Survey Text

2012
2007
2002
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2012
Survey form view entire document:  text  image

QuestionID: ALT.531_00.000

Instrument Variable Name: TP1_COND Adult CAM
QuestionText:
For what health problems, symptoms, or conditions did you {fill1: see a practitioner for/use} {fill2: modality}?
*Enter all that apply, separate with commas.
01 Abdominal pain
02 Acid reflux or heartburn
03 Feeling anxious, nervous or worried
04 Asthma
05 Arthritis
06 Attention Deficit Disorder/Hyperactivity
07 Benign tumors, cysts
08 Bipolar Disorder
09 Birth defect
10 Cancer
11 High Cholesterol
12 Chronic Bronchitis
13 Circulation problems (other than in the legs)
14 Coronary heart disease
15 Dental pain
16 Depression
17 Diabetes
18 Digestive allergy
19 Excessive sleepiness during the day
20 Excessive use of alcohol or tobacco
21 Fatigue or lack of energy more than 3 days
22 Fever more than 1 day
23 Fibromyalgia
24 Fracture, bone/joint injury
25 Gout
26 Gynecologic problem
27 Hay fever
28 Head or chest cold
29 Hearing problem
30 Heart condition or disease, other than coronary heart disease
31 Hernia
32 Hypertension
33 Infectious diseases or problems of the immune system
34 Influenza or pneumonia
35 Insomnia or trouble sleeping
36 Jaw pain
37 Joint pain or stiffness/Other joint condition
38 Knee problems (not arthritis, not joint injury)
39 Liver problem
40 Lung/breathing problem
41 Lupus
42 Memory loss or loss of other cognitive function
43 Menopause
44 Menstrual problems
45 Intellectual disability, also known as mental retardation
46 Missing limbs (fingers, toes or digits), amputee
47 Nausea and/or vomiting
48 Neurological problems
49 Osteoporosis, tendinitis
50 Allergies other than hay fever, respiratory, food, digestive, or skin allergies
51 Chronic pain
52 Other developmental problem
53 Injury other than fracture, bone/joint injury
54 Mental health disorders
55 Muscle or bone pain
56 Nerve damage, including carpal tunnel syndrome
57 Problems with being overweight
58 Phobia or fears
59 Polio (myelitis), paralysis, para/quadriplegia
60 Poor circulation in your legs
61 Prostate trouble or impotence
62 Recurring headache, other than migraine
63 Respiratory allergy
64 Rheumatoid arthritis
65 Senility
66 Sinusitis
67 Eczema or any kind of skin allergy
68 Skin problems, other than eczema or skin allergies
69 Sore throat other than strep or tonsillitis
70 Sprain or strain
71 Frequent stress
72 Strep throat or tonsillitis
73 Substance abuse, other than alcohol or tobacco
74 Filled problem from AFLHCA_S1
75 Filled problem from AFLHCA_S2
76 Ulcer
77 Urinary problems
78 Varicose veins, hemorrhoids
79 Vision problem
80 Weak or failing kidneys
81 COPD
82 Back pain or problem
83 Neck pain or problem
84 Severe headache or migraine
85 Stomach or intestinal illness
86 Other specify
97 Refused
99 Don't know
UniverseText: Sample adults 18+ who have used first of top three modalities and saw a practitioner or used modality for a specific health problem, symptom or condition
SkipInstructions:
(1-86) If TP1_CNT GT 1 [goto TP1_CMST],
else if TP1_CNT=1 [goto TP1_CHLP];
(86) [goto TP1_SPEC];
(R,D) if self-care modality (ALT_TP31 in (6,7,10-16)) [goto TP1_RS5];
else [goto TP1_RS6]
QuestionID: ALT.531_00.010

