW

F1 RESPONDENT I.D . #

CENTRE # - SUBJECT #

F2 INTERVIEWER I.D. #

CENTRE # - INTERVIEWER #

F3 ASSESSMENT TIME POINT (1, 2, ETC.)

F4 INTERVIEW DATE ___ ___/___ ___/___ ___ month day year

F5 LIVING SITUATION AT TIME OFINTERVIEW (CIRCLE ONLY ONE)

Independent in Community 1

Assisted Living 2

Hospitalized 3

F6 SAMPLE (CIRCLE ONLY ONE)General population 1

Drug related problems 2

Alcohol related problems 3

Mental health problems 4

Physical problems 5

Other (specify) 6

__________________________

4

SECTION 2. DEMOGRAPHIC AND BACKGROUND INFORMATION

PREAMBLE

This interview has been developed by the World Health Organization to better understand thedifficulties people may have due to their health conditions. The information that you provide inthis interview is confidential and will be used only for research.

FOR RESPONDENTS FROM THE GENERAL POPULATION (NOT THE CLINICALPOPULATION) SAY: Even if you are healthy and have no difficulties, it is necessary that I askall of the questions for completeness.

I will begin with some background questions.

A1 RECORD SEX AS OBSERVED Female 1Male 2

A2 How old are you now? ___/___ years

A3 How many years in all did you spend studying inschool, college or university?

___/___ years

A4 What is your current marital status?(SELECT THE SINGLE BEST OPTION)

Never married 1

Currently married 2

Separated 3

Divorced 4

Widowed 5

Cohabiting 6

5

A5 Which describes your main work status best?(SELECT THE SINGLE BEST OPTION)

Paid work 1

Self employed, such as own 2 your business or farming

Non paid work, such as 3 volunteer or charity

Student 4

Keeping house/Homemaker 5

Retired 6

Unemployed (health reasons) 7

Unemployed (other reasons) 8

Other (specify) 9

__________________________

6

SECTION 3: PREAMBLE

SAY TO RESPONDENT:The interview is about difficulties people have because of health conditions. (HANDFLASHCARD #1 TO RESPONDENT). By health condition I mean diseases or illnesses, otherhealth problems that may be short or long lasting, injuries, mental or emotional problems andproblems with alcohol or drugs.

I remind you to keep all of your health problems in mind as you answer the questions. When I askyou about difficulties in doing an activity think about (POINT TO FLASHCARD #1).

• Increased effort• Discomfort or pain• Slowness• Changes in the way you do the activity

(POINT TO FLASHCARD #1). When answering, I’d like you to think back over the last 30days. I also would like you to answer these questions thinking about how much difficulty youhave, on average over the past 30 days, while doing the activity as you usually do it.

(HAND FLASHCARD #2 TO RESPONDENT). Use this scale when responding. (READSCALE ALOUD): None, mild, moderate, severe, extreme or cannot do.

(FLASHCARDS #1 AND #2 SHOULD REMAIN VISIBLE TO THE RESPONDENTTHROUGHOUT THE INTERVIEW. )

7

SECTION 4. CORE QUESTIONS

SHOW FLASHCARD #2 to participant

In the last 30 days how much difficulty did you have in:

None Mild Moderate SevereExtreme/Cannot

Do

S1 Standing for long periods such as30 minutes? 1 2 3 4 5

S2 Taking care of your householdresponsibilities? 1 2 3 4 5

S3 Learning a new task, for example,learning how to get to a newplace?

1 2 3 4 5

S4 How much of a problem did youhave joining in communityactivities (for example, festivities,religious or other activities) in thesame way as anyone else can?

1 2 3 4 5

S5 How much have you beenemotionally affected by yourhealth problems?

1 2 3 4 5

IF ANY OF S1-S5 ARE ENDORSED (RATED GREATER THAN NONE),CONTINUE WITH S6-S12

OTHERWISE, THIS IS THE END OF THE INTERVIEW.

This concludes our interview, thank you for participating.

8



Do

S6 Concentrating on doing somethingfor ten minutes? 1 2 3 4 5

S7 Walking a long distance such as akilometre [or equivalent]?

1 2 3 4 5

S8 Washing your whole body? 1 2 3 4 5

S9 Getting dressed? 1 2 3 4 5

S10 Dealing with people you do notknow? 1 2 3 4 5

S11 Maintaining a friendship? 1 2 3 4 5

S12 Your day to day work? 1 2 3 4 5

H3 Overall, in the past 30 days, how manydays were these difficulties present?

RECORD NUMBER OF DAYS

___/___

CONTINUE BY ADMINISTERING THE SPECIFIED DOMAINS ASFOLLOWS:

IF QUESTION ISENDORSED (CODED 2-5)

GO TO DOMAIN NUMBER

S3 or S6 1 on page 7




S2 or S12 5 on pages 11-12

S4 or S5 6 on page 13 –14

9

DOMAIN 1 Understanding and Communicating

Now I am going to ask some questions about understanding and communicating.

show flashcards #1 AND #2for responses greater than NONE (1), ASK: how many days was this difficulty present?RECORD NUMBER OF DAYS (0 - 30)

In the last 30 days, how much difficulty did you have in:


Do

NumberDays

D1.2 Remembering to do importantthings?

1 2 3 4 5 _______D1.2d

D1.3 Analysing and finding solutions toproblems in day to day life?

1 2 3 4 5 _______D1.3d

D1.5 Generally understanding what peoplesay?

1 2 3 4 5 _______D1.5d

D1.6 Starting and maintaining a conversation? 1 2 3 4 5 _______D1.6d

Probe:

IF ANY OF D1.1 – D1.6 ARE RATED GREATER THAN NONE (1), ASK:


Do

P1.1 How much did these difficulties interferewith your life? 1 2 3 4 5

10

DOMAIN 2 Getting Around

I am now going to ask you about difficulties in getting around.

