Item format | Item | Item stem | Item content | Number and wording of response options | Attribution to health |
---|---|---|---|---|---|
A | A1 | Are you able to … | … do two hours of physical labor? | 5 Without any difficulty 4 With a little difficulty 3 With some difficulty 2 With much difficulty 1 Unable to do | No |
A2a | … do yard work like raking leaves, weeding or pushing a lawn mower? | ||||
A3 | … climb several flights of stairs? | ||||
A4a | … go for a walk of at least 15 minutes? | ||||
A5a | … open previously opened jars? | ||||
B | B1a | Does your health now limit you in … | … doing two hours of physical labor? | 5 Not at all 4 Very little 3 Somewhat 2 Quite a lot 1 Cannot do | Yes |
B2 | … doing yard work like raking leaves, weeding or pushing a lawn mower? | ||||
B3a | … climbing several flights of stairs? | ||||
B4 | … going for a walk of at least 15 minutes? | ||||
B5 | … opening previously opened jars? | ||||
C | C1 | How difficult is it for you to … | … do two hours of physical labor? | 6 Very easy 5 Easy 4 Slightly difficult 3 Difficult 2 Very difficult 1 Impossible | No |
C2 | … do yard work like raking leaves, weeding or pushing a lawn mower? | ||||
C3 | … climb several flights of stairs? | ||||
C4 | … go for a walk of at least 15 minutes? | ||||
C5 | … open previously opened jars? |