Start
nshd_06_pq
STRICTLY CONFIDENTIAL
MRC NATIONAL SURVEY OF HEALTH AND DEVELOPMENT
MRC Unit for Lifelong Health & Ageing
Royal Free & University College Medical School
Department of Epidemiology and Public Health
Postal Questionnaire 2008
This questionnaire is about your health and about your family and work life.
When completing the questionnaire please use a pen to circle the appropriate response to each question and provide further details where requested either in boxes or in the space provided. Some questions don’t apply to everybody. Where you should skip questions that do not apply to you it tells you which question to go to next at the side of the answer you have circled (i.e. go to Q2). Otherwise please continue through each question in turn.
If you wish to provide further information in relation to any of the questions, please use the space provided at the back of the questionnaire booklet. At the end of the questionnaire you will also be asked to fill in a consent form that will allow us to access your hospital and GP records. If you have changed address recently or are about to do so, please provide your new address in the space on the back of the consent form.
All information you give us will be treated in the strictest confidence. If you have any queries do not hesitate to telephone us
When you have finished filling in the questionnaire and the consent form on page 25 please use the prepaid envelope provided to post it back to us. Thank you very much for your time and co-operation.
intro i

Please enter the date you completed this questionnaire:

Generic date
Questions 1 to 24 are about your health. Some ask about your current health and some about your health since 1999.
1

How is your health in general?

1
Excellent
2
Very good
3
Good
4
Fair
5
Poor
2

Compared to one year ago, how would you rate your health in general now?

1
Much better now than one year ago
2
Somewhat better now than one year ago
3
About the same as one year ago
4
Somewhat worse than one year ago
5
Much worse than one year ago
3 a

Do you ever have any pain or discomfort in your chest?

0
No
1
Yes
If No to question 3a go to Q5a
qc_3_a == 0
Else
3 b

Do you get this pain or discomfort when you walk uphill or hurry?

0
No
1
Yes
2
Never walk uphill or hurry
3 c

Do you get it when you walk at an ordinary pace on the level?

0
No
1
Yes
2
Never walk
3 d

What do you do if you get this pain while walking?

1
Stop or slow down
2
Carry on
3
Carry on after using a spray or taking tablet under your tongue (nitroglycerine)
4
Not applicable
3 e

Does the pain or discomfort in your chest go away if you stand still?

0
No
1
Yes
If No to question 3e go to Q3g
qc_3_e == 0
Else
3 f

How long does it take to go away?

1
10 minutes or less
2
More than 10 minutes
3 g

Where do you get this pain or discomfort? Mark the place(s) with an X on the diagram.

3 h

Did you see a doctor because of this pain or discomfort?

0
No
1
Yes, hospital specialist
2
Yes, GP and hospital specialist
If yes
qc_3_h == 1 || qc_3_h == 2
3 h(i)

what did they say it was?

Generic text
4 a

Since 1999 have you had a severe pain across the front of your chest lasting half an hour or more?

0
No
1
Yes
If No to question 4a go to Q5a
qc_4_a == 0
Else
4 b

Did you talk to a doctor about it?

0
No
1
Yes
If No to question 4b go to Q4d
qc_4_b == 0
Else
4 c

What did he/she say it was?

Generic text
4 d

How many of these attacks have you had since 1999? Number of attacks

How many
5 a

Do you get pain in either leg on walking?

0
No
1
Yes
2
Confined to chair/bed
If No or Confined to chair/bed to question 5a go to Q6a
qc_5_a == 0 || qc_5_a == 2
Else
5 b

Does this pain ever begin when you are standing still or sitting?

0
No
1
Yes
If Yes to question 5b go to Q6a
qc_5_b == 1
Else
5 c

In what part of your leg do you feel it?

1
Calves
2
Thighs
3
Buttocks
4
None of these
If None of these to question 5c go to Q6a
qc_5_c == 4
Else
5 d

Do you get it if you walk uphill or hurry?

0
No
1
Yes
2
Never walk uphill or hurry
If No to question 5d go to Q6a
qc_5_d == 0
Else
5 e

Do you get it when you walk at an ordinary pace on the level?

0
No
1
Yes
2
Never walk
If Never walk to question 5e go to Q6a
qc_5_e == 2
Else
5 f

Does the pain ever disappear while you are walking?

0
No
1
Yes
If Yes to question 5f go to Q6a
qc_5_f == 1
Else
5 g

What do you do if you get it when you are walking?

1
Stop or slow down
2
Carry on
If Carry on to question 5g go to Q6a
qc_5_g == 2
Else
5 h

What happens to it if you stand still?

0
Still not relieved
1
Relieved
If Still not relieved to question 5h go to Q6a
qc_5_h == 0
Else
5 i

How soon is the pain relieved?

1
10 minutes or less
2
More than 10 minutes
6 a

Since 1999 has a doctor told you that you have had angina?

0
No
1
Yes
6 b

Since 1999 has a doctor told you that you have had a heart attack (myocardial infarct/coronary thrombosis)?

0
No
1
Yes
6 c

Since 1999 have you had any other heart trouble suspected or confirmed? (e.g. valve disease, congenital heart disease or irregular heart beat)

0
No
1
Yes
If 'Yes',
qc_6_c == 1
6 c(i)

please specify:

Generic text
7 a

Since 1999 have you had a sudden speech problem which got better after a day?

0
No
1
Yes
7 b

Since 1999 have you had sudden sight problems which got better after a day?

0
No
1
Yes
7 c

Since 1999 have you had a sudden weakness in an arm or leg which got better after a day?

0
No
1
Yes
8

Since 1999 have you been told by a doctor that you have blood pressure problems?

0
No
1
Yes
9

Since 1999 have you been told by a doctor that you have had a stroke?

0
No
1
Yes
10 a

Since 1999 have you been told that you have diabetes?

0
No
1
Yes
If No to question 10a go to Q11a
qc_10_a == 0
Else
10 b

How old were you when you were first told that you had diabetes? Age ... years

Age
10 c

Is your diabetes controlled by

1
Diet alone
2
Tablets
3
Insulin injections
11 a

Since 1999 have you been told by a doctor that you have a thyroid disorder?

0
No
1
Yes
If No to question 11a go to Q12a
qc_11_a == 0
Else
11 b

What kind of thyroid disorder have you had?

1
Goitre
2
Hyperthyroidism
3
Hypothyroidism
4
Other
11 c

Have you had any treatment for your thyroid disorder?

0
No
1
Medication (please specify)
2
Other treatment (please specify)
Generic text
Other
12 a

Since 1999 have you been told by a doctor that you have fits or epilepsy?

0
No
1
Yes
If No to question 12a go to Q13
qc_12_a == 0
Else
12 b

Have you been prescribed:

1
Medication
2
Other treatment (please specify)
Other
13

Since 1999 have you been told by a doctor that you have cancer?

0
No
1
Yes
If 'Yes',
qc_13 == 1
13 i

please specify site:

Generic text
14

Since 1999 have you suffered from any other troublesome health problem(s) which has been diagnosed by a medical doctor?

0
No
1
Yes
If 'Yes',
qc_14 == 1
14 i

please list below:

Other
Other 2
Other 3
15

Since 1999 have you been knocked unconscious?