Instrument Variable Name: TP1_SPEC Adult CAM
QuestionText:
*Enter condition for which [fill1: modality] was used. If respondent gives more than one condition, probe for condition which is most important.
97 Refused
99 Don't Know
Verbatim Verbatim response
UniverseText: Sample adults 18+ who have used first of top three modalities and used modality to treat other health problem or condition
SkipInstructions:
(Allow 75, R,D) If TP1_CNT GT 1 [goto TP1_CMST], elseif TP1_CNT =1 [goto TP1_CHLP];
(R,D) If TP1_CNT=1 and if self-care modality (ALT_TP31 in (6,7,10-16)) [goto TP1_RS5];
else [goto TP1_RS6]

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2007
Survey form view entire document:  text  image

Question ID: : ALT.222_00.000

Instrument Variable Name: EHT_COND
Question Text:
?[F1]
For what health problems or conditions did you use energy healing therapy?
*Enter all that apply, separate with commas.
01 Acid reflux or heartburn
02 Angina
03 Anxiety
04 Asthma
05 Arthritis
06 Attention Deficit Disorder/Hyperactivity
07 Autism
08 Benign tumors, cysts
09 Bipolar Disorder
10 Birth defect
11 Cancer
12 Cholesterol
13 Chronic Bronchitis
14 Circulation problems (other than in the legs)
15 Constipation severe enough to require medication
16 Coronary heart disease
17 Dementia, including Alzheimer's Disease
18 Dental pain
19 Depression
20 Diabetes
21 Emphysema
22 Excessive sleepiness during the day
23 Excessive use of alcohol or tobacco
24 Fibromyalgia
25 Fracture, bone/joint injury
26 Gout
27 Gum disease
28 Gynecologic problem
29 Hay fever
30 Hearing problem
31 Heart attack
32 Other heart condition or disease
33 Hernia
34 Hypertension
35 Inflammatory bowel disease
36 Influenza or pneumonia
37 Insomnia or trouble sleeping
38 Irritable bowel
39 Jaw pain
40 Joint pain or stiffness/other joint condition
41 Knee problems (not arthritis, not joint injury)
42 Liver problem
43 Lung/breathing problem (not already listed)
44 Lupus
45 Mania or psychosis
46 Memory loss or loss of other cognitive function
47 Menopause
48 Menstrual problems
49 Mental retardation
50 Missing limbs (fingers, toes or digits), amputee
51 Osteoporosis, tendinitis
52 Other developmental problem
53 Other injury
54 Other nerve damage, including carpal tunnel syndrome
55 Phobia or fears
56 Polio (myelitis), paralysis, para/quadriplegia
57 Poor circulation in legs
58 Prostate trouble or impotence
59 Regular headaches
60 Rheumatoid arthritis
61 Schizophrenia
62 Seizures
63 Senility
64 Sinusitis
65 Skin problems
66 Sprain or strain
67 Stroke
68 Substance abuse, other than alcohol or tobacco
69 Filled problem
70 Filled problem
71 Ulcer
72 Urinary problem
73 Varicose veins, hemorrhoids
74 Vision problem
75 Weak or failing kidneys
76 Weight problem
77 Back pain or problem
78 Head or chest cold
79 Neck pain or problem
80 Severe headache or migraine
81 Stomach or intestinal illness
82 Other - specify
97 Refused
99 Don't know
Universe Text: Sample adults 18+ who use energy healing therapy for a specific condition
Skip Instructions:
(1-81) If more than one condition selected, [goto EHT_MOST], elseif only one condition selected, [goto
EHT_MED]
(82) [goto EHT_SPEC]
(Refused,Don't know) goto EHT_ENG
Question ID: : ALT.223_00.000

Instrument Variable Name: EHT_SPEC
Question Text:
*Enter condition for which energy healing therapy was used. If respondent gives more than one condition, probe for
condition most important for using energy healing therapy.
97 Refused
99 Don't know
Verbatim Verbatim response
Universe Text: Sample adults 18+ who used energy healing therapy to treat other health problem or condition
Skip Instructions:
(Allow 75) if more than one condition selected [goto EHT_MOST]; else if only one condition selected [goto
EHT_MED]
(R,D) [if more than one condition (1-81) selected [goto EHT_MOST]; elseif only one condition (1-81) selected
[goto EHT_MED]; else [goto EHT_ENG]

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2002
Survey form view entire document:  text  image

ALT.005

For what health problems or conditions did you use energy healing therapy/Reiki?

