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

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11. Did other people take over <strong>and</strong> perform your usual household tasks in the past month inconnection with health problems?NoYes, namely (more than one answer is possible):• family members for..................... hours• other persons receiving no pay for..................... hours• home care for..................... hours• other paid care for..................... hours…………………………………………………………………………………………………………….23
General questions1. Sex:malefemaleDate of birth: ............_............_.........................What is the highest level of education that you have completed?Primary school (lower school, special education)Lower vocational education (e.g. LTS, LHNO, LEAO, domestic training school)Lower general secondary education (e.g. VMBO, ULO, MULO, MAVO)Secondary vocational education (e.g. MTS, MEAO, MHNO)Senior general secondary education (e.g. HBS, MMS, HAVO, VWO, gymnasium)Higher professional education (e.g. HTS, HEAO, HHNO)UniversityOther, namely:....................................................................................................................................................................................................................2. What is your current civil status?SingleMarried/long-term cohabitationDivorcedWidow(er)3. Below is a list of chronic conditions <strong>and</strong> disorders. Please indicate the conditions you have orhadduring the past year?Asthma, chronic bronchitis or COPDInfection of the nasal cavity, frontal sinus cavity or CCCCCSevere heart condition or myocardial infarction24
Page 1 and 2: ManualShort Form- Health and Labour
Page 3 and 4: User conditionsThis questionnaire w
Page 5 and 6: 1. IntroductionBackgroundIn economi
Page 7 and 8: Random sample size, effect size and
Page 9 and 10: Valuation module 1There are two met
Page 11 and 12: Individuals with health problems ar
Page 13 and 14: without absenteeism may also be val
Page 15 and 16: followed by the question of whether
Page 17 and 18: ‘unpaid help’ (what is known as
Page 19 and 20: 4. References1. Nederlandse richtli
Page 21 and 22: This questionnaire concerns the con
Page 23: 9. Which of the following situation
Page 27 and 28: Overstressed, depression, severe ne
Page 29 and 30: -3 = have paid work, nohindrance (H
Page 31 and 32: ecause of health problems4. Did not
Page 33 and 34: ALG3O Thyroid disease 1=YESALG3PPer

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

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