SHOW FLASHCARDS #1 AND #2

for responses greater than NONE (1), ASK: how many days was this difficulty present?RECORD NUMBER OF DAYS (0-30)



Do

NumberDays

D2.2 Standing up from sitting down? 1 2 3 4 5 _______D2.2d

D2.3 Moving around inside your home? 1 2 3 4 5 _______D2.3d

D2.4 Getting out of your home? 1 2 3 4 5 _______D2.4d

Probe:

IF ANY OF D2.1 –D2.5 ARE RATED GREATER THAN NONE (1), ASK:


Do


11

DOMAIN 3 Self Care

I am now going to ask you about difficulties in taking care of yourself.


for responses greater than NONE (1), SHOW FLASHCARD #3ASK: how many days was this difficulty present? RECORD NUMBER OF DAYS (0-30)



Do

NumberDays

D3.3 Eating? 1 2 3 4 5 _______D3.3d

D3.4 Staying by yourself for a few days? 1 2 3 4 5_______

D3.4d

Probe:



Do


12

DOMAIN 4 Getting along with people

I am now going to ask you about difficulties in getting along with people. Please remember that Iam asking only about difficulties that are due to health problems. By this I mean diseases orillnesses, injuries, mental or emotional problems and problems with alcohol or drugs.


for responses greater than NONE (1), SHOW FLASHCARD #3ASK: how many days was this difficulty present?RECORD NUMBER OF DAYS (0-30)



Do

NumberDays

D4.3 Getting along with people who are closeto you?

1 2 3 4 5 _______D4.3d

D4.4 Making new friends? 1 2 3 4 5 _______D4.4d

D4.5 Sexual activities? 1 2 3 4 5 _______D4.5d

Probe:



Do


13

DOMAIN 5 Life Activities

• Household ActivitiesThe following questions are about activities involved in maintaining your household, and incaring for the people with whom you live or those close to you. These activities include cooking,cleaning, shopping, caring for others and caring for your belongings.

D5.1 How many hours do you spend in theseactivities in a typical week?

RECORD NUMBER OF HOURS__/__


for responses greater than NONE (1), ASK: how many days was this difficulty present?RECORD NUMBER OF DAYS (0-30)

Because of your health condition, in the last 30 days, how much difficulty did you have in:


Do

NumberDays

D5.3 Doing your most important householdtasks well?

1 2 3 4 5 _______D5.3d

D5.4 Getting all the household work done thatyou needed to do?

1 2 3 4 5 _______D5.4d

D5.5 Getting your household work done asquickly as needed?

1 2 3 4 5 _______D5.5d

IF ANY OF D5.2 – D5.5 ARE RATED GREATER THAN NONE (1), ASK:None Mild Moderate Severe

Extreme/Cannot Do


D5.6 In the last 30 days, on how many daysdid you reduce or completely misshousehold work because of your healthcondition?

RECORD NUMBER OF DAYS __/__

14

IF RESPONDENT WORKS (PAID, NON-PAID, SELF EMPLOYED) OR GOES TOSCHOOL, COMPLETE QUESTIONS D5.7-D5.13. OTHERWISE, SKIP TO D6.1 ON THENEXT PAGE

Now I will ask some questions about your work or school activities.

D5.7 How many hours do you spend inwork (which includes school) in a typicalweek?

RECORD NUMBER OF HOURS __ /__


for responses greater than NONE (1), ASK: how many days was this difficulty present?RECORD NUMBER OF DAYS (0-30)Because of your health condition, in the last 30 days how much difficulty did you have in:


Do

NumberDays

D5.9 Doing your most important work taskswell?

1 2 3 4 5 _______D5.9d

D5.10 Getting all the work done that you needto do?

1 2 3 4 5 _______D5.10d

D5.11 Getting your work done as quickly asneeded?

1 2 3 4 5 _______D5.11d

D5.12 Have you had to work at a lower level because of a healthcondition?

No 1Yes 2

D5.13 Did you earn less money as the result of a healthcondition?

No 1Yes 2


None Mild Moderate SevereExtreme

/Cannot Do

P5.2 How much did these difficultiesinterfere with your life? 1 2 3 4 5

D5.14 In the last 30 days, on how many daysdid you miss work for half a day ormore because of your health condition?


15

DOMAIN 6 Participation in Society

Now, I am going to ask you about your participation in society and the impact of your healthproblems on you and your family. Some of these questions may involve problems that go beyondthe last 30 days, however in answering, please focus on the last 30 days. Again, I remind you toanswer these questions while thinking about health problems: physical, mental or emotional,alcohol or drug related.


NOTE THAT THE NUMBER OF DAYS FOR EACH QUESTION IN THIS DOMAIN ISNOT REQUESTED.

In the last 30 days: None Mild Moderate SevereExtreme

/Cannot Do

D6.2 How much of a problem did you havebecause of barriers or hindrances in theworld around you?

1 2 3 4 5

D6.3 How much of a problem did you haveliving with dignity because of theattitudes and actions of others?

1 2 3 4 5

D6.4 How much time did you spend on yourhealth condition, or its consequences?

1 2 3 4 5

D6.6 How much has your health been a drainon the financial resources of you oryour family?

1 2 3 4 5

D6.7 How much of a problem did yourfamily have because of your healthproblems?

1 2 3 4 5

D6.8 How much of a problem did you have indoing things by yourself for relaxationor pleasure?

1 2 3 4 5

16

Probe: IF ANY OF D6.1 – D6.8 ARE RATED GREATER THAN NONE (1), ASK:


Do

P6.1 How much did these problems interferewith your life? 1 2 3 4 5

P6.2 In the last 30 days, for how many daysdid you have these difficulties?


H3 Overall, in the past 30 days, how manydays did you experience any of thedifficulties that we have discussed duringthis interview?


___/___


17

Health Conditions:• Diseases, illnesses or other health problems• Injuries• Mental or emotional problems• Problems with alcohol• Problems with drugs

Having difficulty with an activity means:


Think about the past 30 days only

Flashcard #1

Flashcard #2

1 2 3 4 5

None Mild Moderate Severe Extreme/ Cannot Do

2

1

World Health Organization For Office Use Only:

Disability Assessment Schedule II __ __ __ - __ __ __ - ___Center# Subject # - Time #

Phase 2 Field Trials – Health Services Research12-Item Self-Administered Version __ __/ __ __ / __ __

Day / Month / Year

Pop: Dwelling:q Gen 1 Independentq Drg 1 Assistedq Alc 1 Hospitalizedq Mnhq Physq Other

H1 How do you rate your overallhealth in the past 30 days?

