Survey on Living with Neurological Conditions in Canada

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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.

Table of Contents

Proxy interview (XGRN)

Proxy interview (XGRN) - Question identifier:XGRN_N01

Do you want to complete this component by proxy?

1. Yes
2. No

Proxy interview (XGRN) - Question identifier:XGRN_N02

Record the reason why this component is being completed by proxy. Proxy interviews are to occur only if the mental or physical health of the selected member makes it impossible to complete the interview during the collection period. If the reason for the proxy interview is neither of these choices, please press <F10> to exit the application and assign an appropriate outcome code.

1. Physical health condition
2. Mental health condition

Proxy interview (XGRN) - Question identifier:XGRN_N03

Enter the condition.

CCHS2012NEUR - XGRN_N03E

Proxy interview (XGRN) - Question identifier:XGRN_Q04

Do you and ^FNAME ^LNAME live in the same household?

1. Yes
2. No

Proxy interview (XGRN) - Question identifier:XGRN_Q05

What is your relationship to ^FNAME ^LNAME?

1. Husband/Wife
2. Common-law partner
3. Father/Mother
4. Son/Daughter
5. Brother/Sister
6. Foster father/mother
7. Foster son/daughter
8. Grandfather/mother
9. Grandson/daughter
10. In-law
11. Other related
12. Unrelated
98. RF
99. DK

Survey introduction (XINT)

Survey introduction (XINT) - Question identifier:XINT_R01

This survey is conducted under the authority of the statistics Act in collaboration with the Public Health Agency of Canada. The purpose of this survey is to collect information on Canadians with neurological conditions. Data from the survey will be used by health professionals and public health programs, with the aim of improving health outcomes for Canadians with neurological conditions.

^DT_INTROE

Survey introduction (XINT) - Question identifier:XINT_R02

Your answers will be kept strictly confidential and used only for statistical purposes. While participation is voluntary, your assistance is essential if the results are to be accurate.

General health (XGEN)

General health (XGEN) - Question identifier:XGEN_R01

I would like to start with some general background questions.

General health (XGEN) - Question identifier:XGEN_Q01

In general, would you say your health is... ?

1. Excellent
2. Very good
3. Good
4. Fair
5. Poor
8. RF
9. DK

General health (XGEN) - Question identifier:XGEN_Q02

Compared to one year ago, how would you say your health is now? Is it... ?

1. Much better now than 1 year ago
2. Somewhat better now (than 1 year ago)
3. About the same as 1 year ago
4. Somewhat worse now (than 1 year ago)
5. Much worse now (than 1 year ago)
8. RF
9. DK

General health (XGEN) - Question identifier:XGEN_Q03

Thinking about the amount of stress in your life, would you say that most days are... ?

1. Not at all stressful
2. Not very stressful
3. A bit stressful
4. Quite a bit stressful
5. Extremely stressful
8. RF
9. DK

Diagnosis (XDIN)

Diagnosis (XDIN) - Question identifier:XDIN_R01A

Now, I'd like to ask some questions about neurological conditions, which are conditions that affect the brain, spinal cord, nerves or muscles. We are interested in conditions which are expected to last or have already lasted six months or more and have been diagnosed by a doctor or other health professional.

Diagnosis (XDIN) - Question identifier:XDIN_Q01A

To begin, do you have migraine headaches that have been diagnosed by a health professional?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q01B

In the past 12 months:

... did you have a headache where you felt nauseated or sick to your stomach?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q01C

In the past 12 months:

... did light bother you when you had a headache (a lot more than when you did not have a headache)?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q01D

(In the past 12 months:)

... did your headache limit your ability to work, study, or do what you needed to do for at least one day?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q01E

How old were you when you were first diagnosed with migraine headaches?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q01F

How old were you when you first started experiencing symptoms related to your migraine headaches?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q01G

Compared to when you were first diagnosed, how would you say your migraine headaches are now? Are they... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q01H

What are the reasons your migraine headaches are better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q02A

Do you have multiple sclerosis?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q02B

How old were you when you were first diagnosed with multiple sclerosis?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q02C

How old were you when you first started experiencing symptoms related to your multiple sclerosis?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q02D

Have you received any of the following treatments for your multiple sclerosis?

1. Medication, including injections, infusions or pills
2. Venous angioplasty or liberation therapy
3. Stem cell therapy or bone marrow transplant
4. Urinary catheterization
5. Complementary or alternative medicine treatments
6. Rehabilitation therapy, including physical, occupational, speech or massage therapy
7. Counselling or psychotherapy
8. No treatment received for multiple sclerosis
9. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q02E

Compared to when you were first diagnosed, how would you say your multiple sclerosis is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q02F

What are the reasons your multiple sclerosis is better now?