FR: MARK ALL THAT APPLY. ENTER (N) FOR NO MORE.

(1) Yes
(2) No
(7) Refused
(9) Don't know
EHPCON01 (01) Allergic reaction to food
EHPCON02 (02) Allergic reaction to medication
EHPCON03 (03) Angina
EHPCON04 (04) Anxiety/depression
EHPCON05 (05) Arthritis, gout, lupus, or fibromyalgia
EHPCON06 (06) Asthma
EHPCON07 (07) Benign tumors, cysts
EHPCON08 (08) Birth defect
EHPCON09 (09) Bowel problems or constipation
EHPCON10 (10) Cancer
EHPCON11 (11) Cataracts
EHPCON12 (12) Cholesterol
EHPCON13 (13) Chronic bronchitis
EHPCON14 (14) Recurring pain
EHPCON15 (15) Circulation problems (other than in the legs)
EHPCON16 (16) Congestive heart failure
EHPCON17 (17) Coronary heart disease
EHPCON18 (18) Diabetes
EHPCON19 (19) Diabetic retinopathy
EHPCON20 (20) Emphysema
EHPCON21 (21) Excessive sleepiness during the day
EHPCON22 (22) Jaw pain
EHPCON23 (23) Fracture, bone/joint injury
EHPCON24 (24) Glaucoma
EHPCON25 (25) Gynecologic problems
EHPCON26 (26) Hay fever
EHPCON27 (27) Hearing problem
EHPCON28 (28) Heart attack
EHPCON29 (29) Heart condition or disease
EHPCON30 (30) Hernia
EHPCON31 (31) Hypertension
EHPCON32 (32) Irregular heartbeat
EHPCON33 (33) Knee problems (not arthritis, not joint injury)
EHPCON34 (34) Lung/breathing problem (not already listed)
EHPCON35 (35) Macular degeneration
EHPCON36 (36) Menopause
EHPCON37 (37) Menstrual problems
EHPCON38 (38) Mental retardation
EHPCON39 (39) Joint pain or stiffness
EHPCON40 (40) Missing limbs (fingers, toes, or digits), amputee
EHPCON41 (41) Multiple sclerosis
EHPCON42 (42) Neuropathy
EHPCON43 (43) Osteoporosis, tendinitis
EHPCON44 (44) Other developmental problem
EHPCON45 (45) Other injury
EHPCON46 (46) Other nerve damage, including carpal tunnel syndrome
EHPCON47 (47) Parkinson's
EHPCON48 (48) Polio (myelitis), paralysis, para/quadriplegia
EHPCON49 (49) Poor circulation in your legs
EHPCON50 (50) Insomnia or trouble sleeping
EHPCON51 (51) Liver problem
EHPCON52 (52) Dental pain
EHPCON53 (53) Prostate trouble or impotence
EHPCON54 (54) Seizures
EHPCON55 (55) Senility
EHPCON56 (56) Sinusitis
EHPCON57 (57) Skin problems
EHPCON58 (58) Sprain or strain
EHPCON59 (59) Stroke
EHPCON60 (60) Text of first other specify
EHPCON61 (61) Text of second other specify
EHPCON62 (62) Thyroid problem
EHPCON63 (63) Ulcer
EHPCON64 (64) Urinary problem
EHPCON65 (65) Varicose veins, hemorrhoids
EHPCON66 (66) Vision problems (not already listed)
EHPCON67 (67) Weak or failing kidneys
EHPCON68 (68) Weight problems
EHPCON69 (69) Back pain or problem
EHPCON70 (70) Head or chest cold
EHPCON71 (71) Neck pain or problem
EHPCON72 (72) Severe headache or migraine
EHPCON73 (73) Stomach or intestinal illness
EHPCON74 (74) Other, specify