Very good Good Moderate Bad Very Bad

This questionnaire asks about difficulties due to health conditions. Health conditions includediseases or illnesses, other health problems that may be short or long lasting, injuries, mental oremotional problems, and problems with alcohol or drugs.

Think back over the last 30 days and answer these questions thinking about how much difficultyyou had doing the following activities. For each question, please circle only one response.


S1 Standing for long periods such as 30minutes?


Do

S2 Taking care of your householdresponsibilities?


Do

S3 Learning a new task, for example,learning how to get to a new place?


Do

S4 How much of a problem did you havejoining in community activities (forexample, festivities, religious or otheractivities) in the same way as anyone elsecan?


Do

S5 How much have you been emotionallyaffected by your health problems?


Do

Please continue to the next page …

2


S6 Concentrating on doing something forten minutes?


Do



Do

S8 Washing your whole body? None Mild Moderate SevereExtreme/Cannot

Do

S9 Getting dressed? None Mild Moderate SevereExtreme/Cannot

Do

S10 Dealing with people you do not know? None Mild Moderate SevereExtreme/Cannot

Do

S11 Maintaining a friendship? None Mild Moderate SevereExtreme/Cannot

Do

S12 Your day to day work? None Mild Moderate SevereExtreme/Cannot

Do

H2 Overall, how much did thesedifficulties interfere with your life?

Not at all Mildly Moderately Severely Extremely

H3 Overall, in the past 30 days, howmany days were these difficultiespresent?


___/___

H4 In the past 30 days, for how manydays were you totally unable to carryout your usual activities or workbecause of any health condition?


___/___

H5 In the past 30 days, not counting thedays that you were totally unable, forhow many days did you cut back orreduce your usual activities or workbecause of any health condition?


___/___

This completes the questionnaire. Thank you.



WHODAS II

Phase 2 Field Trials – Health Services Research12-Item Interviewer Administered Version

February 2000

2







For additional information, please contact:Dr T. Bedirhan ÜstünGroup LeaderAssessment, Classification and Epidemiology GroupWorld Health OrganizationCH – 1211 Geneva 27

Switzerland

Tel: + + 41 22 791 3609Fax: + + 41 22 791 4885Email: [email protected]

3











Assisted Living 2

Hospitalized 3





Physical problems 5

Other (specify) 6

__________________________

4


PREAMBLE







___/___ years


Never married 1

Currently married 2

Separated 3

Divorced 4

Widowed 5

Cohabiting 6

5


Paid work 1



Student 4


Retired 6



Other (specify) 9

__________________________

6

SECTION 3: PREAMBLE







7

SECTION 4. CORE QUESTIONS


Read choices to respondent.


SHOW FLASHCARD #2 to participant



Do

S1 Standing for long periods such as30 minutes? 1 2 3 4 5

S2 Taking care of your householdresponsibilities? 1 2 3 4 5

S3 Learning a new task, for example,learning how to get to a newplace?

1 2 3 4 5

S4 How much of a problem did youhave joining in communityactivities (for example, festivities,religious or other activities) in thesame way as anyone else can?

1 2 3 4 5

S5 How much have you beenemotionally affected by yourhealth problems?

1 2 3 4 5

Continue to next page…

8



Do

S6 Concentrating on doing somethingfor ten minutes? 1 2 3 4 5


1 2 3 4 5

S8 Washing your whole body? 1 2 3 4 5

S9 Getting dressed? 1 2 3 4 5

S10 Dealing with people you do notknow? 1 2 3 4 5

S11 Maintaining a friendship? 1 2 3 4 5

S12 Your day to day work? 1 2 3 4 5


Do

H2 Overall, how much did these difficultiesinterfere with your life?Read choices to respondent.

1 2 3 4 5

H3 Overall, in the past 30 days, how manydays were these difficulties present?


___/___

H4 In the past 30 days, for how many dayswere you totally unable to carry out yourusual activities or work because of anyhealth condition?


__/__

H5 In the past 30 days, not counting the daysthat you were totally unable, for how manydays did you cut back or reduce your usualactivities or work because of any healthcondition?


__/__


9





Flashcard #1

Flashcard #2

1 2 3 4 5


2

1


Disability Assessment Schedule II __ __ __ - __ __ __ - ___ Center# Subject # Time #


Day / Month / Year

Pop: Dwelling:q Gen � Independentq Drg � Assistedq Alc � Hospitalizedq Mnhq Physq Other



This questionnaire asks about difficulties due to health conditions. Health conditions includediseases or illnesses, other health problems that may be short or long lasting, injuries, mentalor emotional problems, and problems with alcohol or drugs.

Think back over the last 30 days and answer these questions thinking about how muchdifficulty you had doing the following activities. For each question, please circle only oneresponse.


Understanding and communicating

D1.1 Concentrating on doing something for ten minutes? None Mild Moderate SevereExtreme/Cannot

Do

D1.2 Remembering to do important things? None Mild Moderate SevereExtreme/Cannot

Do

D1.3 Analyzing and finding solutions to problems in day today life?


Do

D1.4 Learning a new task, for example, learning how to get toa new place?


Do

D1.5 Generally understanding what people say? None Mild Moderate SevereExtreme/Cannot

Do

D1.6 Starting and maintaining a conversation? None Mild Moderate SevereExtreme/Cannot

Do

Getting around

D2.1 Standing for long periods such as 30 minutes? None Mild Moderate SevereExtreme/Cannot

Do

D2.2 Standing up from sitting down? None Mild Moderate SevereExtreme/Cannot

Do

D2.3 Moving around inside your home? None Mild ModerateSevere Extreme/

CannotDo

D2.4 Getting out of your home? None Mild Moderate SevereExtreme/Cannot

Do

D2.5 Walking a long distance such as a kilometre (orequivalent)?