0
No
1
Yes
16 a

Do you usually cough first thing in the morning in the winter?

0
No
1
Yes
16 b

Do you usually cough during the day or night in winter?

0
No
1
Yes
If you answered ‘No’ to both 16a and 16b go to Q17a
If you answered ‘Yes’ to either 16a or 16b answer 16c
qc_16_a == 1 || qc_16_b == 1
16 c

Do you cough like this on most days for as much as 3 months each year?

0
No
1
Yes
17 a

Do you usually bring up any phlegm (spit from the chest) first thing in the morning in winter?

0
No
1
Yes
17 b

Do you usually bring up any phlegm during the day or at night in winter?

0
No
1
Yes
If you answered ‘No’ to both 17a and 17b go to Q18
If you answered ‘Yes’ to either 17a or 17b answer 17c
qc_17_a == 1 || qc_17_b == 1
17 c

Do you bring up phlegm on most days for as much as 3 months each year?

0
No
1
Yes
18

In the past 3 years, have you had a period of cough and phlegm lasting for 3 weeks or more?

0
No
1
Yes
19 a

Does your chest ever sound wheezy or whistling?

0
No
1
Yes
If No to question 19a go to Q20a
qc_19_a == 0
Else
19 b

Do you get this most days or nights?

0
No
1
Yes
20 a

During the past 3 years have you had any chest illness, for example, bronchitis or pneumonia, which has kept you off work or indoors for a week or more?

0
No
1
Yes
If No to question 20a go to Q21a
qc_20_a == 0
Else
20 b

How many illnesses like this have you had in the last 3 years?

1
One
2
More than one
20 c

Did you consult a doctor about this during the last 3 years?

0
No
1
Yes
These questions concern any test(s) or treatment(s) you may have had in hospital for chest pain or heart disease.
If you answer ‘Yes’ to a question please fill in the requested details.
21 a

Have you ever had an exercise/stress ECG heart tracing whilst walking or running on a treadmill?

0
No
1
Yes
If No to question 21a go to Q21b
qc_21_a == 0
Else
21 a(i)

Hospital name/ town:

Generic text
21 a(ii)

Name of consultant:

Generic text
21 a(iii)

Were you an NHS or private patient?

1
NHS
2
Private
21 a(iv)

Date of test:

Generic date
21 b

Have you ever had an angiogram or X-ray of your coronary arteries (a dye test of the arteries)?

0
No
1
Yes
If No to question 21b go to Q21c
qc_21_b == 0
Else
21 b(i)

Hospital name/ town:

Generic text
21 b(ii)

Name of consultant:

Generic text
21 b(iii)

Were you an NHS or private patient?

1
NHS
2
Private
21 b(iv)

Date of test:

Generic date
21 c

Have you ever had angioplasty of coronary arteries (balloon treatment for angina) or insertion of a stent?

0
No
1
Yes
If No to question 21c go to Q21d
qc_21_c == 0
Else
21 c(i)

Hospital name/ town:

Generic text
21 c(ii)

Name of consultant:

Generic text
21 c(iii)

Name of ward:

Generic text
21 c(iv)

Were you an NHS or private patient?

1
NHS
2
Private
21 c(v)

Date of admission to hospital:

Generic date
21 c(vi)

Length of stay in hospital: Number of days

How many
21 d

Have you ever had a coronary artery bypass graft (CABG) operation?

0
No
1
Yes
If No to question 21d go to Q21e
qc_21_d == 0
Else
21 d(i)

Hospital name/ town:

Generic text
21 d(ii)

Name of consultant:

Generic text
21 d(iii)

Name of ward:

Generic text
21 d(iv)

Were you an NHS or private patient?

1
NHS
2
Private
21 d(v)

Date of admission to hospital:

Generic date
21 d(vi)

Length of stay in hospital: Number of days

How many
21 e

Have you ever had an admission to hospital with chest pain, angina or heart attack?

0
No
1
Yes
If No to question 21e go to Q21f
qc_21_e == 0
Else
21 e(i)

Hospital name/ town:

Generic text
21 e(ii)

Name of consultant:

Generic text
21 e(iii)

Name of ward:

Generic text
21 e(iv)

Were you NHS or private patient?

1
NHS
2
Private
21 e(v)

Date of admission to hospital:

Generic date
21 e(vi)

Length of stay in hospital: Number of days

How many
21 f

Have you ever had other heart tests or operations or admissions to hospital for other heart trouble?

0
No
1
Yes
If No to question 21f go to Q22a
qc_21_f == 0
Else
21 f(i)

Please specify test, operation or reason for hospital admission (e.g. 24 hour ECG, pacemaker, thallium scan, echocardiogram, or resting ECG)

Generic text
21 f(ii)

Hospital name/ town:

Generic text
21 f(iii)

Name of consultant:

Generic text
21 f(iv)

Name of ward:

Generic text
21 f(v)

Were you an NHS or private patient?

1
NHS
2
Private
21 f(vi)

Date of admission to hospital or date of test/procedure:

Generic date
21 f(vii)

Length of stay in hospital: Number of days

How many
IN-PATIENT HOSPITAL ADMISSIONS
22 a

Since 1999 have you been admitted to hospital as an in-patient (that is you spent at least one night in hospital) for any other reason not already mentioned in question 21?

0
No
1
Yes
If ‘Yes’,
qc_22_a == 1
please fill in details of each hospital admission in the table below, starting from the earliest admission. Please use one column for each hospital admission and fill in the details requested in the boxes provided. REMEMBER YOU DO NOT NEED TO REPEAT INFORMATION ALREADY PROVIDED IN QUESTION 21.
_admission < 7
22 a(i)

Hospital Name/Town:

Generic text
22 a(ii)

Name of Consultant:

Generic text
22 a(iii)

Name of Ward:

Generic text
22 a(iv)

Were you an NHS or private patient?

1
NHS
2
Private
3
Overseas
22 a(v)

Date of admission.

Generic date
22 a(vi)

How many days did you stay in hospital? Number of days

How many
22 a(vii)

Why were you admitted to hospital?

Generic text
22 a(viii)

Was this problem the result of an injury?

1
Yes
0
No
If yes,
qc_22_viii == 1
22 a(viii)

please specify cause of injury

Generic text
22 a(ix)

What treatment(s) did you have?

Generic text
22 b

Have you had any other hospital admissions since 1999?

0
No
1
Yes
HOSPITAL DAY SURGERY AND OUTPATIENT TREATMENTS
23

Since 1999, have you been to hospital for treatment or surgery and then come home again on the same day (that is you did not spend a night in hospital)?

0
No
1
Yes
If ‘Yes’,
qc_23 == 1
please fill in details of each illness or condition in the table below. Please use one column for each illness or condition (even if you visited the hospital more than once for treatment for the same problem).
_illness < 7
23 i

Why did you go to hospital?

Generic text
23 ii

Was this problem the result of an injury?

1
Yes
0
No
If yes,
qc_23_ii == 1
23 ii(a)

please specify cause of injury

Generic text
23 iii

Were you an NHS or private patient?