1. Medication
2. Venous angioplasty or liberation therapy
3. Stem cell therapy or bone marrow transplant
4. Urinary catheterization
5. Neurological condition in remission
6. Complementary or alternative medicine treatments
7. Rehabilitation therapy
8. Counselling or psychotherapy
9. Surgery (excluding venous angioplasty and liberation therapy)
10. Other medical treatment
11. Coping strategy
12. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q03A

Do you have epilepsy?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q03B

Do you currently take medication for epilepsy?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q03C

Have you had a seizure in the past five years?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q03D

How old were you when you were first diagnosed with epilepsy?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q03E

How old were you when you first started experiencing symptoms related to your epilepsy?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q03F

Compared to when you were first diagnosed, how would you say your epilepsy is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q03G

What are the reasons your epilepsy is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q04A

Do you have cerebral palsy?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q04B

How old were you when you were first diagnosed with cerebral palsy?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q04C

How old were you when you first started experiencing symptoms related to your cerebral palsy?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q04D

Compared to when you were first diagnosed, how would you say your cerebral palsy is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q04E

What are the reasons your cerebral palsy is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q05A

Do you have spina bifida?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q05B

Compared to when you were first diagnosed, how would you say your spina bifida is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q05C

What are the reasons your spina bifida is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q06A

Remember, we're interested in conditions diagnosed by a health professional.

Do you have hydrocephalus?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q06B

How old were you when you were first diagnosed with hydrocephalus?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q06C

How old were you when you first started experiencing symptoms related to your hydrocephalus?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q06D

Compared to when you were first diagnosed, how would you say your hydrocephalus is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q06E

What are the reasons your hydrocephalus is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q07A

Do you have muscular dystrophy?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q07B

How old were you when you were first diagnosed with muscular dystrophy?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q07C

How old were you when you first started experiencing symptoms related to your muscular dystrophy?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q07D

Compared to when you were first diagnosed, how would you say your muscular dystrophy is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q07E

What are the reasons your muscular dystrophy is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q08A

Do you have dystonia?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q08B

How old were you when you were first diagnosed with dystonia?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q08C

How old were you when you first started experiencing symptoms related to your dystonia?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q08D

Compared to when you were first diagnosed, how would you say your dystonia is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q08E

What are the reasons your dystonia is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q09A

Do you have Tourette's syndrome?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q09B

How old were you when you were first diagnosed with Tourette's syndrome?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q09C

How old were you when you first started experiencing symptoms related to your Tourette's syndrome?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q09D

Compared to when you were first diagnosed, how would you say your Tourette's syndrome is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q09E

What are the reasons your Tourette's syndrome is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q10A

Do you have Parkinson's disease?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q10B

How old were you when you were first diagnosed with Parkinson's disease?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q10C

How old were you when you first started experiencing symptoms related to your Parkinson's disease?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q10D

Compared to when you were first diagnosed, how would you say your Parkinson's disease is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q10E

What are the reasons your Parkinson's disease is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q11A

Do you have ALS (Lou Gehrig's disease/amyotrophic lateral sclerosis)?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q11B

How old were you when you were first diagnosed with ALS (Lou Gehrig's disease/amyotrophic lateral sclerosis)?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q11C

How old were you when you first started experiencing symptoms related to your ALS (Lou Gehrig's disease/amyotrophic lateral sclerosis)?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q11D

Compared to when you were first diagnosed, how would you say your ALS is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q11E

What are the reasons your ALS is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q12A

Do you have Huntington's disease?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q12B

How old were you when you were first diagnosed with Huntington's disease?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q12C

How old were you when you first started experiencing symptoms related to your Huntington's disease?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q12D

Compared to when you were first diagnosed, how would you say your Huntington's disease is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q12E

What are the reasons your Huntington's disease is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q13A

(Remember, we're interested in conditions diagnosed by a health professional.)

Do you have Alzheimer's disease or any other dementia?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q13B

Is this... ?

1. Alzheimer's disease
2. Other dementia
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q13C

How old were you when you were first diagnosed with ^DT_ALZE?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q13D

How old were you when you first started experiencing symptoms related to your ^DT_ALZE?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q13E

Compared to when you were first diagnosed, how would you say your ^DT_ALZE ^DT_ISARE now? ^DT_ITTHEY... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q13F

What are the reasons your ^DT_ALZE ^DT_ISARE better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q14A

Do you suffer from the effects of a stroke?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q14B

Have you ever had a stroke (that has been diagnosed by a health professional)?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q14C

How old were you when you first started experiencing these effects?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q14D

Compared to when you first started experiencing the effects of your stroke, how would you say your condition is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q14E

What are the reasons your condition is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q15A

Do you have a neurological condition caused by a brain or spinal cord tumour?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q15B

Is this a... ?

1. Brain tumour
2. Spinal cord tumour
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q15C

How old were you when you were first diagnosed with your ^DT_TUMOURE?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q15D

How old were you when you first started experiencing symptoms related to your ^DT_TUMOURE?

Minimum: 0 Maximum: 999

Diagnosis (XDIN) - Question identifier:XDIN_Q15E

Compared to when you were first diagnosed, how would you say your ^DT_TUMOURE ^DT_ISARE2 now? ^DT_ITTHEY2... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q15F

What are the reasons your ^DT_TUMOURE ^DT_ISARE2 better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q16A

Do you have a neurological condition caused by a spinal cord injury?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q16B

Was the spinal cord injury caused by trauma? A traumatic spinal cord injury is damage to the spinal cord caused by physical impact, for example, a car crash or a fall, that results in paralysis, loss of strength, loss of sensation, or difficulty controlling the bowel or bladder.

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q16C

How old were you when you were first diagnosed with a spinal cord injury?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q16D

Compared to when you were first diagnosed, how would you say your spinal cord injury is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q16E

What are the reasons your spinal cord injury is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q17A

Remember, we're interested in conditions which are expected to last or have already lasted six months or more and have been diagnosed by a doctor or other health professional.