Do


2


Self Care

D3.1 Washing your whole body? None Mild Moderate SevereExtreme/Cannot

Do

D3.2 Getting dressed? NoneMild Moderate Severe Extreme/

CannotDo

D3.3 Eating? NoneMild Moderate Severe Extreme/

CannotDo

D3.4 Staying by yourself for a few days? NoneMild Moderate Severe Extreme/

CannotDo

Getting along with people

D4.1 Dealing with people you do not know? None MildModerate Severe Extreme/

CannotDo

D4.2 Maintaining a friendship? None Mild Moderate SevereExtreme/Cannot

Do

D4.3 Getting along with people who are close to you? None Mild Moderate SevereExtreme/Cannot

Do

D4.4 Making new friends? None Mild Moderate SevereExtreme/Cannot

Do

D4.5 Sexual activities? None Mild Moderate SevereExtreme/Cannot

Do

Life activities

D5.1 Taking care of your household responsibilities? None Mild Moderate SevereExtreme/Cannot

Do

D5.2 Doing most important household tasks well? None Mild Moderate SevereExtreme/Cannot

Do

D5.3 Getting all the household work done that you needed todo?

None Mild Moderate Severe Extreme/Cannot

Do

D5.4 Getting your household work done as quickly asneeded?


Do

IF YOU WORK (PAID, NON-PAID, SELF EMPLOYED) OR GO TO SCHOOL, COMPLETEQUESTIONS D5.5-D5.8 BELOW. OTHERWISE, SKIP TO D6.1 AT THE TOP OF THE NEXT PAGE.


D5.5 Your day to day work/school? None Mild Moderate SevereExtreme/Cannot

Do

D5.6 Doing your most important work/school tasks well? None Mild Moderate SevereExtreme/Cannot

Do

D5.7 Getting all the work done that you need to do? None Mild Moderate SevereExtreme/Cannot

Do

D5.8 Getting your work done as quickly as needed? None Mild Moderate SevereExtreme/Cannot

Do


3

In the last 30 days:

Participation in Society

D6.1 How much of a problem did you have in joining incommunity activities (for example, festivities, religiousor other activities) in the same way as anyone else can


Do

D6.2 How much of a problem did you have because ofbarriers or hindrances in the world around you?


Do

D6.3 How much of a problem did you have living withdignity because of the attitudes and actions of others


Do

D6.4 How much time did you spend on your health condition,or its consequences


Do

D6.5 How much have you been emotionally affected by yourhealth condition


Do

D6.6 How much has your health been a drain on the financialresources of you or your family


Do

D6.7 How much of a problem did your family have becauseof your health problems


Do

D6.8 How much of a problem did you have in doing things byyourself for relaxation or pleasure


Do

H2 Overall, how much did these difficulties interferewith your life?


H3 Overall, in the past 30 days, how many dayswere these difficulties present?


___/___

H4 In the past 30 days, for how many days were youtotally unable to carry out your usual activities orwork because of any health condition?


___/___

H5 In the past 30 days, not counting the days that youwere totally unable, for how many days did youcut back or reduce your usual activities or workbecause of any health condition?


___/___




WHODAS II

Phase 2 Field Trials – Health Services Research36-Item Interviewer Administered, Days Version

February 2000

2







For additional information, please contact:Dr T. Bedirhan ÜstünGroup LeaderAssessment, Classification and Epidemiology GroupWorld Health OrganizationCH – 1211 Geneva 27SwitzerlandTel: + + 41 22 791 3609Fax: + + 41 22 791 4885Email: [email protected]

3











Assisted Living 2

Hospitalized 3





Physical problems 5

Other (specify) 6

__________________________

4


PREAMBLE







___/___ years


Never married 1

Currently married 2

Separated 3

Divorced 4

Widowed 5

Cohabiting 6

5


Paid work 1



Student 4


Retired 6



Other (specify) 9

__________________________

6

SECTION 3: PREAMBLE







7

SECTION 4. DOMAIN REVIEWS


I am going to ask some questions about understanding and communicating.


FOR RESPONSES GREATER THAN NONE (1), ASK: How many days was this difficultypresent? RECORD NUMBER OF DAYS (0 -30)



Do

NumberDays

D1.1 Concentrating on doing something for tenminutes? 1 2 3 4 5 _______

D1.1d

D1.2 Remembering to do importantthings?

1 2 3 4 5 _______D1.2d


1 2 3 4 5 _______D1.3d

D1.4 Learning a new task, for example,learning how to get to a new place?

1 2 3 4 5 _______D1.4d


1 2 3 4 5 _______D1.5d


Probe:



Do


8




FOR RESPONSES GREATER THAN NONE (1), ASK: How many days was this difficultypresent? RECORD NUMBER OF DAYS (0-30)



Do

NumberDays

D2.1 Standing for long periods such as 30minutes? 1 2 3 4 5 _______

D2.1d


D2.3 Moving around inside your home? 1 2 3 4 5 _______D2.3d

D2.4 Getting out of your home? 1 2 3 4 5 _______D2.4d

D2.5 Walking a long distance such as akilometre [or equivalent]?

1 2 3 4 5 _______D2.5d

Probe:



Do


9

DOMAIN 3 Self Care

I am now going to ask you about difficulties in taking care of yourself.





Do

NumberDays

D3.1 Washing your whole body? 1 2 3 4 5 _______D3.1d

D3.2 Getting dressed? 1 2 3 4 5 _______D3.2d

D3.3 Eating? 1 2 3 4 5 _______D3.3d

D3.4 Staying by yourself for a few days? 1 2 3 4 5_______D3.4d

Probe:



Do


10







Do

NumberDays

D4.1 Dealing with people you do not know? 1 2 3 4 5 _______D4.1d

D4.2 Maintaining a friendship? 1 2 3 4 5 _______D4.2d

D4.3 Getting along with people who are closeto you?

1 2 3 4 5 _______D4.3d



Probe:



Do


11


• Household ActivitiesThe following questions are about activities involved in maintaining your household, and incaring for the people with whom you live or those close to you. These activities include cooking,cleaning, shopping, caring for others and caring for your belongings.

D5.1 How many hours do you spend in theseactivities in a typical week?

RECORD NUMBER OF HOURS __/__



Because of your health condition, in the last 30 days, how much difficulty did you have in:


Do

NumberDays

D5.2 Taking care of your householdresponsibilities?

1 2 3 4 5 _______D5.2d

D5.3 Doing your most important householdtasks well?

