Survey Text

2016
2012
2008
top
2016
Survey form view entire document:  text  image

Question ID: BAL.250_00.000

Instrument Variable Name: BCAUS1
Questionnaire File Name: Sample Adult
Question Text:
What did the doctor(s) or health care professional(s) tell you was the cause or causes of your dizziness or balance problem(s)?
* Enter all that apply, separate with commas.
*Read the list if necessary.
01 Allergies
02 Anxiety or depression
03 Benign positional vertigo (BPV or BPPV)
04 Crystals-loose or dislodged in ear
05 Diabetes
06 Headache or migraines
07 Head or neck trauma or concussion
08 Heart disease
09 Inner ear infection, viral labrynthitis
10 Méniêre’s (Men-e-AIRZ) disease
11 Neurological-multiple sclerosis (MS), seizures, etc.
12 Side effects from medications (antibiotics, cancer treatments, etc.)
13 Stroke
14 Other health problem(s)
97 Refused
99 Don't know
Universe Text: Sample adults 18+ who were told cause of dizziness or balance problem
Skip Instructions:
(1-14,R,D) [goto BTRET1]

No questionnaire text is available for this sample.


top
2012
Survey form view entire document:  text  image

Question ID:: CBL.045_00.000

Instrument Variable Name:: CBALDGHP
QuestionText:
Did a doctor or other health professional EVER tell you a diagnosis or reason for {fill1: S.C. name}'s dizziness or balance problems?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: Sample children 3+ who have had episodes of balance problems or dizziness in the past 12 months
SkipInstructions:
(1) [goto CBALDIGN]
(2,R,D) [goto CBALPART]
Question ID:: CBL.050_00.000

Instrument Variable Name:: CBALDIGN
QuestionText:
What diagnoses or reasons were you told caused {fill1: S.C. name}'s balance or dizziness problems?
*Enter all that apply, separate with commas.
01 Ear infections (inner ear infection, otitis media, fluid in ears)
02 Vision problems/Blurred vision
03 Positional dizziness or vertigo (BPPV)
04 Severe headaches or migraine
05 Head or neck injury or concussion
06 Neurologic disorders including seizures, stroke, or brain tumors
07 Developmental motor coordination disorder ("clumsy" child)
08 Malformation of the ear
09 Other genetic cause (Asperger Syndrome, Usher's Syndrome, etc.)
10 Metabolic problem, such as "low blood sugar" (hypoglycemia)
11 Prescription medication or drugs
12 Other
97 Refused
99 Don't Know
UniverseText: Sample children 3+ who have ever been told a diagnosis for their balance problem or dizziness
SkipInstructions:
(1-12,R,D) [goto CBALPART]

top
2008
Survey form view entire document:  text  image

Question ID:BAL.250_00.000

Instrument Variable Name:BCAUS
QuestionText:
What did the doctor (s) or health care professional (s) tell you was the cause or causes of your (Fill: most bothersome or only feeling)?
* Enter all that apply, separate with commas.
* Read the list if necessary.
01 Antibiotics given through a needle or tube (I.V.)
02 Arthritis
03 Brain tumor
04 Cogan's syndrome or Sjogren's (SHO-grenz) syndrome
05 Loose or dislodged CRYSTALS in your ear or BPPV (benign positional vertigo)
06 Diabetes
07 Head or neck trauma or concussion
08 Heart disease
09 Inner ear infection
10 Meniere's (Men-e-AIRZ) disease
11 Migraine headaches
12 Neurological or muscular conditions (such as M.S., or M.D.)
13 Side effect or medicines or drugs
14 Stroke
15 TMJ or Temporal mandibular joint disorder
16 Other health problem(s)
97 Refused
99 Don't know
UniverseText:Sample adults 18+ who were told cause of symptoms of dizziness or balance problem
SkipInstructions:
(1-16, R, D) [goto BTRET]