Do you have a neurological condition caused by a brain injury?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q17B

Was the brain injury related to ^DT_CONDSE you have already reported?

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q17C

Was the brain injury caused by trauma? A traumatic brain injury is damage to the brain caused by physical impact, for example, a hit to the head, a car crash or a fall, that results in difficulties with attention, cognition, language, memory, behaviour or movement.

1. Yes
2. No
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q17D

How old were you when you were first diagnosed with a brain injury?

Minimum: 0 Maximum: 130

Diagnosis (XDIN) - Question identifier:XDIN_Q17E

Compared to when you were first diagnosed, how would you say your brain injury is now? Is it... ?

1. Much better now
2. Somewhat better now
3. About the same
4. Somewhat worse now
5. Much worse now
8. RF
9. DK

Diagnosis (XDIN) - Question identifier:XDIN_Q17F

What are the reasons your brain injury is better now?

1. Medication
2. Surgery
3. Neurological condition in remission
4. Complementary or alternative medicine treatments
5. Rehabilitation therapy
6. Other medical treatment
7. Coping strategy
8. Other
98. RF
99. DK

Diagnosis (XDIN) - Question identifier:XDIN_R18

You have said you do not have a neurological condition covered by this survey. Since this survey applies only to people with certain neurological conditions, you are not eligible to participate in the Survey on Living with Neurological Conditions in Canada. Thank you for your time.

Chronic conditions (XCCN)

Chronic conditions (XCCN) - Question identifier:XCCN_R01

Now, I'd like to ask about other chronic health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted six months or more and that have been diagnosed by a health professional.

Chronic conditions (XCCN) - Question identifier:XCCN_Q01

Do you have heart disease?

1. Yes
2. No
8. RF
9. DK

Chronic conditions (XCCN) - Question identifier:XCCN_Q02

^DT_PREGNANT you ever been diagnosed with high blood pressure?

1. Yes
2. No
8. RF
9. DK

Chronic conditions (XCCN) - Question identifier:XCCN_Q03

In the past month, have you taken any medicine for high blood pressure?

1. Yes
2. No
8. RF
9. DK

Chronic conditions (XCCN) - Question identifier:XCCN_Q04

(Remember, we're interested in conditions diagnosed by a health professional.)

^DT_PREGNANT you ever been diagnosed with diabetes?

1. Yes
2. No
8. RF
9. DK

Chronic conditions (XCCN) - Question identifier:XCCN_Q05

Do you have a mood disorder such as depression, bipolar disorder, mania or dysthymia?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN)

Health utility index (XHUN) - Question identifier:XHUN_R01

The next set of questions asks about your day-to-day health. The questions are not about illnesses like colds that affect people for short periods of time. They are concerned with a person's usual abilities.

You may feel that some of these questions do not apply to you, but it is important that we ask the same questions of everyone.

Health utility index (XHUN) - Question identifier:XHUN_Q01

Are you usually able to see well enough to read ordinary newsprint without glasses or contact lenses?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q02

Are you usually able to see well enough to read ordinary newsprint with glasses or contact lenses?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q03

Are you able to see at all?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q04

Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q05

Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q06

Are you usually able to hear what is said in a group conversation with at least 3 other people without a hearing aid?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q07

Are you usually able to hear what is said in a group conversation with at least 3 other people with a hearing aid?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q08

Are you able to hear at all?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q09

Are you usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q10

Are you usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q11

Are you usually able to be understood completely when speaking with strangers in your own language?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q12

Are you able to be understood partially when speaking with strangers?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q13

Are you able to be understood completely when speaking with those who know you well?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q14

Are you able to be understood partially when speaking with those who know you well?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q15

Are you usually able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q16

Are you able to walk at all?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q17

Do you require mechanical support such as braces, a cane or crutches to be able to walk around the neighbourhood?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q18

Do you require the help of another person to be able to walk?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q19

Do you require a wheelchair to get around?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q20

How often do you use a wheelchair?

1. Always
2. Often
3. Sometimes
4. Never
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q21

Do you need the help of another person to get around in the wheelchair?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q22

Are you usually able to grasp and handle small objects such as a pencil or scissors?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q23

Do you require the help of another person because of limitations in the use of hands or fingers?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q24

Do you require the help of another person with... ?

1. Some tasks
2. Most tasks
3. Almost all tasks
4. All tasks
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q25

Do you require special equipment, for example, devices to assist in dressing, because of limitations in the use of hands or fingers?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q26

Would you describe yourself as being usually... ?

1. Happy and interested in life
2. Somewhat happy
3. Somewhat unhappy
4. Unhappy with little interest in life
5. So unhappy that life is not worthwhile
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q27

How would you describe your usual ability to remember things?

1. Able to remember most things
2. Somewhat forgetful
3. Very forgetful
4. Unable to remember anything at all
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q28

How would you describe your usual ability to think and solve day-to-day problems?

1. Able to think clearly and solve problems
2. Having a little difficulty
3. Having some difficulty
4. Having a great deal of difficulty
5. Unable to think or solve problems
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q29

Are you usually free of pain or discomfort?

1. Yes
2. No
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q30

How would you describe the usual intensity of your pain or discomfort?

1. Mild
2. Moderate
3. Severe
8. RF
9. DK

Health utility index (XHUN) - Question identifier:XHUN_Q31

How many activities does your pain or discomfort prevent?

