Canadian Armed Forces Transition and Well-being Survey (CAFTWS)
For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- HC: De-facto marital status without confirmation - MSNC
- Statement of linkage (SL)
- Demographic Information 2 (DM2)
- Health and Well-being (HWB)
- Life Satisfaction Minimum (LSM)
- Life Stress (LS)
- Release from Military (RM)
- Deployment Experience (DEXP)
- Transition Experiences (TE)
- Transition Programs and Services Use (TPSU)
- Employment Services (ES)
- Financial Services (FS)
- Peer Support and Outreach Service (PSOS)
- Family Services (FMS)
- Health Care Services (HCS)
- Physical Health Conditions (CC1P)
- Pain and discomfort (HUP)
- Mental Health Conditions (CC2M)
- ADLS Screener (ADLS)
- Activities of Daily Living (ADL)
- Help with Everyday Activities (HEA)
- Distress (DIS)
- Interpersonal Relationship and Social Support (IRSS)
- Social Provisions (SPS)
- General Health (GEN)
- Education (EDU)
- Employment Status (EMS)
- Income (INC)
- Income 2 (INC2)
HC: De-facto marital status without confirmation - MSNC
HC: De-facto marital status without confirmation - MSNC - Question identifier:MSNC_Q01
What is [your/FNAME's] marital status? [Are/Is you/he/she]... ?
- 1: Married
- 2: Living common-law
- 3: Widowed
- 4: Separated
- 5: Divorced
- 6: Single, never married
- 9: Don't know
- 8: Refusal
Statement of linkage (SL)
Statement of linkage (SL) - Question identifier:SL_R01
Statistics Canada may combine your responses from this survey with information from other surveys and administrative data sources.
Demographic Information 2 (DM2)
Demographic Information 2 (DM2) - Question identifier:DM2_Q10
Including yourself, how many persons usually live in your household?
Min = 1; Max = 99
Demographic Information 2 (DM2) - Question identifier:DM2_Q20
How many of these persons are dependent children of 18 years or younger?
Min = 0; Max = 99
Demographic Information 2 (DM2) - Question identifier:DM2_Q30
How many of these persons are over 70 years of age?
Min = 0; Max = 99
Demographic Information 2 (DM2) - Question identifier:DM2_Q40
What is your first official language?
- 1: English
- 2: French
Health and Well-being (HWB)
Health and Well-being (HWB) - Question identifier:HWB_R10
The following questions ask about your current physical and mental well-being.
Health and Well-being (HWB) - Question identifier:HWB_Q10
In general, would you say your physical health is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Health and Well-being (HWB) - Question identifier:HWB_Q20
In general, would you say your mental health is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Life Satisfaction Minimum (LSM)
Life Satisfaction Minimum (LSM) - Question identifier:LSM_Q10
Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?
- 00: Very dissatisfied
- 01: |
- 02: |
- 03: |
- 04: |
- 05: |
- 06: |
- 07: |
- 08: |
- 09: V
- 10: Very satisfied
- 98: RF
- 99: DK
Life Stress (LS)
Life Stress (LS) - Question identifier:LS_Q10
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
Life Stress (LS) - Question identifier:LS_Q20
Thinking about stress in your day-to-day life, what would you say is the most important thing contributing to feelings of stress you may have?
- 01: Time pressures / Not enough time
- 02: Own physical health problem or condition
- 03: Own emotional or mental health problem or condition
- 04: Financial situation (e.g., not enough money, debt)
- 05: Working conditions (e.g., hours of work, your own working conditions)
- 06: School
- 07: Employment status (e.g., unemployment)
- 08: Personal relationships
- 09: Discrimination
- 10: Personal and family's safety
- 11: Health of spouse or partner
- 12: Health of family members other than spouse or partner
- 13: Caring for - own children
- 14: Caring for - others
- 15: Other personal or family responsibilities
- 16: Transition - Stress leaving the military, transitioning to civilian life
- 17: Uncertainty / Fear of future
- 18: Other
- 19: Nothing
- 98: RF
- 99: DK
Life Stress (LS) - Question identifier:LS_Q30
In general, how would you rate your ability to manage stress?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Release from Military (RM)
Release from Military (RM) - Question identifier:RM_R10
The next few questions are about your release.