1 2 3 4 5 _______D5.3d

D5.4 Getting all the household work done thatyou needed to do?

1 2 3 4 5 _______D5.4d

D5.5 Getting your household work done asquickly as needed?

1 2 3 4 5 _______D5.5d



Do


D5.6 In the last 30 days, on how many daysdid you reduce or completely misshousehold work because of your healthcondition?


12

IF RESPONDENT WORKS (PAID, NON-PAID, SELF EMPLOYED) OR GOES TOSCHOOL, COMPLETE QUESTIONS D5.7-D5.13. OTHERWISE, SKIP TO D6.1 ON THENEXT PAGE

Now I will ask some questions about your work or school.

D5.7 How many hours do you spend inwork (which includes school) in a typicalwork week?



FOR RESPONSES GREATER THAN NONE (1), ASK: How many days was this difficultypresent? RECORD NUMBER OF DAYS (0-30)Because of your health condition, in the last 30 days how much difficulty did you have in:


Do

NumberDays

D5.8 Your day to day work? 1 2 3 4 5 _______D5.8d

D5.9 Doing your most important work taskswell?

1 2 3 4 5 _______D5.9d

D5.10 Getting all the work done that you needto do?

1 2 3 4 5 _______D5.10d

D5.11 Getting your work done as quickly asneeded?

1 2 3 4 5 _______D5.11d

D5.12 Have you had to work at a lower level because of a healthcondition?

No 1Yes 2

D5.13 Did you earn less money as the result of a healthcondition?

No 1Yes 2



Do

P5.2 How much did these difficultiesinterfere with your life? 1 2 3 4 5

D5.14 In the last 30 days, on how many daysdid you miss work for half a day ormore because of your health condition?


13


Now, I am going to ask you about your participation in society and the impact of your healthproblems on you and your family. Some of these questions may involve problems that go beyondthe last 30 days, however in answering, please focus on the last 30 days. Again, I remind you toanswer these questions while thinking about health problems: physical, mental or emotional,alcohol or drug related.



In the last 30 days: None Mild Moderate Severe Extreme/Cannot Do

D6.1 How much of a problem did you havejoining in community activities (forexample, festivities, religious or otheractivities) in the same way as anyoneelse can?

1 2 3 4 5

D6.2 How much of a problem did you havebecause of barriers or hindrances in theworld around you?

1 2 3 4 5

D6.3 How much of a problem did you haveliving with dignity because of theattitudes and actions of others?

1 2 3 4 5

D6.4 How much time did you spend on yourhealth condition, or its consequences?

1 2 3 4 5

D6.5 How much have you been emotionallyaffected by your health condition?

1 2 3 4 5

D6.6 How much has your health been a drainon the financial resources of you oryour family?

1 2 3 4 5

14


D6.7 How much of a problem did yourfamily have because of your healthproblems?

1 2 3 4 5

D6.8 How much of a problem did you have indoing things by yourself for relaxationor pleasure?

1 2 3 4 5



Do

P6.1 How much did these problems interferewith your life? 1 2 3 4 5

P6.2 In the last 30 days, for how many daysdid you have these difficulties?


H3 Overall, in the past 30 days, how manydays did you experience any of thedifficulties that we have discussed duringthis interview?


___/___


15





Flashcard #1

Flashcard #2

1 2 3 4 5




Phase 2 Field Trials – Health Services Research6-Item Proxy Informant Version __ __/ __ __ / __ __

Day / Month / Year


This questionnaire asks about difficulties due to health conditions. Health conditions include diseases orillnesses, other health problems that may be short or long lasting, injuries, mental or emotional problems, andproblems with alcohol or drugs.

Think back over the last 30 days and, to the best of your knowledge, answer these questions thinking about howmuch difficulty your relative* had while doing the following activities. For each question, please circle onlyone response.(* This term is defined broadly for the purpose of this questionnaire, and can include friends or acquaintances.)

H1 How do you rate your relative’s overallhealth in the past 30 days?


In the last 30 days, how much difficulty did yourrelative have in…

CS1Understanding and communicating.• Concentrating or remembering• Finding solutions to problems• Learning something new• Generally understanding and

communicating with people

None Mild Moderate Severe Extreme/Cannot Do

CS2Getting around.• Standing for long periods• Standing up from sitting down• Moving around inside the home• Getting out of the home• Difficulty with walking a long distance

such as a kilometer


CS3Self care.• Washing his/her whole body• Getting dressed• Eating• Staying alone for a few days


CS4 Getting along with people.• Dealing with people who are strangers• Maintaining a friendship• Getting along with people who are close• Controlling feelings


CS5 Household activities or work or schoolactivities.• Getting these activities done• Doing these activities well• Doing them as quickly as needed



In the last 30 days, how much difficulty did yourrelative have in…

CS6Participation in society.• The world and other people creating

problems• Discrimination• Problems in living with dignity• Problems joining in community activities


H2 Overall, how much did all of thesedifficulties interfere with your relative’s life?




___/___

H4 In the past 30 days, for how many days wasyour relative totally unable to carry outhis/her usual activities or work because ofany health condition?


___/___

H5 In the past 30 days, not counting the days thatyour relative was totally unable, for howmany days did your relative cut back orreduce his/her usual activities or workbecause of any health condition?


___/___

H6 In the past 30 days, how many days have youseen or spoken with your relative?


___/___

H7 I am the _________ (choose one) of thisperson.

1 = husband or wife

2 = parent

3 = son or daughter

4 = brother or sister

5 = other relative

6 = friend

7 = professional carer

8 = other (specify) _____________




Phase 2 Field Trials – Health Services Research6-Item Clinician Proxy Version __ __/ __ __ / __ __

Day / Month / Year



Think back over the last 30 days and, to the best of your knowledge, answer these questions thinking about howmuch difficulty your patient had while doing the following activities. For each question, please circle only oneresponse.

H1 How do you rate your patient’s overallhealth in the past 30 days?


