Manual Short Form- Health and Labour Questionnaire (SF-HLQ)

This questionnaire concerns the consequences of health problems for employment in a paid joband for unpaid work (e.g. household chores). These questions pertain to the period covering thepast month. Health problems refer both to your physical and emotional problems.Date: ... - .. - 20..1. Do you currently hold a paid job?No, (go to question 9)Yes;How many hours does your contract specify? ………….…… hours per weekOver how many days are these hours distributed? ………….…… daysWhat is your occupation? ...................................................................................2. Did health problems oblige you to be off work at any time in the past month?NoYes, I missed ………….…… days of work(One week has a maximum of 5 days of work)Were you off work for a period longer than the past month because of health problems?NoYes, I reported ill on............... ............... ......................... (go on to question 8)People with health problems sometimes have to miss work because of these problems.Another possibility is that a person goes to work, but is unable to perform as well as he shouldbecause of health problems. Questions 18 through 22 focus on these aspects.3. Was your job performance adversely affected by health problems during the past month?No, not at all (go to question 8)Yes, slightlyYes, very much4. On how many days during the past month did you perform paid work, although you werebothered by health problems?....................... days (Please do not count the days on which you did not work at all becauseyou called in sick.)20