Release from Military (RM) - Question identifier:RM_Q10
How long ago did you release from the military?
- 1: Less than 6 months ago
- 2: 6-12 months ago
- 3: 13-24 months ago
- 4: More than 2 years ago
- 8: RF
- 9: DK
Release from Military (RM) - Question identifier:RM_Q20
What type of release was it?
- 1: Voluntary
- 2: Medical - 3A
- 3: Medical - 3B
- 4: Retirement age
- 5: Involuntary
- 6: Service complete
- 7: Unknown
- 8: RF
Release from Military (RM) - Question identifier:RM_Q30
Was your medical release due to a physical health condition, a mental health condition or both?
- 1: Physical health condition
- 2: Mental health condition
- 3: Both
- 8: RF
- 9: DK
Release from Military (RM) - Question identifier:RM_Q40
How many years did you serve in the Canadian Armed Forces? Please round up to the nearest year.
Min = 0; Max = 100
Release from Military (RM) - Question identifier:RM_Q60
Which environment uniform did you wear for the majority of your career?
- 1: Sea
- 2: Land
- 3: Air
Release from Military (RM) - Question identifier:RM_Q70
What was your component for the majority of your career?
- 1: Regular Force
- 2: Reserve Force
- 8: RF
- 9: DK
Deployment Experience (DEXP)
Deployment Experience (DEXP) - Question identifier:DEXP_R10
For the next few questions, "deployment" means having deployed in support of a mission, such as a NATO mission or a UN tour.
Deployment Experience (DEXP) - Question identifier:DEXP_Q10
Did you ever deploy for any period of time in support of the mission in Afghanistan, since its inception in 2001?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Deployment Experience (DEXP) - Question identifier:DEXP_Q20
Did you ever deploy for any period of time outside of North America in support of any other Canadian Armed Forces operation or humanitarian mission?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Transition Experiences (TE)
Transition Experiences (TE) - Question identifier:TE_Q10
In general, how has your adjustment to civilian life been since you were released from the Canadian Armed Forces?
- 1: Very difficult
- 2: Moderately difficult
- 3: Neither difficult nor easy
- 4: Moderately easy
- 5: Very easy
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_R20
The next set of statements deal with issues related to your transition to civilian life. Please indicate how challenging the following issues were for you.
Transition Experiences (TE) - Question identifier:TE_Q20
How challenging was:
being financially prepared for transition?
- 1: Not at all challenging
- 2: A little challenging
- 3: Moderately challenging
- 4: Very challenging
- 5: Extremely challenging
- 6: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q30
(How challenging was:)
finding employment for yourself?
- 1: Not at all challenging
- 2: A little challenging
- 3: Moderately challenging
- 4: Very challenging
- 5: Extremely challenging
- 6: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q40
(How challenging was:)
your spouse or partner finding employment?
- 1: Not at all challenging
- 2: A little challenging
- 3: Moderately challenging
- 4: Very challenging
- 5: Extremely challenging
- 6: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q50
(How challenging was:)
identifying educational opportunities for yourself?
- 1: Not at all challenging
- 2: A little challenging
- 3: Moderately challenging
- 4: Very challenging
- 5: Extremely challenging
- 6: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q60
(How challenging was:)
your spouse or partner identifying educational opportunities?
- 1: Not at all challenging
- 2: A little challenging
- 3: Moderately challenging
- 4: Very challenging
- 5: Extremely challenging
- 6: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q70
(How challenging was:)
relocating (e.g., finding housing, schools and community resources at your new location)?
- 1: Not at all challenging
- 2: A little challenging
- 3: Moderately challenging
- 4: Very challenging
- 5: Extremely challenging
- 6: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q80
(How challenging was:)
finding a health care provider after transition for yourself?
- 1: Not at all challenging
- 2: A little challenging
- 3: Moderately challenging
- 4: Very challenging
- 5: Extremely challenging
- 6: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q90
(How challenging was:)
understanding Veterans Affairs Canada (VAC) benefits and services available to you and your family?
- 1: Not at all challenging
- 2: A little challenging
- 3: Moderately challenging
- 4: Very challenging
- 5: Extremely challenging
- 6: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q100
(How challenging was:)
losing your military identity?
- 1: Not at all challenging
- 2: A little challenging
- 3: Moderately challenging
- 4: Very challenging
- 5: Extremely challenging
- 6: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q110
(How challenging was:)
losing touch with your military peers?