In the last 30 days, how much difficulty did yourpatient have in…

CS1Understanding and communicating.• Concentrating or remembering• Finding solutions to problems• Learning something new• Generally understanding and

communicating with people


CS2Getting around.• Standing for long periods• Standing up from sitting down• Moving around inside the home• Getting out of the home• Difficulty with walking a long distance

such as a kilometer


CS3Self care.• Washing his/her whole body• Getting dressed• Eating• Staying alone for a few days


CS4 Getting along with people.• Dealing with people who are strangers• Maintaining a friendship• Getting along with people who are close• Controlling feelings


CS5 Household activities or work or schoolactivities.• Getting these activities done• Doing these activities well• Doing them as quickly as needed



In the last 30 days, how much difficulty did yourpatient have in…

CS6Participation in society.• The world and other people creating

problems• Discrimination• Problems in living with dignity• Problems joining in community activities


H2 Overall, how much did all of thesedifficulties interfere with your patient’s life?




___/___

H4 In the past 30 days, for how many days wasyour patient totally unable to carry outhis/her usual activities or work because ofany health condition?


___/___

H5 In the past 30 days, not counting the days thatyour patient was totally unable, for howmany days did your patient cut back orreduce his/her usual activities or workbecause of any health condition?


___/___

H6 In the past 30 days, how many days have youseen or spoken with your patient?


___/___


1



Phase 2 Field Trials – Health Services Research36-Item Proxy Informant Version __ __/ __ __ / __ __

Day / Month / Year



Think back over the last 30 days and, to the best of your knowledge, answer these questions thinking about howmuch difficulty your relative* had while doing the following activities. For each question, please circle onlyone response.

(* This term is defined broadly for the purpose of this questionnaire, and can include friends or acquaintances.)

H1 How do you rate your relative’s overallhealth in the past 30 days?


In the last 30 days, how much difficulty did your relative havein…



Do


Do



Do



Do


Do


Do


2

In the last 30 days, how much difficulty did your relative havein:

Getting around


Do


Do

D2.3 Moving around inside the home? None Mild Moderate SevereExtreme/Cannot

Do

D2.4 Getting out of the home? None Mild Moderate SevereExtreme/Cannot

Do



Do

Self Care

D3.1 Washing his/her whole body? None Mild Moderate SevereExtreme/Cannot

Do

D3.2 Getting dressed? None Mild Moderate SevereExtreme/Cannot

Do

D3.3 Eating? None Mild Moderate SevereExtreme/Cannot

Do

D3.4 Staying by himself/herself for a few days? None Mild Moderate SevereExtreme/Cannot

Do


D4.1 Dealing with people he/she does not know? None Mild Moderate SevereExtreme/Cannot

Do


Do

D4.3 Getting along with people who are close to him/her? None Mild Moderate SevereExtreme/Cannot

Do


Do


Do

Life activities

D5.1 Taking care of his/her household responsibilities? None Mild Moderate SevereExtreme/Cannot

Do

D5.2 Doing his/her most important household tasks well? None Mild Moderate SevereExtreme/Cannot

Do

D5.3 Getting all the household work done that is needed? None Mild Moderate SevereExtreme/Cannot

Do

D5.4 Getting the household work done as quickly as needed? None Mild Moderate SevereExtreme/Cannot

Do


3

IF YOUR RELATIVE WORKS (PAID, NON-PAID, SELF EMPLOYED) OR GOES TO SCHOOL,COMPLETE QUESTIONS D5.5-D5.8 BELOW. OTHERWISE, SKIP TO D6.1 NEAR THE MIDDLEOF THE PAGE.

In the last 30 days, how much difficulty did your relativehave in:

D5.5 His/her day to day work/school? None Mild Moderate SevereExtreme/Cannot

Do

D5.6 Doing his/her most important work/school tasks well? None Mild Moderate SevereExtreme/Cannot

Do

D5.7 Getting all the work done that is needed? None Mild Moderate SevereExtreme/Cannot

Do

D5.8 Getting the work done as quickly as needed? None Mild Moderate SevereExtreme/Cannot

Do

Participation in society


D6.1 How much of a problem did your relative have injoining in community activities (for example, festivities,religious or other activities) in the same way as anyoneelse can?


Do

D6.2 How much of a problem did your relative have becauseof barriers or hindrances in the world around him/her?


Do

D6.3 How much of a problem did your relative have livingwith dignity because of the attitudes and actions ofothers?


Do

D6.4 How much time did your relative spend on his/her healthcondition, or its consequences?


Do

D6.5 How much has your relative been emotionally affectedby his/her health condition?


Do

D6.6 How much has his/her health been a drain on his/herfinancial resources or on the financial resources of otherrelatives?


Do

D6.7 How much of a problem did you or the rest of his/herfamily have because of his/her health problems?


Do

D6.8 How much of a problem did your relative have in doingthings by him/herself for relaxation or pleasure?


Do


4

H2 Overall, how much did all of these difficultiesinterfere with your relative’s life?




___/___

H4 In the past 30 days, for how many days wasyour relative totally unable to carry out his/herusual activities or work because of any healthcondition?


___/___

H5 In the past 30 days, not counting the days thatyour relative was totally unable, for how manydays did your relative cut back or reducehis/her usual activities or work because of anyhealth condition?


___/___

H6 In the past 30 days, how many days have youseen or spoken with your relative?


___/___

H7 I am the ___________ (choose one) of thisperson.

1 = husband or wife

2 = parent

3 = son or daughter

4 = brother or sister

5 = other relative

6 = friend

7 = professional carer

8 = other (specify) _____________


1


Disability Assessment Schedule II __ __ __ - __ __ __ - ___ Center# Subject # Time #


Day / Month / Year

Pop: Dwelling:q Gen � Independentq Drg � Assistedq Alc � Hospitalizedq Mnhq Physq Other



This questionnaire asks about difficulties due to health conditions. Health conditions includediseases or illnesses, other health problems that may be short or long lasting, injuries, mentalor emotional problems, and problems with alcohol or drugs.

Think back over the last 30 days and answer these questions thinking about how muchdifficulty you had doing the following activities. For each question, please circle only oneresponse.