1
NHS
2
Private
3
Overseas
23 iv

Date of beginning of treatment:

Generic date
23 v

How many times did you visit the hospital for treatment for this illness/condition? Number of visits

How many
23 vi

What treatment did you have at the hospital?

Generic text
24

Do you regularly take any medicines, tablets, tonics or pills prescribed by a doctor?

0
No
1
Yes
If 'Yes'
qc_24 == 1
24 i
please give details in the table below. Use one row for each prescribed medication.
Name of prescribed medicine What is it for?
Generic textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric text
1
2
3
4
5
6
7
8
9
10
The following questions are about your family.
25

Does your household own or rent your accommodation?

1
Own it outright
2
Being bought with a mortgage or loan
3
Rent it from the Council
4
Rent it from a relative
5
Rent it from a private landlord
6
Rent it from a housing association
7
Other (please specify)
Other
26

How many people in total live in your household, including yourself? Include those who live in the household but are away e.g. working away or a student. Number

How many
If only yourself, go to Q28a
qc_26 == '1'
Else
27 a

Do you have a husband/wife or partner living in this household?

1
Husband/wife
2
Partner
3
Neither
If Neither to question 27a go to Q28a
qc_27_a == 3
Else
27 b

What is your husband/wife or partner’s highest level of qualification?

1
CSE
2
GCSE
3
GCSE O Level
4
A/S Level
5
GCE A Level (or S Level)
6
Scottish School Certificate, Higher School Certificate or Scottish School Qualification
7
Diploma of Higher Education
8
First degree (e.g. BA, BSc)
9
Other degree level qualification such as graduate membership of professional institute
10
Higher degree (e.g. PhD, MSc)
11
Nursing or other para-medical qualification
12
PGCE – Post-graduate Certificate of Education
13
Other teaching qualification
14
None of these
28 a

Since 1999 have you been married, remarried, separated, divorced or widowed?

0
No
1
Married or remarried
2
Separated
3
Divorced
4
Widowed
If Married or remarried to question 28a go to Q28b
qc_28_a == 1
28 b

In what year were you married/ remarried? Year

Generic date
If Separated or Divorced to question 28a go to Q28c
qc_28_a == 2 || qc_28_a == 3
28 c

When did you stop living together? Year

Generic date
If Widowed to question 28a go to Q28d
qc_28_a == 4
28 d

When did your husband/wife or partner die? Year

Generic date
29 a

So, are you currently

1
Single, that is never married
2
Married & living with husband/wife
3
Married & separated from husband/wife
4
Divorced
5
Widowed
If Single, that is never married to question 29a go to Q29b
qc_29_a == 1
29 b

Since 1999, have you lived with a partner for more than a year?

0
No
1
Yes
30 a

Since 1999, have you had any children?

0
No
1
Yes
If No to question 30a go to Q31
qc_30_a == 0
Else
30 b

How many children have you had since 1999? Number of children

How many
Please fill in details of each child below.
_child < && (_child <= qc_30_b) && _child <= 3
30 b(i)

Male / Female

1
Male
2
Female
30 b(ii)

Year of birth

Date of birth
31 a

Do you have any grandchildren?

0
No
1
Yes
2
Yes, step grandchildren
If No to question 31a go to Q32
qc_31_a == 0
Else
31 b

How many grandchildren do you have? Number of grandchildren

How many
31 c

In what year was your first grandchild born? Year

Date of birth
The following questions are about work and retirement.
32

Have you retired from your main occupation, even if you are now doing other paid work?

0
No
1
Yes
If Yes to question 32 go to Q34
qc_32 == 1
Else
33

At what age do you plan to retire from your main occupation? Age ... years

Age
If Yes to question 32 go to Q34
qc_32 == 1
34

How old were you when you retired from your main occupation? Age ... years

Age
35

What was the reason you retired from your main occupation?

1
Usual retirement age for your job
2
Retired with husband/wife/partner
3
Left early with good bonus
4
Made redundant
5
Unhappy with job
6
Health reasons
7
Other reason, (please specify)
Other
36

Are you currently in paid work, including part-time work and self-employment?

0
No
1
Yes
If No to question 36 go to Q41
qc_36 == 0
Else
37 a

What is the full title of your current main job?

Generic text
37 b

What are the main things you do in the job.

Generic text
37 c

What does the firm/organisation you work for mainly make or do (at the place where you work)?

Generic text
37 d

Are you working as an employee or self-employed?

1
Employee
2
Self employed
If Self employed to question 37d go to Q38a
qc_37_d == 2
Else
37 e

Do you have any managerial duties, or are you supervising any other employees?

1
Manager
2
Foreman, supervisor or charge hand
3
Not supervising others
37 f

How many employees are there at the place where you work?

1
1-9
2
10 to 24
3
25 to 499
4
500 or more
If Self-employed to question 37d go to Q38a
qc_37_d == 2
38 a

Are you working on your own or do you have employees?

1
On own/with partner(s) but no employees
2
With employees
If On own/with partner(s) but no employees to question 38a go to Q39
qc_38_a == 1
Else
38 b

How many people do you employ at the place where you work?

1
1-9
2
10 to 24
3
25 to 499
4
500 or more
39

Do you work full time or part-time?

1
Full time i.e. 30 hours or more per week
2
Part-time
40 a

How many hours a week do you usually work in this job, including regular overtime? Hours

Hours in week
40 b

Does your employer contribute towards your pension?

0
No
1
Yes
40 c

In what year did you start this job? Year

Generic date
40 d

As well as this job, do you have a second job?

0
No
1
Yes
Now go to question 44
If No to question 36 go to Q41
qc_36 == 0
41

Are you seriously looking for any kind of paid work?

0
No
1
Yes
If Yes to question 41 go to Q43
qc_41 == 1
Else
42

What is the main reason you are not looking for paid work?

1
Retired
2
Looking after home, family (including grandchildren), or friend
3
Laid off for a short time
4
Temporarily sick or injured
5
Other reason (please specify)
Other
43

Since 1999 have you had any paid work?

0
No
1
Yes
If No to question 43 go to Q46
qc_43 == 0
Else
44

Since 1999, how many jobs have you had altogether, including any job held in 1999 and any current job? Number of jobs

How many
45 a

Since 1999, have you had any spells of a month or more when you were not in any kind of paid work? (please include spells out of work in 1999)

0
No
1
Yes
If No to question 45a go to Q46
qc_45_a === 0
Else
45 b

Since 1999, how much of the time have you not been in any paid work?

1
Less than 6 months
2
6 - 11 months
3
1-4 years
4
5 years
5
Since 1999
45 c

How much of that time were you unemployed, that is, seriously looking for work?

1
None of the time
2
Less than 6 months
3
6 - 11 months
4
1 - 4 years
5
5 years
6
Since 1999
46

Has your husband/wife or partner retired from their main occupation, even if they are now doing other paid work?

0
No
1
Yes
2
Husband/wife or partner never worked
3
No husband/wife or partner
If Yes to question 46 go to Q48
qc_46 == 1
Else
47

At what age does your husband/ wife or partner plan to retire from their main occupation? Age ... years

Age
If Yes to question 46 go to Q48
qc_46 == 1
48

How old was your husband/ wife or partner when they retired from their main occupation? Age ... years

Age
49

What was the reason they retired from their main occupation?