- 1: Not at all challenging
- 2: A little challenging
- 3: Moderately challenging
- 4: Very challenging
- 5: Extremely challenging
- 6: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_R120
Think about what life is like now that you have released. Please answer no, somewhat, or yes to each one. 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.
Transition Experiences (TE) - Question identifier:TE_Q120
I have secured a good job.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q130
I have enrolled in an educational institution.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q140
I am prepared for retirement.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q150
I am satisfied with my prospects for a job or other main activity.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q170
I am financially prepared for civilian life.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q180
I am confident that I can make ends meet.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q190
I am confident that my physical or mental health will not interfere with my work, family or community life.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q200
I have access to the health care I need.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q210
I am satisfied with support that I get from my family, friends or community.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q220
I have hobbies and interests outside of the military life.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q230
I have suitable housing arrangements.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q240
I am living in my preferred location.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q250
I have adjusted well to civilian life.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Experiences (TE) - Question identifier:TE_Q260
My family has adjusted well to my transition to civilian life.
- 1: No
- 2: Somewhat
- 3: Yes
- 4: Not applicable
- 8: RF
- 9: DK
Transition Programs and Services Use (TPSU)
Transition Programs and Services Use (TPSU) - Question identifier:TPSU_Q10
How would you rate the level of support that you received from your chain of command throughout the release process?
Would you say it was...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Transition Programs and Services Use (TPSU) - Question identifier:TPSU_R20
The next questions are about programs and services you may have used in relation to your transition.
Transition Programs and Services Use (TPSU) - Question identifier:TPSU_Q20
Have you ever used or been posted to IPSC, JPSU?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Transition Programs and Services Use (TPSU) - Question identifier:TPSU_Q30
Overall, how satisfied are you with the services provided by the IPSC, JPSU?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Transition Programs and Services Use (TPSU) - Question identifier:TPSU_Q40
Did you attend a SCAN (Second Career Assistance Network) transition seminar?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Transition Programs and Services Use (TPSU) - Question identifier:TPSU_Q50
Have you heard of the SCAN (Second Career Assistance Network) transition seminar?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Transition Programs and Services Use (TPSU) - Question identifier:TPSU_Q60
Did you attend a Transition Interview with Veterans Affairs Canada (VAC)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Transition Programs and Services Use (TPSU) - Question identifier:TPSU_Q70
Have you heard of a Transition Interview with Veterans Affairs Canada (VAC)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Employment Services (ES)
Employment Services (ES) - Question identifier:ES_Q10
Did you use any employment services offered by the Canadian Armed Forces (CAF) SCAN services program?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q20
Overall, how satisfied were you with the SCAN employment services?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q30
Have you heard of the SCAN services?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q40
What are some of the reasons why you have not used the SCAN services?
- 01: Not ready to ask for help
- 02: Not available in the area I live in
- 03: Not available at time required / inconvenient hours
- 04: Waiting time too long
- 05: Cost - too expensive / can't afford it
- 06: Didn't have time for it
- 07: Didn't know where to go or who to call
- 08: Language barrier
- 09: Doctor did not think it was necessary
- 10: Not eligible for this service
- 11: Still waiting for this service
- 12: Other
- 13: Did not need it
- 98: RF
- 99: DK
Employment Services (ES) - Question identifier:ES_Q50
Did you use any services offered by the Military Employment Transition Program?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q60
Overall, how satisfied were you with the Military Employment Transition Program?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q70
Have you heard of the Military Employment Transition Program?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q80
What are some of the reasons why you have not used the Military Employment Transition Program services?
- 01: Not ready to ask for help
- 02: Not available in the area I live in
- 03: Not available at time required / inconvenient hours
- 04: Waiting time too long
- 05: Cost - too expensive / can't afford it
- 06: Didn't have time for it
- 07: Didn't know where to go or who to call
- 08: Language barrier
- 09: Doctor did not think it was necessary
- 10: Not eligible for this service
- 11: Still waiting for this service
- 12: Other
- 13: Did not need it
- 98: RF
- 99: DK
Employment Services (ES) - Question identifier:ES_Q90
Did you use any services offered by the Canadian Armed Forces (CAF) Return to Work Program?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q100
Overall, how satisfied were you with the Return to Work Program?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q110
Have you heard of the Return to Work Program?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q120
What are some of the reasons why you have not used the Return to Work Program?