1. None
2. A few
3. Some
4. Most
8. RF
9. DK

Incontinence (XINN)

Incontinence (XINN) - Question identifier:XINN_R01

Some people with chronic health conditions have difficulties with bladder or bowel control.

Incontinence (XINN) - Question identifier:XINN_Q01

Do you ever experience involuntary leakage or have difficulty controlling your bladder function?

1. Yes
2. No
8. RF
9. DK

Incontinence (XINN) - Question identifier:XINN_Q02

Do you ever experience involuntary leakage or have difficulty controlling your bowel function?

1. Yes
2. No
8. RF
9. DK

Social support (XSSN)

Social support (XSSN) - Question identifier:XSSN_R01

People sometimes look to others for companionship, assistance or other types of support.

Social support (XSSN) - Question identifier:XSSN_Q01

How often is each of the following kinds of support available to you if you need it:

... someone to confide in or talk to about yourself or your problems?

1. None of the time
2. A little of the time
3. Some of the time
4. Most of the time
5. All of the time
8. RF
9. DK

Social support (XSSN) - Question identifier:XSSN_Q02

How often is each of the following kinds of support available to you if you need it:

... someone to do something enjoyable with?

1. None of the time
2. A little of the time
3. Some of the time
4. Most of the time
5. All of the time
8. RF
9. DK

Social support (XSSN) - Question identifier:XSSN_Q03

(How often is each of the following kinds of support available to you if you need it:)

... someone to take you to the doctor if you needed it?

1. None of the time
2. A little of the time
3. Some of the time
4. Most of the time
5. All of the time
8. RF
9. DK

Social support (XSSN) - Question identifier:XSSN_Q04

(How often is each of the following kinds of support available to you if you need it:)

... someone to turn to for help in an emergency?

1. None of the time
2. A little of the time
3. Some of the time
4. Most of the time
5. All of the time
8. RF
9. DK

Medication use (XMEN)

Medication use (XMEN) - Question identifier:XMEN_R01

The next few questions are about medications for your ^DT_CON1E that have been prescribed by a doctor or other health professional.

^DT_INTROXMENE

Medication use (XMEN) - Question identifier:XMEN_Q01

In the past three months, have you taken any prescription medications for your ^DT_CON1E?

1. Yes
2. No
8. RF
9. DK

Medication use (XMEN) - Question identifier:XMEN_Q02

What are the reasons that you have not taken any prescription medications for your ^DT_CON1E in the past three months?

1. No medication prescribed from a doctor or health professional
2. Do not want to take medication at this time
3. Side-effects caused by medication
4. Medication not working
5. Ran out of medication
6. Too costly / financial constraints
7. Neurological condition(s) controlled without medication/ don't need medication
8. Other
98. RF
99. DK

Medication use (XMEN) - Question identifier:XMEN_Q03

Do you experience any side effects caused by medications taken for your ^DT_CON1E?

1. Yes
2. No
8. RF
9. DK

Medication use (XMEN) - Question identifier:XMEN_Q04

Overall, how much do these side effects affect your life?

1. Not at all
2. A little bit
3. Moderately
4. Quite a bit
5. Extremely
8. RF
9. DK

Restriction of activities (XRAN)

Restriction of activities (XRAN) - Question identifier:XRAN_R01

The next few questions deal with any limitations in your usual activities caused by your ^DT_CON1E.

Restriction of activities (XRAN) - Question identifier:XRAN_Q01

First a question about driving. Do you currently have a valid driver's license?

1. Yes
2. No
8. RF
9. DK

Restriction of activities (XRAN) - Question identifier:XRAN_Q02

^DT_HASHAVE_C your ^DT_CON1E ever prevented you from driving, even for a short period of time?

1. Yes
2. No
8. RF
9. DK

Restriction of activities (XRAN) - Question identifier:XRAN_Q03

Are you prevented from having a valid driver's license because of your ^DT_CON1E?

1. Yes
2. No
8. RF
9. DK

Restriction of activities (XRAN) - Question identifier:XRAN_Q04

How much do you feel that your ^DT_CON1E ^DT_HASHAVE limited your educational opportunities?

1. Not at all
2. A little bit
3. Moderately
4. Quite a bit
5. Extremely
8. RF
9. DK

Restriction of activities (XRAN) - Question identifier:XRAN_Q05

How much do you feel that your ^DT_CON1E ^DT_HASHAVE limited your job opportunities?

1. Not at all
2. A little bit
3. Moderately
4. Quite a bit
5. Extremely
8. RF
9. DK

Restriction of activities (XRAN) - Question identifier:XRAN_Q06

How much do you feel that your ^DT_CON1E ^DT_HASHAVE limited you in getting a good night's sleep?

1. Not at all
2. A little bit
3. Moderately
4. Quite a bit
5. Extremely
8. RF
9. DK

Restriction of activities (XRAN) - Question identifier:XRAN_Q07

Overall, how much do you feel that your ^DT_CON1E ^DT_AFFECT your life?

1. Not at all
2. A little bit
3. Moderately
4. Quite a bit
5. Extremely
8. RF
9. DK

Work activities (XWAN)

Work activities (XWAN) - Question identifier:XWAN_R01

The next questions concern work activities.