1
Usual retirement age for their job
2
Retired with husband/wife/partner
3
Left early with good bonus
4
Made redundant
5
Unhappy with job
6
Health reasons
7
Other reason, (please specify)
Other
If No or Yes to question 46 go to Q50
qc_46 == 0 || qc_46 == 1
50

Is your husband/wife or partner currently in paid work, including part-time work and self-employment?

0
No
1
Yes
If No to question 50 go to Q53
qc_50 == 0
Else
51 a

What is the full title of your husband/wife or partner's current main job?

Generic text
51 b

What are the main things they do in the job?

Generic text
51 c

What does the firm/organisation they work for mainly make or do (at the place where they work)?

Generic text
51 d

Are they working as an employee or are they self-employed?

1
Employee
2
Self-employed
If Self-employed to question 51d go to Q52a
qc_51_d == 2
Else
51 e

Do they have any managerial duties, or are they supervising any other employees?

1
Manager
2
Foreman, supervisor or charge hand
3
Not supervising others
51 f

How many employees are there at the place where they work?

1
1-9
2
10 to 24
3
25 to 499
4
500 or more
If Self-employed to question 51d go to Q52a
qc_51_d == 2
52 a

Do they work on their own or do they have any employees?

1
On own/with partner(s) but no employees
2
With employees
If On own/with partner(s) but no employees to question 52a go to Q54a
qc_52_a == 1
Else
52 b

How many people do they employ at the place where they work?

1
1-9
2
10 to 24
3
25 to 499
4
500 or more
If No to question 50 go to Q53
qc_50 == 0
53

Since 1999 has your husband/wife or partner had any paid work?

0
No
1
Yes
These questions are about your smoking habits.
54 a

Do you smoke cigarettes at all nowadays?

0
No
1
Yes
If No to question 54a go to Q55a
qc_54_a == 0
Else
54 b

How many cigarettes a day do you usually smoke? If you smoke roll-ups, please give the equivalent number of cigarettes. Number of cigarettes

How many
54 c

What is the main brand of cigarettes you smoke? Please specify brand:

Generic text
54 d

At what age did you start smoking? ... Years

Age
Now go to question 56a
If No to question 54a go to Q55a
qc_54_a == 0
55 a

Have you ever smoked cigarettes regularly, by which we mean at least one cigarette a day for 12 months or more?

0
No
1
Yes
If No to question 55a go to Q56a
qc_55_a == 0
Else
55 b

How long ago did you give up smoking? ... Weeks ago OR ... Months ago OR ... Years ago

How many
How many 2
How many 3
55 c

At what age did you start smoking? ... Years

Age
56 a

Do you smoke a pipe?

0
No
1
Yes
If No to question 56a go to Q57a
qc_56_a == 0
Else
56 b(i)

How much pipe tobacco do you usually smoke per week? Amount

How many
56 b(ii)

Is that grams or ounces?

1
Grams
2
Ounces
56 c

What brand of tobacco do you smoke? Please specify brand:

Generic text
57 a

Do you smoke cigars?

0
No
1
Yes
If No to question 57a go to Q58
qc_57_a == 0
Else
57 b

How many cigars do you smoke per week? Number of cigars

How many
57 c

What brand of cigars do you smoke? Please specify brand:

Generic text
58

In your spare time are you involved in any of the following activities?

0
No
1
Yes
If yes,
qc_58 == 1
58 a-g
please indicate how often you have taken part in these activities in the last 12 months.
-

3 - Weekly

2 - Monthly

1 - Less often

0 - Never
Church-related group or religious activities, e.g. board/standing committee, men’s/ women’s group
Job-related association, e.g. trade union or business/professional organisation
Recreational groups, e.g. bowling league, golf club or other sports club; chess, bridge or other game-based group; book reading or creative-writing group; art, music or craft based group
Civic-political group, e.g. political party club, Chamber of Commerce, local government, parent-teacher association or other school-based work
Other voluntary work
Other groups or clubs, including Lions or Rotary
Other social activities, e.g. going to pubs, cinema, theatre or concerts with others
The final questions are about how you have been feeling recently and your quality of life.
59 a-j
The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
-

1 - Yes, limited a lot

2 - Yes, limited a little

3 - No, not limited at all
Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling or playing golf
Lifting or carrying groceries
Climbing several flights of stairs
Climbing one flight of stairs
Bending, kneeling or stooping
Walking more than one mile
Walking half a mile
Walking one hundred yards
Bathing and dressing yourself
60 a-d
During the past four weeks have you had any of the following problems with your work or other regular daily activities as a result of your physical health?
-

1 - Yes

0 - No
Cut down the amount of time you spent on work or other activities
Accomplished less than you would like
Were limited in the kind of work or other activities you could do
Had difficulty performing the work or other activities (for example, it took extra effort)
61 a-c
During the past four weeks have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?
-

1 - Yes

0 - No
Cut down the amount of time you spent on work or other activities
Accomplished less than you would like
Didn’t do work or other activities as carefully as usual
62

During the past four weeks to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbours or groups?

0
Not at all
1
Slightly
2
Moderately
3
Quite a bit
4
Extremely
63

How much bodily pain have you had during the past four weeks?

0
None
1
Very mild
2
Mild
3
Moderate
4
Severe
5
Very severe
64

During the past four weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?

0
Not at all
1
A little bit
2
Moderately
3
Quite a bit
4
Extremely
65 a-i
How much of the time during the past four weeks…
-

1 - All of the time

2 - Most of the time

3 - A good bit of the time

4 - Some of the time

5 - A little bit of the time

6 - None of the time
Did you feel full of life?
Have you been a very nervous person?
Have you felt so down in the dumps that nothing could cheer you up?
Have you felt calm and peaceful?
Did you have a lot of energy?
Have you felt downhearted and low?
Did you feel worn out?
Have you been a happy person?
Did you feel tired?
66

During the past four weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting friends, relatives, etc)?

1
All of the time
2
Most of the time
3
Some of the time
4
A little bit of the time
5
None of the time
67 a-d
Please choose the answer that best describes how TRUE or FALSE each of the following statements is for you:
-

1 - Definitely true

2 - Mostly true

3 - Don’t know

4 - Mostly false

5 - Definitely false
I seem to get sick a little easier than other people
I'm as healthy as anyone I know
I expect my health to get worse
My health is excellent
outro i

If you would like to give further details to any questions or make any comments about the questionnaire, please feel free to do so in the space below:

Long text
Thank you very much for the time you have spent filling in this questionnaire.
Please could you now fill in the consent form on page 25 and, if you have moved house recently, turn to the back page of the questionnaire and provide us with your new address. Please put the questionnaire in the pre-paid envelope and post it back to us.
STRICTLY CONFIDENTIAL
MRC National Survey of Health and Development Royal Free & University College Medical School Department of Epidemiology and Public Health
CONSENT: ACCESS TO HOSPITAL AND GP RECORDS
We may need to obtain additional details about your health from your hospital records and from your general practitioner (GP). In order to do this we need to ask your permission. Please complete the following:
I ... give my consent for the MRC National Survey of Health and Development to access my hospital and GP records. I understand that all information provided will be treated in the strictest confidence and used for medical research purposes only.
outro ii

Date

Generic date
outro iii

Please give details of your GP: GP’s name

Generic text
outro iv

Please give details of your GP: Address

Generic text
outro v

Please give details of your GP: Postcode.