- 01: Not ready to ask for help
- 02: Not available in the area I live in
- 03: Not available at time required / inconvenient hours
- 04: Waiting time too long
- 05: Cost - too expensive / can't afford it
- 06: Didn't have time for it
- 07: Didn't know where to go or who to call
- 08: Language barrier
- 09: Doctor did not think it was necessary
- 10: Not eligible for this service
- 11: Still waiting for this service
- 12: Other
- 13: Did not need it
- 98: RF
- 99: DK
Employment Services (ES) - Question identifier:ES_Q130
Did you use any employment services offered by the Vocational Rehabilitation Program?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q140
Overall, how satisfied were you with the Vocational Rehabilitation Program?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q150
Have you heard of the Vocational Rehabilitation Program?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Employment Services (ES) - Question identifier:ES_Q160
What are some of the reasons why you have not used the Vocational Rehabilitation Program?
- 01: Not ready to ask for help
- 02: Not available in the area I live in
- 03: Not available at time required / inconvenient hours
- 04: Waiting time too long
- 05: Cost - too expensive / can't afford it
- 06: Didn't have time for it
- 07: Didn't know where to go or who to call
- 08: Language barrier
- 09: Doctor did not think it was necessary
- 10: Not eligible for this service
- 11: Still waiting for this service
- 12: Other
- 13: Did not need it
- 98: RF
- 99: DK
Financial Services (FS)
Financial Services (FS) - Question identifier:FS_Q10
Did you use any financial services offered by the Service Income Security Insurance Program (SISIP)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Financial Services (FS) - Question identifier:FS_Q20
Overall, how satisfied were you with the Service Income Security Insurance Program (SISIP)?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Financial Services (FS) - Question identifier:FS_Q30
Have you heard of the Service Income Security Insurance Program (SISIP)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Financial Services (FS) - Question identifier:FS_Q40
What are some of the reasons why you have not used the Service Income Security Insurance Program (SISIP)?
- 01: Not ready to ask for help
- 02: Not available in the area I live in
- 03: Not available at time required / inconvenient hours
- 04: Waiting time too long
- 05: Cost - too expensive / can't afford it
- 06: Didn't have time for it
- 07: Didn't know where to go or who to call
- 08: Language barrier
- 09: Doctor did not think it was necessary
- 10: Not eligible for this service
- 11: Still waiting for this service
- 12: Other
- 13: Did not need it
- 98: RF
- 99: DK
Peer Support and Outreach Service (PSOS)
Peer Support and Outreach Service (PSOS) - Question identifier:PSOS_Q10
Did you use any peer support and outreach services offered by the Operational Stress Injury Social Support Program (OSISS)?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Peer Support and Outreach Service (PSOS) - Question identifier:PSOS_Q20
Overall, how satisfied were you with the Operational Stress Injury Social Support Program (OSISS)?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Peer Support and Outreach Service (PSOS) - Question identifier:PSOS_Q30
Have you heard of the Operational Stress Injury Social Support Program (OSISS)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Peer Support and Outreach Service (PSOS) - Question identifier:PSOS_Q40
What are some of the reasons why you have not used the Operational Stress Injury Social Support Program (OSISS)?
- 01: Not ready to ask for help
- 02: Not available in the area I live in
- 03: Not available at time required / inconvenient hours
- 04: Waiting time too long
- 05: Cost - too expensive / can't afford it
- 06: Didn't have time for it
- 07: Didn't know where to go or who to call
- 08: Language barrier
- 09: Doctor did not think it was necessary
- 10: Not eligible for this service
- 11: Still waiting for this service
- 12: Other
- 13: Did not need it
- 98: RF
- 99: DK
Family Services (FMS)
Family Services (FMS) - Question identifier:FMS_Q10
Did you use any services offered by the Military Family Services Program (MFSP) or the Veteran Family Program?