Work activities (XWAN) - Question identifier:XWAN_Q01

Last week, did you work at a job or business (regardless of the number of hours worked)?

1. Yes
2. No
3. Permanently unable to work
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q02

Last week, did you have a job or business from which you were absent?

1. Yes
2. No
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q03

On average, how many hours do you usually work per week?

Minimum: 0 Maximum: 168

Work activities (XWAN) - Question identifier:XWAN_Q04

In the past 3 months, how many days of work have you missed because of your ^DT_CON1E?

Minimum: 0 Maximum: 92

Work activities (XWAN) - Question identifier:XWAN_Q05

What is the main reason why you are not currently working at a job or business?

1. ^DT_CON1E_C
2. Own other illness, condition or disability
3. Caring for own children
4. Caring for elder relative (60 years of age or older)
5. Other personal or family responsibilities
6. Going to school
7. Temporary layoff due to business condition
8. Seasonal layoff
9. Casual job, no work available
10. Work schedule (e.g. shift work)
11. Self-employed, no work available
12. Seasonal business
13. Retired
14. Other
98. RF
99. DK

Work activities (XWAN) - Question identifier:XWAN_Q06

Have you ever worked at a job or business?

1. Yes
2. No
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q07

Did you have ^DT_YOURC ^DT_CON1E while you were working?

1. Yes
2. No
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_R08

Now some questions about changes to your work activities because of your ^DT_CON1E. Please include only changes which lasted for three months or more.

Work activities (XWAN) - Question identifier:XWAN_Q08

Because of your ^DT_CON1E, did you ever:

... change the type of work you ^DT_DODID for a period which lasted for three months or more?

1. Yes
2. No
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q09

Because of your ^DT_CON1E, did you ever:

... change the way in which you ^DT_CARRY out your work for a period which lasted for three months or more?

1. Yes
2. No
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q10

(Because of your ^DT_CON1E, did you ever:)

... reduce the number of hours you ^DT_WORK for a period which lasted for three months or more?

1. Yes
2. No
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q10A

By how many hours a week? Was it... ?

1. Less than 5 hours a week
2. 5 hours to less than 10 hours a week
3. 10 hours to less than 20 hours a week
4. 20 hours or more a week
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q10B

Did you reduce your work hours... ?

1. Temporarily
2. Permanently
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q10C

For how long did you make this change to your work hours?

1. 3 to 6 months
2. 7 to 12 months
3. Over 1 year but less than 3 years
4. 3 to 5 years
5. Over 5 years
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q11

Because of your ^DT_CON1E, did you ever:

... stop work altogether for a period which lasted for three months or more?

1. Yes
2. No
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q11A

Did you stop work... ?

1. Temporarily
2. Permanently
8. RF
9. DK

Work activities (XWAN) - Question identifier:XWAN_Q11B

For how long did you stop work?

1. 3 to 6 months
2. 7 to 12 months
3. Over 1 year but less than 3 years
4. 3 to 5 years
5. Over 5 years
8. RF
9. DK

Formal assistance received for everyday activities (XFAN)

Formal assistance received for everyday activities (XFAN) - Question identifier:XFAN_R01

Now, some questions on assistance you may have received at home, work or school because of your ^DT_CON1E, for things like health care, home maker or other support services. Please include only assistance provided by paid workers or employees, or volunteer organizations. Exclude assistance from family, friends, or neighbours.

Formal assistance received for everyday activities (XFAN) - Question identifier:XFAN_Q01

In the past 12 months, did you receive short-term or long-term assistance at home, work or school because of your ^DT_CON1E?

1. Yes
2. No
8. RF
9. DK

Formal assistance received for everyday activities (XFAN) - Question identifier:XFAN_Q02

For which of the following activities did you receive assistance?

1. Personal care such as assistance with eating, dressing, bathing, or toileting
2. Medical care such as help taking medicine or help with nursing
care (for example, dressing changes or foot care)
3. Managing care such as making appointments or managing personal finances
4. Help with activities such as housework, home maintenance or
outdoor work
5. Childcare
6. Transportation, including trips to the doctor or for shopping
7. Meal preparation or delivery
8. Emotional support
9. Other
98. RF
99. DK

Formal assistance received for everyday activities (XFAN) - Question identifier:XFAN_Q03

In the past 12 months, how often did you receive assistance? Was it... ?

1. Daily
2. At least once a week
3. At least once a month
4. Less than once a month
8. RF
9. DK

Informal assistance received for everyday activities (XIAN)

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_R01

The next questions are about assistance provided by family, friends or neighbours. Please include only assistance you received at home, work or school because of your ^DT_CON1E, for things like health care, home maker or other support services. Exclude assistance from paid workers or employees, or volunteer organizations.

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q01

In the past 12 months, did you receive short-term or long-term assistance at home, work or school from family, friends or neighbours because of your ^DT_CON1E?

1. Yes
2. No
8. RF
9. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q02

For which of the following activities did you receive assistance?

1. Personal care such as assistance with eating, dressing, bathing, or toileting
2. Medical care such as help taking medicine or help with nursing care (for example, dressing changes or foot care)
3. Managing care such as making appointments or managing personal finances
4. Help with activities such as housework, home maintenance or
outdoor work
5. Childcare
6. Transportation, including trips to the doctor or for shopping
7. Meal preparation or delivery
8. Emotional support
9. Other
98. RF
99. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_R03

Now some questions about the family member, friend or neighbour, who, over the past 12 months, dedicated the most time and resources providing you with assistance for your ^DT_CON1E.