Do


Do



Do



Do


Do


Do

Getting around


Do


Do

D2.3 Moving around inside your home? None Mild ModerateSevere Extreme/

CannotDo

D2.4 Getting out of your home? None Mild Moderate SevereExtreme/Cannot

Do



Do


2


Self Care

D3.1 Washing your whole body? None Mild Moderate SevereExtreme/Cannot

Do

D3.2 Getting dressed? NoneMild Moderate Severe Extreme/

CannotDo

D3.3 Eating? NoneMild Moderate Severe Extreme/

CannotDo

D3.4 Staying by yourself for a few days? NoneMild Moderate Severe Extreme/

CannotDo


D4.1 Dealing with people you do not know? None MildModerate Severe Extreme/

CannotDo


Do

D4.3 Getting along with people who are close to you? None Mild Moderate SevereExtreme/Cannot

Do


Do


Do

Life activities

D5.1 Taking care of your household responsibilities? None Mild Moderate SevereExtreme/Cannot

Do

D5.2 Doing most important household tasks well? None Mild Moderate SevereExtreme/Cannot

Do

D5.3 Getting all the household work done that you needed todo?


Do

D5.4 Getting your household work done as quickly asneeded?


Do

IF YOU WORK (PAID, NON-PAID, SELF EMPLOYED) OR GO TO SCHOOL, COMPLETEQUESTIONS D5.5-D5.8 BELOW. OTHERWISE, SKIP TO D6.1 AT THE TOP OF THE NEXT PAGE.


D5.5 Your day to day work/school? None Mild Moderate SevereExtreme/Cannot

Do

D5.6 Doing your most important work/school tasks well? None Mild Moderate SevereExtreme/Cannot

Do

D5.7 Getting all the work done that you need to do? None Mild Moderate SevereExtreme/Cannot

Do

D5.8 Getting your work done as quickly as needed? None Mild Moderate SevereExtreme/Cannot

Do


3


Participation in Society

D6.1 How much of a problem did you have in joining incommunity activities (for example, festivities, religiousor other activities) in the same way as anyone else can


Do

D6.2 How much of a problem did you have because ofbarriers or hindrances in the world around you?


Do

D6.3 How much of a problem did you have living withdignity because of the attitudes and actions of others


Do

D6.4 How much time did you spend on your health condition,or its consequences


Do

D6.5 How much have you been emotionally affected by yourhealth condition


Do

D6.6 How much has your health been a drain on the financialresources of you or your family


Do

D6.7 How much of a problem did your family have becauseof your health problems


Do

D6.8 How much of a problem did you have in doing things byyourself for relaxation or pleasure


Do

H2 Overall, how much did these difficulties interferewith your life?




___/___

H4 In the past 30 days, for how many days were youtotally unable to carry out your usual activities orwork because of any health condition?


___/___

H5 In the past 30 days, not counting the days that youwere totally unable, for how many days did youcut back or reduce your usual activities or workbecause of any health condition?


___/___




WHODAS II

Phase 2 Field Trials – Health Services Research36-Item Interviewer Administered, Proxy Informant Version

February 2000

2







For additional information, please contact:Dr T. Bedirhan ÜstünGroup LeaderAssessment, Classification and Epidemiology GroupWorld Health OrganizationCH – 1211 Geneva 27SwitzerlandTel: + + 41 22 791 3609Fax: + + 41 22 791 4885Email: [email protected]

3











Assisted Living 2

Hospitalized 3





Physical problems 5

Other (specify) 6

__________________________

4

F7 PERSON COMPLETNG THISINTERVIEW IS ___________ OFPRIMARY RESPONDENT

Husband or wife 1

Parent 2

Son or daughter 3

Brother or sister 4

Other relative 5

Friend 6

Professional Carer 7

Other (specify) 8

__________________________

5


PREAMBLE


To the best of your knowledge, please answer these questions thinking about how muchdifficulty (insert name of primary respondent) had while doing the following activities as(he/she) usually does them.

FOR RESPONDENTS FROM THE GENERAL POPULATION (NOT THE CLINICALPOPULATION) SAY: Even if (insert name of primary respondent) is healthy and has nodifficulties, it is necessary that I ask all of the questions for completeness.

First, I will begin with some background questions about you. QUESTIONS A1 TO A5 REFERTO THE PERSON BEING CURRENTLY INTERVIEWED , NOT TO THE PRIMARY(PATIENT) REPSONDENT.




___/___ years


Never married 1

Currently married 2

Separated 3

Divorced 4

Widowed 5

Cohabiting 6

6


Paid work 1



Student 4


Retired 6



Other (specify) 9

__________________________

7

SECTION 3: PREAMBLE


I remind you to keep all of (insert name of primary respondent) health problems in mind as youanswer the questions. When I ask you about difficulties in doing an activity think about (POINTTO FLASHCARD #1).

• Increased effort• Discomfort or pain• Slowness• Changes in the way one does the activity

(POINT TO FLASHCARD #1). When answering, I’d like you to think back over the last 30days. I also would like you to answer these questions thinking about how much difficulty (insertname of primary respondent) had, on average over the past 30 days, while doing the activity as[he/she] usually does it.


(FLASHCARDS #1 AND #2 SHOULD REMAIN VISIBLE TO THE RESPONDENTTHROUGHOUT THE INTERVIEW. CARD #3 IS TO BE USED WHEN THERESPONDENT PROVIDES THE NUMBER OF DAYS DIFFICULTY WASEXPERIENCED).

8

SECTION 4. DOMAIN REVIEWS


I am going to ask some questions about understanding and communicating.


FOR RESPONSES GREATER THAN NONE (1), SHOW FLASHCARD #3ASK: How many days was this difficulty present? RECORD CODES FOR DAYS (A-E)

In the last 30 days, how much difficulty did (insert name of primary respondent) have in:


Do

DaysCode

D1.1 Concentrating on doing something for tenminutes? 1 2 3 4 5 _______

D1.1d

D1.2 Remembering to do importantThings?

1 2 3 4 5 _______D1.2d


1 2 3 4 5 _______D1.3d

D1.4 Learning a new task, for example,learning how to get to a new place?