- 1: Yes
- 2: No
- 3: Not eligible for this service/Not released for medical reasons/Not applicable
- 8: RF
- 9: DK
Family Services (FMS) - Question identifier:FMS_Q20
Overall, how satisfied were you with the Military Family Services Program (MFSP) or the Veteran Family Program?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Family Services (FMS) - Question identifier:FMS_Q30
Have you heard of the Military Family Services Program (MFSP) or the Veteran Family Program?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Family Services (FMS) - Question identifier:FMS_Q40
What are some of the reasons why you have not used the Military Family Services Program (MFSP) or the Veteran Family Program?
- 01: Not ready to ask for help
- 02: Not available in the area I live in
- 03: Not available at time required / inconvenient hours
- 04: Waiting time too long
- 05: Cost - too expensive / can't afford it
- 06: Didn't have time for it
- 07: Didn't know where to go or who to call
- 08: Language barrier
- 09: Doctor did not think it was necessary
- 10: Not eligible for this service
- 11: Still waiting for this service
- 12: Other
- 13: Did not need it
- 98: RF
- 99: DK
Health Care Services (HCS)
Health Care Services (HCS) - Question identifier:HCS_Q10
Did you use any health care services offered by the Veteran Independence Program (VIP)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health Care Services (HCS) - Question identifier:HCS_Q20
Overall, how satisfied were you with the Veteran Independence Program (VIP)?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Health Care Services (HCS) - Question identifier:HCS_Q30
Have you heard of the Veteran Independence Program (VIP)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health Care Services (HCS) - Question identifier:HCS_Q40
What are some of the reasons why you have not used the Veteran Independence Program (VIP)?
- 01: Not ready to ask for help
- 02: Not available in the area I live in
- 03: Not available at time required / inconvenient hours
- 04: Waiting time too long
- 05: Cost - too expensive / can't afford it
- 06: Didn't have time for it
- 07: Didn't know where to go or who to call
- 08: Language barrier
- 09: Doctor did not think it was necessary
- 10: Not eligible for this service
- 11: Still waiting for this service
- 12: Other
- 13: Did not need it
- 98: RF
- 99: DK
Health Care Services (HCS) - Question identifier:HCS_Q50
Did you use any health care services offered by the Rehabilitation Program?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health Care Services (HCS) - Question identifier:HCS_Q60
Overall, how satisfied were you with the Rehabilitation Program?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Health Care Services (HCS) - Question identifier:HCS_Q70
Have you heard of the Rehabilitation Program?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health Care Services (HCS) - Question identifier:HCS_Q80
What are some of the reasons why you have not used the Rehabilitation Program services?
- 01: Not ready to ask for help
- 02: Not available in the area I live in
- 03: Not available at time required / inconvenient hours
- 04: Waiting time too long
- 05: Cost - too expensive / can't afford it
- 06: Didn't have time for it
- 07: Didn't know where to go or who to call
- 08: Language barrier
- 09: Doctor did not think it was necessary
- 10: Not eligible for this service
- 11: Still waiting for this service
- 12: Other
- 13: Did not need it
- 98: RF
- 99: DK
Physical Health Conditions (CC1P)
Physical Health Conditions (CC1P) - Question identifier:CC1P_R10
Now I'd like to ask about certain long-term physical health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.
Physical Health Conditions (CC1P) - Question identifier:CC1P_Q10
Do you currently have any of the following long-term physical health conditions that have been diagnosed by a health professional?
- 01: Arthritis, for example, osteoarthritis, rheumatoid arthritis, gout or any other type, excluding fibromyalgia?
- 02: Chronic pain or discomfort?
- 03: Bowel disorder, such as Crohn's Disease, ulcerative colitis, Irritable Bowel Syndrome (IBS) or bowel incontinence?
- 04: Hearing problems (even if a hearing aid is used)?
- 05: Heart disease?
- 06: Migraines?
- 07: Other
- 08: None of the above
- 98: RF
- 99: DK
Pain and discomfort (HUP)
Pain and discomfort (HUP) - Question identifier:HUP_R10
The next set of questions asks about the level of pain or discomfort you usually experience. They are not about illnesses like colds that affect people for short periods of time.
Pain and discomfort (HUP) - Question identifier:HUP_Q10
Are you usually free of pain or discomfort?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Pain and discomfort (HUP) - Question identifier:HUP_Q20
How would you describe the usual intensity of your pain or discomfort?