Generic text
If you have recently changed your address or are about to do so, please will you provide your new address and telephone number below.
outro vi

New address:

Generic text
outro vii

I am now living at this address

1
YES
2
/NO
outro viii

I will be living at this address from ... (please give date)

Generic date
outro ix

New telephone number:

Generic text
If you do not wish to complete the questionnaire we would be grateful if you could tell us why and return the uncompleted questionnaire to us in the pre-paid envelope:
outro x

Please give your reason for not completing the questionnaire:

Long text
End

nshd_06_pq

s_intro_i
STRICTLY CONFIDENTIAL
s_intro_ii
MRC NATIONAL SURVEY OF HEALTH AND DEVELOPMENT
s_intro_iii
MRC Unit for Lifelong Health & Ageing
s_intro_iv
Royal Free & University College Medical School
s_intro_v
Department of Epidemiology and Public Health
s_intro_vi
Postal Questionnaire 2008
s_intro_vii
This questionnaire is about your health and about your family and work life.
s_intro_viii
When completing the questionnaire please use a pen to circle the appropriate response to each question and provide further details where requested either in boxes or in the space provided. Some questions don’t apply to everybody. Where you should skip questions that do not apply to you it tells you which question to go to next at the side of the answer you have circled (i.e. go to Q2). Otherwise please continue through each question in turn.
s_intro_ix
If you wish to provide further information in relation to any of the questions, please use the space provided at the back of the questionnaire booklet. At the end of the questionnaire you will also be asked to fill in a consent form that will allow us to access your hospital and GP records. If you have changed address recently or are about to do so, please provide your new address in the space on the back of the consent form.
s_intro_x
All information you give us will be treated in the strictest confidence. If you have any queries do not hesitate to telephone us
s_intro_xi
When you have finished filling in the questionnaire and the consent form on page 25 please use the prepaid envelope provided to post it back to us. Thank you very much for your time and co-operation.
intro i
Please enter the date you completed this questionnaire:
Generic date
s_q1
Questions 1 to 24 are about your health. Some ask about your current health and some about your health since 1999.
1
How is your health in general?
1
Excellent
2
Very good
3
Good
4
Fair
5
Poor
2
Compared to one year ago, how would you rate your health in general now?
1
Much better now than one year ago
2
Somewhat better now than one year ago
3
About the same as one year ago
4
Somewhat worse than one year ago
5
Much worse than one year ago
3 a
Do you ever have any pain or discomfort in your chest?
0
No
1
Yes
3 b
Do you get this pain or discomfort when you walk uphill or hurry?
0
No
1
Yes
2
Never walk uphill or hurry
3 c
Do you get it when you walk at an ordinary pace on the level?
0
No
1
Yes
2
Never walk
3 d
What do you do if you get this pain while walking?
1
Stop or slow down
2
Carry on
3
Carry on after using a spray or taking tablet under your tongue (nitroglycerine)
4
Not applicable
3 e
Does the pain or discomfort in your chest go away if you stand still?
0
No
1
Yes
3 f
How long does it take to go away?
1
10 minutes or less
2
More than 10 minutes
3 g
Where do you get this pain or discomfort? Mark the place(s) with an X on the diagram.
3 h
Did you see a doctor because of this pain or discomfort?
0
No
1
Yes, hospital specialist
2
Yes, GP and hospital specialist
3 h(i)
what did they say it was?
Generic text
If yes
4 a
Since 1999 have you had a severe pain across the front of your chest lasting half an hour or more?
0
No
1
Yes
4 b
Did you talk to a doctor about it?
0
No
1
Yes
4 c
What did he/she say it was?
Generic text
4 d
How many of these attacks have you had since 1999? Number of attacks
How many
5 a
Do you get pain in either leg on walking?
0
No
1
Yes
2
Confined to chair/bed
5 b
Does this pain ever begin when you are standing still or sitting?
0
No
1
Yes
5 c
In what part of your leg do you feel it?
1
Calves
2
Thighs
3
Buttocks
4
None of these
5 d
Do you get it if you walk uphill or hurry?
0
No
1
Yes
2
Never walk uphill or hurry
5 e
Do you get it when you walk at an ordinary pace on the level?
0
No
1
Yes
2
Never walk
5 f
Does the pain ever disappear while you are walking?
0
No
1
Yes
5 g
What do you do if you get it when you are walking?
1
Stop or slow down
2
Carry on
5 h
What happens to it if you stand still?
0
Still not relieved
1
Relieved
5 i
How soon is the pain relieved?
1
10 minutes or less
2
More than 10 minutes
6 a
Since 1999 has a doctor told you that you have had angina?
0
No
1
Yes
6 b
Since 1999 has a doctor told you that you have had a heart attack (myocardial infarct/coronary thrombosis)?
0
No
1
Yes
6 c
Since 1999 have you had any other heart trouble suspected or confirmed? (e.g. valve disease, congenital heart disease or irregular heart beat)
0
No
1
Yes
6 c(i)
please specify:
Generic text
If 'Yes',
7 a
Since 1999 have you had a sudden speech problem which got better after a day?
0
No
1
Yes
7 b
Since 1999 have you had sudden sight problems which got better after a day?
0
No
1
Yes
7 c
Since 1999 have you had a sudden weakness in an arm or leg which got better after a day?
0
No
1
Yes
8
Since 1999 have you been told by a doctor that you have blood pressure problems?
0
No
1
Yes
9
Since 1999 have you been told by a doctor that you have had a stroke?
0
No
1
Yes
10 a
Since 1999 have you been told that you have diabetes?
0
No
1
Yes
10 b
How old were you when you were first told that you had diabetes? Age ... years
Age
10 c
Is your diabetes controlled by
1
Diet alone
2
Tablets
3
Insulin injections
11 a
Since 1999 have you been told by a doctor that you have a thyroid disorder?
0
No
1
Yes
11 b
What kind of thyroid disorder have you had?
1
Goitre
2
Hyperthyroidism
3
Hypothyroidism
4
Other
11 c
Have you had any treatment for your thyroid disorder?
0
No
1
Medication (please specify)
2
Other treatment (please specify)
Generic text
Other
12 a
Since 1999 have you been told by a doctor that you have fits or epilepsy?
0
No
1
Yes
12 b
Have you been prescribed:
1
Medication
2
Other treatment (please specify)
Other
13
Since 1999 have you been told by a doctor that you have cancer?
0
No
1
Yes
13 i
please specify site:
Generic text
If 'Yes',
14
Since 1999 have you suffered from any other troublesome health problem(s) which has been diagnosed by a medical doctor?
0
No
1
Yes
14 i
please list below:
Other
Other 2
Other 3
If 'Yes',
15
Since 1999 have you been knocked unconscious?
0
No
1
Yes
16 a
Do you usually cough first thing in the morning in the winter?
0
No
1
Yes
16 b
Do you usually cough during the day or night in winter?
0
No
1
Yes
s_q16b
If you answered ‘No’ to both 16a and 16b go to Q17a
16 c
Do you cough like this on most days for as much as 3 months each year?
0
No
1
Yes
If you answered ‘Yes’ to either 16a or 16b answer 16c
17 a
Do you usually bring up any phlegm (spit from the chest) first thing in the morning in winter?
0
No
1
Yes
17 b
Do you usually bring up any phlegm during the day or at night in winter?
0
No
1
Yes
s_q17b
If you answered ‘No’ to both 17a and 17b go to Q18
17 c
Do you bring up phlegm on most days for as much as 3 months each year?
0
No
1
Yes
If you answered ‘Yes’ to either 17a or 17b answer 17c
18
In the past 3 years, have you had a period of cough and phlegm lasting for 3 weeks or more?
0
No
1
Yes
19 a
Does your chest ever sound wheezy or whistling?
0
No
1
Yes
19 b
Do you get this most days or nights?
0
No
1
Yes
20 a
During the past 3 years have you had any chest illness, for example, bronchitis or pneumonia, which has kept you off work or indoors for a week or more?
0
No
1
Yes
20 b
How many illnesses like this have you had in the last 3 years?
1
One
2
More than one
20 c
Did you consult a doctor about this during the last 3 years?
0
No
1
Yes
s_q21a_i
These questions concern any test(s) or treatment(s) you may have had in hospital for chest pain or heart disease.
s_q21a_ii
If you answer ‘Yes’ to a question please fill in the requested details.
21 a
Have you ever had an exercise/stress ECG heart tracing whilst walking or running on a treadmill?
0
No
1
Yes
21 a(i)
Hospital name/ town:
Generic text
21 a(ii)
Name of consultant:
Generic text
21 a(iii)
Were you an NHS or private patient?
1
NHS
2
Private
21 a(iv)
Date of test:
Generic date
21 b
Have you ever had an angiogram or X-ray of your coronary arteries (a dye test of the arteries)?
0
No
1
Yes
21 b(i)
Hospital name/ town:
Generic text
21 b(ii)
Name of consultant:
Generic text
21 b(iii)
Were you an NHS or private patient?
1
NHS
2
Private
21 b(iv)
Date of test:
Generic date
21 c
Have you ever had angioplasty of coronary arteries (balloon treatment for angina) or insertion of a stent?
0
No
1
Yes
21 c(i)
Hospital name/ town:
Generic text
21 c(ii)
Name of consultant:
Generic text
21 c(iii)
Name of ward:
Generic text
21 c(iv)
Were you an NHS or private patient?
1
NHS
2
Private
21 c(v)
Date of admission to hospital:
Generic date
21 c(vi)
Length of stay in hospital: Number of days
How many
21 d
Have you ever had a coronary artery bypass graft (CABG) operation?
0
No
1
Yes
21 d(i)
Hospital name/ town:
Generic text
21 d(ii)
Name of consultant:
Generic text
21 d(iii)
Name of ward:
Generic text
21 d(iv)
Were you an NHS or private patient?
1
NHS
2
Private
21 d(v)
Date of admission to hospital:
Generic date
21 d(vi)
Length of stay in hospital: Number of days
How many
21 e
Have you ever had an admission to hospital with chest pain, angina or heart attack?
0
No
1
Yes
21 e(i)
Hospital name/ town:
Generic text
21 e(ii)
Name of consultant:
Generic text
21 e(iii)
Name of ward:
Generic text
21 e(iv)
Were you NHS or private patient?
1
NHS
2
Private
21 e(v)
Date of admission to hospital:
Generic date
21 e(vi)
Length of stay in hospital: Number of days
How many
21 f
Have you ever had other heart tests or operations or admissions to hospital for other heart trouble?
0
No
1
Yes
21 f(i)
Please specify test, operation or reason for hospital admission (e.g. 24 hour ECG, pacemaker, thallium scan, echocardiogram, or resting ECG)
Generic text
21 f(ii)
Hospital name/ town:
Generic text
21 f(iii)
Name of consultant:
Generic text
21 f(iv)
Name of ward:
Generic text
21 f(v)
Were you an NHS or private patient?
1
NHS
2
Private
21 f(vi)
Date of admission to hospital or date of test/procedure:
Generic date
21 f(vii)
Length of stay in hospital: Number of days
How many
s_q22a_i
IN-PATIENT HOSPITAL ADMISSIONS
22 a
Since 1999 have you been admitted to hospital as an in-patient (that is you spent at least one night in hospital) for any other reason not already mentioned in question 21?
0
No
1
Yes
s_q22a_ii
please fill in details of each hospital admission in the table below, starting from the earliest admission. Please use one column for each hospital admission and fill in the details requested in the boxes provided. REMEMBER YOU DO NOT NEED TO REPEAT INFORMATION ALREADY PROVIDED IN QUESTION 21.
If ‘Yes’,