1 2 3 4 5 _______D1.4d


1 2 3 4 5 _______D1.5d


Probe:



Do

P1.1 How much did these difficulties interferewith [his/her] life? 1 2 3 4 5

9







Do

DaysCode

D2.1 Standing for long periods such as 30minutes? 1 2 3 4 5 _______

D2.1d


D2.3 Moving around inside the home? 1 2 3 4 5 _______D2.3d

D2.4 Getting out of the home? 1 2 3 4 5 _______D2.4d

D2.5 Walking a long distance such as akilometre [or equivalent]?

1 2 3 4 5 _______D2.5d

Probe:



Do


10

DOMAIN 3 Self Care

I am now going to ask you about difficulties in taking care of oneself.





Do

DaysCode

D3.1 Washing [his/her] whole body? 1 2 3 4 5 _______D3.1d

D3.2 Getting dressed? 1 2 3 4 5 _______D3.2d

D3.3 Eating? 1 2 3 4 5 _______D3.3d

D3.4Staying by [himself/herself] for a fewdays?

1 2 3 4 5 _______D3.4d

Probe:



Do


11







Do

DaysCode

D4.1 Dealing with people [he/she] does notknow? 1 2 3 4 5

_______D4.1d

D4.2 Maintaining a friendship? 1 2 3 4 5 _______D4.2d

D4.3 Getting along with people who are closeto [him/her]?

1 2 3 4 5 _______D4.3d



Probe:



Do


12


• Household ActivitiesThe following questions are about activities involved in maintaining a household, and in caringfor the people with whom (insert name of primary respondent) lives or those close to [him/her].These activities include cooking, cleaning, shopping, caring for others and caring for [his/her]belongings.

D5.1 How many hours does [he/she] spend inthese activities in a typical week?

RECORD NUMBER OF HOURS __/__



Because of [his/her] health condition, in the last 30 days, how much difficulty did (insert name ofprimary respondent) have in:


Do

DaysCode

D5.2 Taking care of [his/her] householdresponsibilities?

1 2 3 4 5 _______D5.2d

D5.3 Doing [his/her] most importanthousehold tasks well?

1 2 3 4 5 _______D5.3d

D5.4 Getting all the household work done that[he/she] needed to do?

1 2 3 4 5 _______D5.4d

D5.5 Getting [his/her] household work done asquickly as needed?

1 2 3 4 5 _______D5.5d



Do


D5.6 In the last 30 days, on how many daysdid [he/she] reduce or completely misshousehold work because of [his/her]health condition?


13

IF THE PRIMARY RESPONDENT WORKS (PAID, NON-PAID, SELF EMPLOYED) ORGOES TO SCHOOL, COMPLETE QUESTIONS D5.7-D5.13. OTHERWISE, SKIP TOD6.1 ON THE NEXT PAGE

Now I will ask some questions about (insert name of primary respondent) work or school.

D5.7 How many hours does [he/she] spend inwork (which includes school) in a typicalwork week?



FOR RESPONSES GREATER THAN NONE (1), SHOW FLASHCARD #3ASK: How many days was this difficulty present? RECORD CODES FOR DAYS (A-E)Because of [his/her] health condition, in the last 30 days how much difficulty did (insert name ofprimary respondent) have in:


Do

DaysCode

D5.8 [His/Her] day to day work? 1 2 3 4 5 _______D5.8d

D5.9 Doing [his/her] most important worktasks well?

1 2 3 4 5 _______D5.9d

D5.10 Getting all the work done that [he/she]needs to do?

1 2 3 4 5 _______D5.10d

D5.11 Getting [his/her] work done as quicklyas needed?

1 2 3 4 5 _______D5.11d

D5.12 Has (insert name of primary respondent) had to work at alower level because of a health condition?

No 1Yes 2

D5.13 Did (insert name of primary respondent) earn less moneyas the result of a health condition?

No 1Yes 2



Do

P5.2 How much did these difficultiesinterfere with [his/her] life? 1 2 3 4 5

D5.14 In the last 30 days, on how many daysdid [he/she] miss work for half a day ormore because of [his/her] healthcondition?


14


Now, I am going to ask you about (insert name of primary respondent) participation in societyand the impact of [his/her] health problems on [his/her] family. Some of these questions mayinvolve problems that go beyond the last 30 days, however in answering, please focus on the last30 days. Again, I remind you to answer these questions while thinking about health problems:physical, mental or emotional, alcohol or drug related.




D6.1 How much of a problem did [he/she]have joining in community activities(for example, festivities, religious orother activities) in the same way asanyone else can?

1 2 3 4 5

D6.2 How much of a problem did [he/she]have because of barriers or hindrancesin the world around [hom/her]?

1 2 3 4 5

D6.3 How much of a problem did [he/she]have living with dignity because of theattitudes and actions of others?

1 2 3 4 5

D6.4 How much time did [he/she] spend on[his/her] health condition, or itsconsequences?

1 2 3 4 5

D6.5 How much has [he/she] beenemotionally affected by [his/her] healthcondition?

1 2 3 4 5

D6.6 How much has [his/her] health been adrain on the financial resources for[him/her] or [his/her] family?

1 2 3 4 5

15


D6.7 How much of a problem did [his/her]family have because of [his/her] healthproblems?

1 2 3 4 5

D6.8 How much of a problem did [he/she]have in doing things by[himself/herself] for relaxation orpleasure?

1 2 3 4 5



Do

P6.1 How much did these problems interferewith [his/her] life? 1 2 3 4 5

P6.2 In the last 30 days, for how many daysdid [he/she] have these difficulties?


H3 Overall, in the past 30 days, how manydays did [he/she] experience any of thedifficulties that we have discussedduring this interview?


___/___

H6 In the past 30 days, how manydays have you seen or spokenwith (insert name of primaryrespondent)?


___/___


16



• Increased effort• Discomfort or pain• Slowness• Changes in the way one does the activity


Flashcard #1

Flashcard #2

1 2 3 4 5


Code

A One day

B Up to one week = 2 to 7 days

C Up to two weeks = 8 to 14 days

D More than two weeks = 15 to 29 days

E All days = 30 days

Flashcard #3

Documents

WORLD HEALTH ORGANIZATIONapps.who.int/iris/bitstream/10665/68350/1/a80933.pdfWORLD HEALTH ORGANIZATION DISABILITY ASSESSMENT SCHEDULE WHODAS II Phase 2 Field Trials – Health Services