- 1: Mild
- 2: Moderate
- 3: Severe
- 8: RF
- 9: DK
Pain and discomfort (HUP) - Question identifier:HUP_Q40
Do you think your military service contributed to any of the physical health conditions you previously mentioned?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mental Health Conditions (CC2M)
Mental Health Conditions (CC2M) - Question identifier:CC2M_R10
Now I'd like to ask about certain long-term mental health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.
Mental Health Conditions (CC2M) - Question identifier:CC2M_Q10
Do you have a mood disorder such as depression, bipolar disorder, mania or dysthymia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mental Health Conditions (CC2M) - Question identifier:CC2M_Q20
Do you suffer from the effects of a traumatic brain injury (TBI) or concussion?
- 1: Yes
- 2: No
- 3: Maybe
- 8: RF
- 9: DK
Mental Health Conditions (CC2M) - Question identifier:CC2M_Q30
Do you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mental Health Conditions (CC2M) - Question identifier:CC2M_Q40
What kind of anxiety disorder do you have?
- 1: Phobia
- 2: Obsessive-compulsive disorder (OCD)
- 3: Panic disorder
- 4: Other
- 8: RF
- 9: DK
Mental Health Conditions (CC2M) - Question identifier:CC2M_Q50
Do you have post-traumatic stress disorder (PTSD)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mental Health Conditions (CC2M) - Question identifier:CC2M_Q60
Do you have any other long-term mental health conditions that have been diagnosed by a health professional (not already mentioned)?
- 1: Yes - Specify
- 2: No
- 8: RF
- 9: DK
Mental Health Conditions (CC2M) - Question identifier:CC2M_Q70
Do you think your military service contributed to any of the previously mentioned mental health conditions you identified?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
ADLS Screener (ADLS)
ADLS Screener (ADLS) - Question identifier:ADLS_Q10
Do you have limitations in your daily activities that might be caused by a physical or mental health condition?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Activities of Daily Living (ADL)
Activities of Daily Living (ADL) - Question identifier:ADL_R10
The next few questions are related to current limitations in daily activities that might be caused by a physical or mental health condition. These questions may not apply to you, but we need to ask the same questions of everyone.
Activities of Daily Living (ADL) - Question identifier:ADL_Q10
Because of your physical or mental health condition, how often do you:
have difficulty seeing (even when wearing glasses or contact lenses)?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 5: Not applicable
- 8: RF
- 9: DK
Activities of Daily Living (ADL) - Question identifier:ADL_Q20
Because of your physical or mental health condition, how often do you:
have difficulty hearing (even when using a hearing aid)?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 5: Not applicable
- 8: RF
- 9: DK
Activities of Daily Living (ADL) - Question identifier:ADL_Q30
(Because of your physical or mental health condition, how often do you:)
have difficulty walking, using stairs, using your hands or fingers or doing any other physical activities?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 5: Not applicable
- 8: RF
- 9: DK
Activities of Daily Living (ADL) - Question identifier:ADL_Q40
(Because of your physical or mental health condition, how often do you:)
have difficulty learning, remembering or concentrating?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 5: Not applicable
- 8: RF
- 9: DK
Activities of Daily Living (ADL) - Question identifier:ADL_Q50
(Because of your physical or mental health condition, how often do you:)
reduce the amount or the kind of activity you do at home?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 5: Not applicable
- 8: RF
- 9: DK
Activities of Daily Living (ADL) - Question identifier:ADL_Q60
(Because of your physical or mental health condition, how often do you:)
reduce the amount or the kind of activity you do at work or school?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 5: Not applicable
- 8: RF
- 9: DK
Activities of Daily Living (ADL) - Question identifier:ADL_Q70
(Because of your physical or mental health condition, how often do you:)
reduce the amount or the kind of any other activity you do (e.g., transportation or leisure)?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 5: Not applicable
- 8: RF
- 9: DK
Activities of Daily Living (ADL) - Question identifier:ADL_Q80
(Because of your physical or mental health condition, how often do you:)
reduce your social activities (e.g., visiting friends, relatives)?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 5: Not applicable
- 8: RF
- 9: DK
Help with Everyday Activities (HEA)
Help with Everyday Activities (HEA) - Question identifier:HEA_R10
The next questions are about the help you have received with everyday activities because of your physical or mental health condition in the past year. Include help received from your spouse or partner, from family members, friends or neighbours, and from organizations, whether paid or unpaid. These questions may not apply to you but I need to ask the same questions of everybody.