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q03

Does this person live in the same household as you?

1. Yes
2. No
8. RF
9. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q04

Is this person... ?

1. Male
2. Female
8. RF
9. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q05

How old is this person?

Minimum: 10 Maximum: 130

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q06

What is the relationship of this person to you?

1. Spouse of respondent
2. Common law partner of respondent
3. Ex-spouse/Ex-partner of respondent
4. Son/daughter of respondent
5. Father/mother of respondent
6. Brother/sister of respondent
7. Grandson/granddaughter of respondent
8. Grandfather/grandmother of respondent
9. Son-in-law/daughter-in-law of respondent
10. Father-in-law/mother-in-law of respondent
11. Brother-in-law/sister-in-law of respondent
12. Nephew/niece of respondent
13. Uncle/aunt of respondent
14. Cousin of respondent
15. Same sex partner of respondent
16. Friend of respondent
17. Neighbour of respondent
98. RF
99. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q07

In the past 12 months, how often did you receive assistance from your ^DT_RELATIONSHIP? Was it... ?

1. Daily
2. At least once a week
3. At least once a month
4. Less than once a month
8. RF
9. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q08

In an average day, how many hours of assistance did you receive from your ^DT_RELATIONSHIP?

Minimum: 1 Maximum: 24

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q09

Thinking about the past 12 months, in an average week, on how many days did you receive assistance from your ^DT_RELATIONSHIP?

Minimum: 1 Maximum: 7

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q10

Thinking about the past 12 months, in an average month, on how many days did you receive assistance from your ^DT_RELATIONSHIP?

Minimum: 1 Maximum: 31

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q11

In the past 12 months, on how many days did you receive assistance from your ^DT_RELATIONSHIP?

Minimum: 1 Maximum: 366

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q12

On the days that you received help, how many hours of assistance did you receive from your ^DT_RELATIONSHIP?

Minimum: 1 Maximum: 24

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q13

Last week, did your ^DT_RELATIONSHIP work at a job or business? Please include part-time jobs, seasonal work, contract work, self-employment, baby-sitting and any other paid work, regardless of the number of hours worked.

1. Yes
2. No
8. RF
9. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q14

Last week, did your ^DT_RELATIONSHIP have a job or business from which ^HESHE was absent?

1. Yes
2. No
8. RF
9. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q15

Does your ^DT_RELATIONSHIP work full-time or part-time?

1. Full-time
2. Part-time
8. RF
9. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q16

Has your ^DT_RELATIONSHIP ever worked at a job or business?

1. Yes
2. No
8. RF
9. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q17

Did your ^DT_RELATIONSHIP work at a job or business at the same time as ^HESHE was providing assistance to you?

1. Yes
2. No
8. RF
9. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q18

In order to care for you, did your ^DT_RELATIONSHIP ever:

... reduce the number of hours ^HESHE ^DT_WORK for a period which lasted for three months or more?

1. Yes
2. No
8. RF
9. DK

Informal assistance received for everyday activities (XIAN) - Question identifier:XIAN_Q19

In order to care for you, did your ^DT_RELATIONSHIP ever:

... stop work altogether for a period which lasted for three months or more?

1. Yes
2. No
8. RF
9. DK

Out-of-pocket expenses (XOPN)

Out-of-pocket expenses (XOPN) - Question identifier:XOPN_R01

The next few questions are about any out-of-pocket or direct expenses you may have had because of your ^DT_CON1E.

Exclude amounts for which you have been or will be reimbursed by any insurance or government program.

Out-of-pocket expenses (XOPN) - Question identifier:XOPN_Q01

In the past 12 months, did you have any out-of-pocket or direct expenses for prescription and non-prescription (over-the-counter) medications taken for your ^DT_CON1E, for which you will not be reimbursed?

1. Yes
2. No
8. RF
9. DK

Out-of-pocket expenses (XOPN) - Question identifier:XOPN_Q02

What is your best estimate of the expenses for prescription and non-prescription medications taken for your ^DT_CON1E in the past 12 months? Please stop me when I have read the category which applies to you. Was it... ?

1. Less than $100
2. $100 to less than $200
3. $200 to less than $500
4. $500 to less than $1,000
5. $1,000 to less than $2,000
6. $2,000 to less than $5,000
7. $5,000 or more
8. RF
9. DK

Out-of-pocket expenses (XOPN) - Question identifier:XOPN_Q03

In the past 12 months, did you have any out-of-pocket or direct expenses for assistive devices such as mobility aids, agility aids or specialized equipment that were required because of your ^DT_CON1E for which you will not be reimbursed?

1. Yes
2. No
8. RF
9. DK

Out-of-pocket expenses (XOPN) - Question identifier:XOPN_Q04

What is your best estimate of the expenses for assistive devices that were required because of your ^DT_CON1E in the past 12 months? Please stop me when I have read the category which applies to you. Was it... ?

1. Less than $100
2. $100 to less than $200
3. $200 to less than $500
4. $500 to less than $1,000
5. $1,000 to less than $2,000
6. $2,000 to less than $5,000
7. $5,000 or more
8. RF
9. DK

Out-of-pocket expenses (XOPN) - Question identifier:XOPN_Q05

In the past 12 months, did you have any out-of-pocket or direct expenses for rehabilitation therapy such as physical, occupational, speech or massage therapy that was required because of your ^DT_CON1E for which you will not be reimbursed?