_admission < 7

22 a(i)
Hospital Name/Town:
Generic text
If ‘Yes’,
22 a(ii)
Name of Consultant:
Generic text
If ‘Yes’,
22 a(iii)
Name of Ward:
Generic text
If ‘Yes’,
22 a(iv)
Were you an NHS or private patient?
1
NHS
2
Private
3
Overseas
If ‘Yes’,
22 a(v)
Date of admission.
Generic date
If ‘Yes’,
22 a(vi)
How many days did you stay in hospital? Number of days
How many
If ‘Yes’,
22 a(vii)
Why were you admitted to hospital?
Generic text
If ‘Yes’,
22 a(viii)
Was this problem the result of an injury?
1
Yes
0
No
If ‘Yes’,
22 a(viii)
please specify cause of injury
Generic text
If ‘Yes’,
If yes,
22 a(ix)
What treatment(s) did you have?
Generic text
If ‘Yes’,
22 b
Have you had any other hospital admissions since 1999?
0
No
1
Yes
If ‘Yes’,
s_q23_i
HOSPITAL DAY SURGERY AND OUTPATIENT TREATMENTS
23
Since 1999, have you been to hospital for treatment or surgery and then come home again on the same day (that is you did not spend a night in hospital)?
0
No
1
Yes
s_q23_ii
please fill in details of each illness or condition in the table below. Please use one column for each illness or condition (even if you visited the hospital more than once for treatment for the same problem).
If ‘Yes’,

_illness < 7

23 i
Why did you go to hospital?
Generic text
If ‘Yes’,
23 ii
Was this problem the result of an injury?
1
Yes
0
No
If ‘Yes’,
23 ii(a)
please specify cause of injury
Generic text
If ‘Yes’,
If yes,
23 iii
Were you an NHS or private patient?
1
NHS
2
Private
3
Overseas
If ‘Yes’,
23 iv
Date of beginning of treatment:
Generic date
If ‘Yes’,
23 v
How many times did you visit the hospital for treatment for this illness/condition? Number of visits
How many
If ‘Yes’,
23 vi
What treatment did you have at the hospital?
Generic text
If ‘Yes’,
24
Do you regularly take any medicines, tablets, tonics or pills prescribed by a doctor?
0
No
1
Yes
24 i

please give details in the table below. Use one row for each prescribed medication.

