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1


2011 NHIS Questionnaire - Sample Adult
Adult Disability
Document Version Date: 30-May-12


Question ID: ADB.020_00.000

Instrument Variable Name: P2DAHEAR
QuestionText:
With this next set of questions, we want to learn about people who have physical, mental, or emotional conditions that cause serious difficulties with their daily activities. Though different, these questions may sound similar to ones I asked earlier.
Are you deaf or do you have serious difficulty hearing?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample adults 18+ and random number generator=1
SkipInstructions:
(1,2,D,R) goto P2DASEE


Question ID: ADB.040_00.000

Instrument Variable Name: P2DASEE
QuestionText:
Are you blind or do you have serious difficulty seeing even when wearing glasses?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample adults 18+ and random number generator=1
SkipInstructions:
(1,2,D,R) goto P2DACON


Question ID:ADB.060_00.000

Instrument Variable Name: P2DACON
QuestionText:
Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample adults 18+ and random number generator=1
SkipInstructions:
(1,2,D,R) goto P2DAWALK


Question ID:ADB.080_00.000

Instrument Variable Name: P2DAWALK
QuestionText:
Do you have serious difficulty walking or climbing stairs?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample adults 18+ and random number generator=1
SkipInstructions:
(1,2,D,R) goto P2DADRES


Question ID:ADB.100_00.000

Instrument Variable Name: P2DADRES
QuestionText:
Do you have difficulty dressing or bathing?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample adults 18+ and random number generator=1
SkipInstructions:
(1,2,D,R) goto P2DAERR


Question ID:ADB.120_00.000

Instrument Variable Name: P2DAERR
QuestionText:
Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor's office or shopping?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample adults 18+ and random number generator = 1
SkipInstructions:
(1,2,D,R) goto next section