1. Yes
2. No
8. RF
9. DK

Out-of-pocket expenses (XOPN) - Question identifier:XOPN_Q06

What is your best estimate of the expenses for rehabilitation therapy that was required because of your ^DT_CON1E in the past 12 months? Please stop me when I have read the category which applies to you. Was it... ?

1. Less than $100
2. $100 to less than $200
3. $200 to less than $500
4. $500 to less than $1,000
5. $1,000 to less than $2,000
6. $2,000 to less than $5,000
7. $5,000 or more
8. RF
9. DK

Out-of-pocket expenses (XOPN) - Question identifier:XOPN_Q07

In the past 12 months, did you have any out-of-pocket or direct expenses for home care services such as health care, homemaker, or other support services that were required because of your ^DT_CON1E, for which you will not be reimbursed?

1. Yes
2. No
8. RF
9. DK

Out-of-pocket expenses (XOPN) - Question identifier:XOPN_Q08

What is your best estimate of the expenses for home care services that were required because of your ^DT_CON1E in the past 12 months? Please stop me when I have read the category which applies to you. Was it... ?

1. Less than $100
2. $100 to less than $200
3. $200 to less than $500
4. $500 to less than $1,000
5. $1,000 to less than $2,000
6. $2,000 to less than $5,000
7. $5,000 or more
8. RF
9. DK

Stigma (XSGN)

Stigma (XSGN) - Question identifier:XSGN_R01

The next questions are about how your interactions with other people have been affected because of your ^DT_CON1E.

I am going to read you a series of statements. For each of the following statements, please tell me how often you have felt that way lately.

Stigma (XSGN) - Question identifier:XSGN_Q01

Because of my ^DT_CON1E, some people seemed uncomfortable with me.

1. Never
2. Rarely
3. Sometimes
4. Often
5. Always
8. RF
9. DK

Stigma (XSGN) - Question identifier:XSGN_Q02

Because of my ^DT_CON1E, some people avoided me.

1. Never
2. Rarely
3. Sometimes
4. Often
5. Always
8. RF
9. DK

Stigma (XSGN) - Question identifier:XSGN_Q03

Because of my ^DT_CON1E, I felt left out of things.

1. Never
2. Rarely
3. Sometimes
4. Often
5. Always
8. RF
9. DK

Stigma (XSGN) - Question identifier:XSGN_Q04

I felt embarrassed about my ^DT_CON1E.

1. Never
2. Rarely
3. Sometimes
4. Often
5. Always
8. RF
9. DK

Depression (XDEN)

Depression (XDEN) - Question identifier:XDEN_R01

The following questions deal with problems you may have had during the last two weeks.

Depression (XDEN) - Question identifier:XDEN_Q01

Over the last two weeks, how often have you:

... had little interest or pleasure in doing things?

1. Not at all
2. Several days
3. More than half the days
4. Nearly every day
8. RF
9. DK

Depression (XDEN) - Question identifier:XDEN_Q02

Over the last two weeks, how often have you:

... felt down, depressed, or hopeless?

1. Not at all
2. Several days
3. More than half the days
4. Nearly every day
8. RF
9. DK

Depression (XDEN) - Question identifier:XDEN_Q03

(Over the last two weeks, how often have you:)

... had trouble falling or staying asleep, or sleeping too much?

1. Not at all
2. Several days
3. More than half the days
4. Nearly every day
8. RF
9. DK

Depression (XDEN) - Question identifier:XDEN_Q04

(Over the last two weeks, how often have you:)

... felt tired or had little energy?

1. Not at all
2. Several days
3. More than half the days
4. Nearly every day
8. RF
9. DK

Depression (XDEN) - Question identifier:XDEN_Q05

(Over the last two weeks, how often have you:)

... had poor appetite or overate?

1. Not at all
2. Several days
3. More than half the days
4. Nearly every day
8. RF
9. DK

Depression (XDEN) - Question identifier:XDEN_Q06

Over the last two weeks, how often have you:

... felt bad about yourself, or that you are a failure or have let yourself or your family down?

1. Not at all
2. Several days
3. More than half the days
4. Nearly every day
8. RF
9. DK

Depression (XDEN) - Question identifier:XDEN_Q07

(Over the last two weeks, how often have you:)

... had trouble concentrating on things, such as reading the newspaper or watching television?

1. Not at all
2. Several days
3. More than half the days
4. Nearly every day
8. RF
9. DK

Depression (XDEN) - Question identifier:XDEN_Q08

(Over the last two weeks, how often have you:)

... been moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual?

1. Not at all
2. Several days
3. More than half the days
4. Nearly every day
8. RF
9. DK

Depression (XDEN) - Question identifier:XDEN_Q09

(Over the last two weeks, how often have you:)

... had thoughts that you would be better off dead, or of hurting yourself?

1. Not at all
2. Several days
3. More than half the days
4. Nearly every day
8. RF
9. DK

Depression (XDEN) - Question identifier:XDEN_Q10

How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?

1. Not difficult at all
2. Somewhat difficult
3. Very difficult
4. Extremely difficult
8. RF
9. DK

Education (XEDN)

Education (XEDN) - Question identifier:XEDN_R01

Next, education.