Name of prescribed medicine What is it for?
Generic textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric text
1
2
3
4
5
6
7
8
9
10
If 'Yes'
s_q25
The following questions are about your family.
25
Does your household own or rent your accommodation?
1
Own it outright
2
Being bought with a mortgage or loan
3
Rent it from the Council
4
Rent it from a relative
5
Rent it from a private landlord
6
Rent it from a housing association
7
Other (please specify)
Other
26
How many people in total live in your household, including yourself? Include those who live in the household but are away e.g. working away or a student. Number
How many
27 a
Do you have a husband/wife or partner living in this household?
1
Husband/wife
2
Partner
3
Neither
27 b
What is your husband/wife or partner’s highest level of qualification?
1
CSE
2
GCSE
3
GCSE O Level
4
A/S Level
5
GCE A Level (or S Level)
6
Scottish School Certificate, Higher School Certificate or Scottish School Qualification
7
Diploma of Higher Education
8
First degree (e.g. BA, BSc)
9
Other degree level qualification such as graduate membership of professional institute
10
Higher degree (e.g. PhD, MSc)
11
Nursing or other para-medical qualification
12
PGCE – Post-graduate Certificate of Education
13
Other teaching qualification
14
None of these
28 a
Since 1999 have you been married, remarried, separated, divorced or widowed?
0
No
1
Married or remarried
2
Separated
3
Divorced
4
Widowed
28 b
In what year were you married/ remarried? Year
Generic date
If Married or remarried to question 28a go to Q28b
28 c
When did you stop living together? Year
Generic date
If Separated or Divorced to question 28a go to Q28c
28 d
When did your husband/wife or partner die? Year
Generic date
If Widowed to question 28a go to Q28d
29 a
So, are you currently
1
Single, that is never married
2
Married & living with husband/wife
3
Married & separated from husband/wife
4
Divorced
5
Widowed
29 b
Since 1999, have you lived with a partner for more than a year?
0
No
1
Yes
If Single, that is never married to question 29a go to Q29b
30 a
Since 1999, have you had any children?
0
No
1
Yes
30 b
How many children have you had since 1999? Number of children
How many
s_q30b
Please fill in details of each child below.

_child < && (_child <= qc_30_b) && _child <= 3

30 b(i)
Male / Female
1
Male
2
Female
30 b(ii)
Year of birth
Date of birth
31 a
Do you have any grandchildren?
0
No
1
Yes
2
Yes, step grandchildren
31 b
How many grandchildren do you have? Number of grandchildren
How many
31 c
In what year was your first grandchild born? Year
Date of birth
s_q32
The following questions are about work and retirement.
32
Have you retired from your main occupation, even if you are now doing other paid work?
0
No
1
Yes
33
At what age do you plan to retire from your main occupation? Age ... years
Age
34
How old were you when you retired from your main occupation? Age ... years
Age
If Yes to question 32 go to Q34
35
What was the reason you retired from your main occupation?
1
Usual retirement age for your job
2
Retired with husband/wife/partner
3
Left early with good bonus
4
Made redundant
5
Unhappy with job
6
Health reasons
7
Other reason, (please specify)
Other
If Yes to question 32 go to Q34
36
Are you currently in paid work, including part-time work and self-employment?
0
No
1
Yes
37 a
What is the full title of your current main job?
Generic text
37 b
What are the main things you do in the job.
Generic text
37 c
What does the firm/organisation you work for mainly make or do (at the place where you work)?
Generic text
37 d
Are you working as an employee or self-employed?
1
Employee
2
Self employed
37 e
Do you have any managerial duties, or are you supervising any other employees?
1
Manager
2
Foreman, supervisor or charge hand
3
Not supervising others
37 f
How many employees are there at the place where you work?
1
1-9
2
10 to 24
3
25 to 499
4
500 or more
38 a
Are you working on your own or do you have employees?
1
On own/with partner(s) but no employees
2
With employees
If Self-employed to question 37d go to Q38a
38 b
How many people do you employ at the place where you work?
1
1-9
2
10 to 24
3
25 to 499
4
500 or more
If Self-employed to question 37d go to Q38a
39
Do you work full time or part-time?
1
Full time i.e. 30 hours or more per week
2
Part-time
40 a
How many hours a week do you usually work in this job, including regular overtime? Hours
Hours in week
40 b
Does your employer contribute towards your pension?
0
No
1
Yes
40 c
In what year did you start this job? Year
Generic date
40 d
As well as this job, do you have a second job?
0
No
1
Yes
s_q40d
Now go to question 44
41
Are you seriously looking for any kind of paid work?
0
No
1
Yes
If No to question 36 go to Q41
42
What is the main reason you are not looking for paid work?
1
Retired
2
Looking after home, family (including grandchildren), or friend
3
Laid off for a short time
4
Temporarily sick or injured
5
Other reason (please specify)
Other
If No to question 36 go to Q41
43
Since 1999 have you had any paid work?
0
No
1
Yes
If No to question 36 go to Q41
44
Since 1999, how many jobs have you had altogether, including any job held in 1999 and any current job? Number of jobs
How many
45 a
Since 1999, have you had any spells of a month or more when you were not in any kind of paid work? (please include spells out of work in 1999)
0
No
1
Yes
45 b
Since 1999, how much of the time have you not been in any paid work?
1
Less than 6 months
2
6 - 11 months
3
1-4 years
4
5 years
5
Since 1999
45 c
How much of that time were you unemployed, that is, seriously looking for work?
1
None of the time
2
Less than 6 months
3
6 - 11 months
4
1 - 4 years
5
5 years
6
Since 1999
46
Has your husband/wife or partner retired from their main occupation, even if they are now doing other paid work?
0
No
1
Yes
2
Husband/wife or partner never worked
3
No husband/wife or partner
47
At what age does your husband/ wife or partner plan to retire from their main occupation? Age ... years
Age
48
How old was your husband/ wife or partner when they retired from their main occupation? Age ... years
Age
If Yes to question 46 go to Q48
49
What was the reason they retired from their main occupation?
1
Usual retirement age for their job
2
Retired with husband/wife/partner
3
Left early with good bonus
4
Made redundant
5
Unhappy with job
6
Health reasons
7
Other reason, (please specify)
Other
If Yes to question 46 go to Q48
50
Is your husband/wife or partner currently in paid work, including part-time work and self-employment?
0
No
1
Yes
If No or Yes to question 46 go to Q50
51 a
What is the full title of your husband/wife or partner's current main job?
Generic text
If No or Yes to question 46 go to Q50
51 b
What are the main things they do in the job?
Generic text
If No or Yes to question 46 go to Q50
51 c
What does the firm/organisation they work for mainly make or do (at the place where they work)?
Generic text
If No or Yes to question 46 go to Q50
51 d
Are they working as an employee or are they self-employed?
1
Employee
2
Self-employed
If No or Yes to question 46 go to Q50
51 e
Do they have any managerial duties, or are they supervising any other employees?
1
Manager
2
Foreman, supervisor or charge hand
3
Not supervising others
If No or Yes to question 46 go to Q50
51 f
How many employees are there at the place where they work?
1
1-9
2
10 to 24
3
25 to 499
4
500 or more
If No or Yes to question 46 go to Q50
52 a
Do they work on their own or do they have any employees?
1
On own/with partner(s) but no employees
2
With employees
If No or Yes to question 46 go to Q50
If Self-employed to question 51d go to Q52a
52 b
How many people do they employ at the place where they work?
1
1-9
2
10 to 24
3
25 to 499
4
500 or more
If No or Yes to question 46 go to Q50
If Self-employed to question 51d go to Q52a
53
Since 1999 has your husband/wife or partner had any paid work?
0
No
1
Yes
If No or Yes to question 46 go to Q50
If No to question 50 go to Q53
s_q54a
These questions are about your smoking habits.
54 a
Do you smoke cigarettes at all nowadays?
0
No
1
Yes
54 b
How many cigarettes a day do you usually smoke? If you smoke roll-ups, please give the equivalent number of cigarettes. Number of cigarettes
How many
54 c
What is the main brand of cigarettes you smoke? Please specify brand:
Generic text
54 d
At what age did you start smoking? ... Years
Age
s_q54d
Now go to question 56a
55 a
Have you ever smoked cigarettes regularly, by which we mean at least one cigarette a day for 12 months or more?
0
No
1
Yes
If No to question 54a go to Q55a
55 b
How long ago did you give up smoking? ... Weeks ago OR ... Months ago OR ... Years ago
How many
How many 2
How many 3
If No to question 54a go to Q55a
55 c
At what age did you start smoking? ... Years
Age
If No to question 54a go to Q55a
56 a
Do you smoke a pipe?
0
No
1
Yes
56 b(i)
How much pipe tobacco do you usually smoke per week? Amount
How many
56 b(ii)
Is that grams or ounces?
1
Grams
2
Ounces
56 c
What brand of tobacco do you smoke? Please specify brand:
Generic text
57 a
Do you smoke cigars?
0
No
1
Yes
57 b
How many cigars do you smoke per week? Number of cigars
How many
57 c
What brand of cigars do you smoke? Please specify brand:
Generic text
58
In your spare time are you involved in any of the following activities?
0
No
1
Yes
58 a-g