Help with Everyday Activities (HEA) - Question identifier:HEA_Q10
Because of your physical or mental health condition, in the past year, how often have you usually received:
help with preparing meals?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Help with Everyday Activities (HEA) - Question identifier:HEA_Q20
Because of your physical or mental health condition, in the past year, how often have you usually received:
help with getting to appointments and running errands, such as shopping for groceries or other essential items?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Help with Everyday Activities (HEA) - Question identifier:HEA_Q30
(Because of your physical or mental health condition, in the past year, how often have you usually received:)
help with doing everyday housework, such as dusting and tidying up?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Help with Everyday Activities (HEA) - Question identifier:HEA_Q40
(Because of your physical or mental health condition, in the past year, how often have you usually received:)
help with heavy household chores, such as spring cleaning or yard work?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Help with Everyday Activities (HEA) - Question identifier:HEA_Q50
(Because of your physical or mental health condition, in the past year, how often have you usually received:)
help with personal care such as washing or dressing?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Help with Everyday Activities (HEA) - Question identifier:HEA_Q60
Because of your physical or mental health condition, in the past year, how often have you usually received:
help with taking medication?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Help with Everyday Activities (HEA) - Question identifier:HEA_Q70
(Because of your physical or mental health condition, in the past year, how often have you usually received:)
help with moving about inside your residence?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Help with Everyday Activities (HEA) - Question identifier:HEA_Q80
(Because of your physical or mental health condition, in the past year, how often have you usually received:)
help with looking after your personal finances such as making bank transactions or paying bills?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Help with Everyday Activities (HEA) - Question identifier:HEA_Q90
(Because of your physical or mental health condition, in the past year, how often have you usually received:)
specialized nursing care or medical treatment at home such as injections, therapy, blood or urine testing or catheter care?
- 1: Never
- 2: Sometimes
- 3: Often
- 4: Always
- 8: RF
- 9: DK
Help with Everyday Activities (HEA) - Question identifier:HEA_Q100
During the past year, who would you say you relied on the most for the help you received because of your condition?
- 1: Spouse or partner
- 2: Parent or guardian
- 3: Other family member(s), i.e., daughter, son, aunt, uncle, grandparent, cousin
- 4: Friends
- 5: Health professional(s)
- 6: Community support group(s)
- 7: Other
- 8: RF
- 9: DK
Distress (DIS)
Distress (DIS) - Question identifier:DIS_R10
The following questions deal with feelings you may have had during the past month.
Distress (DIS) - Question identifier:DIS_Q10A
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
tired out for no good reason?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q10B
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
nervous?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q10C
(During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:)
so nervous that nothing could calm you down?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q10D
(During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:)
hopeless?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q10E
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
restless or fidgety?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q10F
(During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:)
so restless you could not sit still?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q10G
(During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:)
sad or depressed?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q10H
(During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:)
so depressed that nothing could cheer you up?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q10I
(During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:)
that everything was an effort?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q10J
(During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:)
worthless?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Interpersonal Relationship and Social Support (IRSS)
Interpersonal Relationship and Social Support (IRSS) - Question identifier:IRSS_R10
The following questions relate to your relationship with your spouse or partner.
Interpersonal Relationship and Social Support (IRSS) - Question identifier:IRSS_Q10
How long have you been in your current relationship? (Round up to the nearest year.)
Min = 00; Max = 99
Interpersonal Relationship and Social Support (IRSS) - Question identifier:IRSS_R20
Each of the following statements might describe the nature of your relationship with your spouse or partner. To what extent do you agree or disagree that each statement describes your relationship?
Interpersonal Relationship and Social Support (IRSS) - Question identifier:IRSS_Q20
We have a good relationship.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Interpersonal Relationship and Social Support (IRSS) - Question identifier:IRSS_Q40
Our relationship is strong.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Interpersonal Relationship and Social Support (IRSS) - Question identifier:IRSS_Q70
Everything considered, I am extremely happy with my relationship.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Interpersonal Relationship and Social Support (IRSS) - Question identifier:IRSS_Q80
My physical or mental health condition has caused strain in our relationship.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 6: Not applicable
- 8: RF
- 9: DK
Interpersonal Relationship and Social Support (IRSS) - Question identifier:IRSS_Q90
How has leaving the military impacted your family's quality of life?