Education (XEDN) - Question identifier:XEDN_Q01

What is the highest certificate, diploma or degree that you have completed?

1. Less than high school diploma or its equivalent
2. High school diploma or a high school equivalency certificate
3. Trade certificate or diploma
4. College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas)
5. University certificate or diploma below the bachelor's level
6. Bachelor's degree (e.g. B.A., B.Sc., LL.B.)
7. University certificate, diploma or degree above the bachelor's level
8. RF
9. DK

Income (XHIN)

Income (XHIN) - Question identifier:XHIN_R01

Now a question about your total household income.

Income (XHIN) - Question identifier:XHIN_Q01

What is your best estimate of the total household income received by all household members, from all sources, before taxes and deductions, in the past 12 months?

Income can come from various sources such as from work, investments, or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, alimony and rental income.

Minimum: -9000000 Maximum: 9000000

Income (XHIN) - Question identifier:XHIN_Q02

What is your best estimate of the total household income received by all household members, from all sources, before taxes and deductions, in the past 12 months? Was it... ?

1. Less than $50,000, including income loss
2. $50,000 and more
8. RF
9. DK

Income (XHIN) - Question identifier:XHIN_Q03

Please stop me when I have read the category which applies to your household. Was it... ?

1. Less than $5,000
2. $5,000 to less than $10,000
3. $10,000 to less than $15,000
4. $15,000 to less than $20,000
5. $20,000 to less than $30,000
6. $30,000 to less than $40,000
7. $40,000 to less than $50,000
8. RF
9. DK

Income (XHIN) - Question identifier:XHIN_Q04

Please stop me when I have read the category which applies to your household. Was it... ?

1. $50,000 to less than $60,000
2. $60,000 to less than $70,000
3. $70,000 to less than $80,000
4. $80,000 to less than $90,000
5. $90,000 to less than $100,000
6. $100,000 to less than $150,000
7. $150,000 and over
8. RF
9. DK

Administration (XADM)

Administration (XADM) - Question identifier:XADM_R01

^DT_STATE would like your permission to link information collected during this interview. This includes linking your survey information to your past and continuing use of health services such as visits to hospitals, clinics and doctor's offices.

Administration (XADM) - Question identifier:XADM_Q01

These organizations have agreed to keep your survey information confidential and use it only for statistical purposes. Do we have your permission for linkage?

1. Yes
2. No
8. RF
9. DK

Administration (XADM) - Question identifier:XADM_Q02A

Having a provincial health number will assist us in linking to this other information. Do you have ^DT_AN ^DT_PROVINCEE health number?

1. Yes
2. No
8. RF
9. DK

Administration (XADM) - Question identifier:XADM_Q02B

For which province is your health number?

10. Newfoundland and Labrador
11. Prince Edward Island
12. Nova Scotia
13. New Brunswick
24. Quebec
35. Ontario
46. Manitoba
47. Saskatchewan
48. Alberta
59. British Columbia
88. Does not have a provincial health number
98. RF
99. DK

Administration (XADM) - Question identifier:XADM_Q02C

What is your health number?

CCHS2012NEUR - XADM_Q02CE

Administration (XADM) - Question identifier:XADM_R03A

Statistics Canada would like your permission to share the information collected in this survey with the Public Health Agency of Canada, Health Canada ^SHAREE.

Administration (XADM) - Question identifier:XADM_Q03B

These organizations have agreed to keep the information confidential and use it only for statistical purposes. Do you agree to share the information provided?

1. Yes
2. No
8. RF
9. DK

Administration (XADM) - Question identifier:XADM_R04

In order to reduce the number of questions on today's survey, Statistics Canada would like to link information from this interview with your information from the ^CCHSYR Canadian Community Health Survey.

Administration (XADM) - Question identifier:XADM_Q04

The linked information will be kept strictly confidential and used only for statistical purposes. Do we have your permission?

1. Yes
2. No
8. RF
9. DK

Administration (XADM) - Question identifier:XADM_R05

Statistics Canada would like your permission to share the linked survey data, that is your information from today's interview and your information from the Canadian Community Health Survey, with the Public Health Agency of Canada, Health Canada ^SHAREE.

Administration (XADM) - Question identifier:XADM_Q05

These organizations have agreed to keep information from both surveys confidential and use it only for statistical purposes. Do we have your permission?

1. Yes
2. No
8. RF
9. DK

Administration (XADM) - Question identifier:XADM_R06

Although you do not agree to link the information collected in today's interview to the ^CCHSYR Canadian Community Health Survey, we would like your permission to share only the information collected today with the Public Health Agency of Canada, Health Canada ^SHAREE.

Administration (XADM) - Question identifier:XADM_Q06

These organizations have agreed to keep the information confidential and use it only for statistical purposes.

Do you agree to share the information from today's interview?

1. Yes
2. No
8. RF
9. DK

Administration (XADM) - Question identifier:XADM_R07

Although you do not agree to share the linked survey information, we would like your permission to share only the information collected in today's interview with the Public Health Agency of Canada, Health Canada ^SHAREE.

Administration (XADM) - Question identifier:XADM_Q07

These organizations have agreed to keep the information confidential and use it only for statistical purposes.

Do you agree to share the information from today's interview?

1. Yes
2. No
8. RF
9. DK

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