please indicate how often you have taken part in these activities in the last 12 months.

-

3 - Weekly

2 - Monthly

1 - Less often

0 - Never
Church-related group or religious activities, e.g. board/standing committee, men’s/ women’s group
Job-related association, e.g. trade union or business/professional organisation
Recreational groups, e.g. bowling league, golf club or other sports club; chess, bridge or other game-based group; book reading or creative-writing group; art, music or craft based group
Civic-political group, e.g. political party club, Chamber of Commerce, local government, parent-teacher association or other school-based work
Other voluntary work
Other groups or clubs, including Lions or Rotary
Other social activities, e.g. going to pubs, cinema, theatre or concerts with others
If yes,
s_q59
The final questions are about how you have been feeling recently and your quality of life.
59 a-j

The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?

-

1 - Yes, limited a lot

2 - Yes, limited a little

3 - No, not limited at all
Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling or playing golf
Lifting or carrying groceries
Climbing several flights of stairs
Climbing one flight of stairs
Bending, kneeling or stooping
Walking more than one mile
Walking half a mile
Walking one hundred yards
Bathing and dressing yourself
60 a-d

During the past four weeks have you had any of the following problems with your work or other regular daily activities as a result of your physical health?

-

1 - Yes

0 - No
Cut down the amount of time you spent on work or other activities
Accomplished less than you would like
Were limited in the kind of work or other activities you could do
Had difficulty performing the work or other activities (for example, it took extra effort)
61 a-c

During the past four weeks have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?

-

1 - Yes

0 - No
Cut down the amount of time you spent on work or other activities
Accomplished less than you would like
Didn’t do work or other activities as carefully as usual
62
During the past four weeks to what extent has your physical health or emotional problems interfered with your normal social activities with family, friends, neighbours or groups?
0
Not at all
1
Slightly
2
Moderately
3
Quite a bit
4
Extremely
63
How much bodily pain have you had during the past four weeks?
0
None
1
Very mild
2
Mild
3
Moderate
4
Severe
5
Very severe
64
During the past four weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?
0
Not at all
1
A little bit
2
Moderately
3
Quite a bit
4
Extremely
65 a-i

How much of the time during the past four weeks…

-

1 - All of the time

2 - Most of the time

3 - A good bit of the time

4 - Some of the time

5 - A little bit of the time

6 - None of the time
Did you feel full of life?
Have you been a very nervous person?
Have you felt so down in the dumps that nothing could cheer you up?
Have you felt calm and peaceful?
Did you have a lot of energy?
Have you felt downhearted and low?
Did you feel worn out?
Have you been a happy person?
Did you feel tired?
66
During the past four weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting friends, relatives, etc)?
1
All of the time
2
Most of the time
3
Some of the time
4
A little bit of the time
5
None of the time
67 a-d

Please choose the answer that best describes how TRUE or FALSE each of the following statements is for you:

-

1 - Definitely true

2 - Mostly true

3 - Don’t know

4 - Mostly false

5 - Definitely false
I seem to get sick a little easier than other people
I'm as healthy as anyone I know
I expect my health to get worse
My health is excellent
outro i
If you would like to give further details to any questions or make any comments about the questionnaire, please feel free to do so in the space below:
Long text
s_outro_i
Thank you very much for the time you have spent filling in this questionnaire.
s_outro_ii
Please could you now fill in the consent form on page 25 and, if you have moved house recently, turn to the back page of the questionnaire and provide us with your new address. Please put the questionnaire in the pre-paid envelope and post it back to us.
s_outro_iii
STRICTLY CONFIDENTIAL
s_outro_iv
MRC National Survey of Health and Development Royal Free & University College Medical School Department of Epidemiology and Public Health
s_outro_v
CONSENT: ACCESS TO HOSPITAL AND GP RECORDS
s_outro_vi
We may need to obtain additional details about your health from your hospital records and from your general practitioner (GP). In order to do this we need to ask your permission. Please complete the following:
s_outro_vii
I ... give my consent for the MRC National Survey of Health and Development to access my hospital and GP records. I understand that all information provided will be treated in the strictest confidence and used for medical research purposes only.
outro ii
Date
Generic date
outro iii
Please give details of your GP: GP’s name
Generic text
outro iv
Please give details of your GP: Address
Generic text
outro v
Please give details of your GP: Postcode.
Generic text
s_outro_viii
If you have recently changed your address or are about to do so, please will you provide your new address and telephone number below.
outro vi
New address:
Generic text
outro vii
I am now living at this address
1
YES
2
/NO
outro viii
I will be living at this address from ... (please give date)
Generic date
outro ix
New telephone number:
Generic text
s_outro_ix
If you do not wish to complete the questionnaire we would be grateful if you could tell us why and return the uncompleted questionnaire to us in the pre-paid envelope:
outro x
Please give your reason for not completing the questionnaire:
Long text
Name

2006-2010 Clinic Study Postal Questionnaire