- 1: It has improved significantly
- 2: It has improved somewhat
- 3: It has stayed about the same
- 4: It has decreased somewhat
- 5: It has decreased significantly
- 8: RF
- 9: DK
Interpersonal Relationship and Social Support (IRSS) - Question identifier:IRSS_Q100
People often turn to others for companionship, assistance or other types of support in difficult times. Please identify the person you would most likely rely on for such help.
- 01: Your spouse or partner
- 02: Your mother
- 03: Your father
- 04: Your brother
- 05: Your sister
- 06: Other family member(s) for example, daughter or son, aunt or uncle, grandparent, cousin(s)
- 07: Your friend(s)
- 08: Your supervisor at work
- 09: Other co-worker(s)
- 10: Health professional(s)
- 11: Other
- 98: RF
- 99: DK
Social Provisions (SPS)
Social Provisions (SPS) - Question identifier:SPS_R10
The next questions are about your current relationships with friends, family members, co-workers, community members, and so on. Please indicate to what extent each statement describes your current relationships with other people.
Social Provisions (SPS) - Question identifier:SPS_Q10
There are people I can depend on to help me if I really need it.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social Provisions (SPS) - Question identifier:SPS_Q20
There are people who enjoy the same social activities I do.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social Provisions (SPS) - Question identifier:SPS_Q30
I have close relationships that provide me with a sense of emotional security and well-being.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social Provisions (SPS) - Question identifier:SPS_Q40
There is someone I could talk to about important decisions in my life.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social Provisions (SPS) - Question identifier:SPS_Q50
I have relationships where my competence and skill are recognized.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social Provisions (SPS) - Question identifier:SPS_Q60
There is a trustworthy person I could turn to for advice if I were having problems.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social Provisions (SPS) - Question identifier:SPS_Q70
I feel part of a group of people who share my attitudes and beliefs.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social Provisions (SPS) - Question identifier:SPS_Q80
I feel a strong emotional bond with at least one other person.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social Provisions (SPS) - Question identifier:SPS_Q90
There are people who admire my talents and abilities.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social Provisions (SPS) - Question identifier:SPS_Q100
There are people I can count on in an emergency.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
General Health (GEN)
General Health (GEN) - Question identifier:GEN_Q10
How would you describe your sense of belonging to your local community? Would you say it is...?
- 1: Very strong
- 2: Somewhat strong
- 3: Somewhat weak
- 4: Very weak
- 8: RF
- 9: DK
Education (EDU)
Education (EDU) - Question identifier:EDU_Q10
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
Employment Status (EMS)
Employment Status (EMS) - Question identifier:EMS_Q10
Which category best describes your current employment status? Are you...?
- 01: Working full-time (30 hours or more per week)
- 02: Working part-time (less than 30 hours per week)
- 03: Self-employed
- 04: Unemployed and looking for work
- 05: A student attending school full-time
- 06: Retired
- 07: Not in the workforce (full-time homemaker or unemployed and not looking for work)
- 08: Other
- 98: RF
- 99: DK
Income (INC)
Income (INC) - Question identifier:INC_R10
Now a question about your total personal income.
Income (INC) - Question identifier:INC_Q10
What is your best estimate of your total personal income, before taxes and deductions, from all sources during the year ending December 31, 2016?
Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, alimony and rental income.
Min = -9000000; Max = 90000000
Income (INC) - Question identifier:INC_Q20
Can you estimate in which of the following groups your personal income falls? Was your total personal income during the year ending December 31, 2016...?
- 1: Less than $30,000 (including income loss)
- 2: $30,000 and more
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q30
Please stop me when I have read the category which applies to you.
- 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 $25,000
- 6: $25,000 to less than $30,000
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q40
Please stop me when I have read the category which applies to you.
- 01: $30,000 to less than $40,000
- 02: $40,000 to less than $50,000
- 03: $50,000 to less than $60,000
- 04: $60,000 to less than $70,000
- 05: $70,000 to less than $80,000
- 06: $80,000 to less than $90,000
- 07: $90,000 to less than $100,000
- 08: $100,000 and over
- 98: RF
- 99: DK
Income 2 (INC2)
Income 2 (INC2) - Question identifier:INC2_Q10
How satisfied are you with your financial situation?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
- Date modified: