{"slug": "ehis-2025-en-final", "title": "Full Questionnaire in English", "pdfUrl": "https://dhir.gov.mt/wp-content/uploads/2026/09/EHIS-2025_EN-Final.pdf", "sourcePage": "https://dhir.gov.mt/en/surveys/european-health-interview-survey-2025-2026/", "group": "Survey", "topic": "European Health Interview Survey 2025 2026", "tables": [{"caption": "Table 1: Reference number", "header": ["Reference number", ""], "rows": [["Interviewer\u2019s username", ""], ["Interview date", ""], ["Interview duration", ""], ["Language used tocomplete thequestionnaire", "1. Maltese2. English"], ["Who will answer thequestionnaire? (Tickone circle only)", "1. Selected individual2. Proxy \u2013 another member of the selected individual\u2019s household3. Proxy \u2013 someone not from the same household as the selectedindividual"], ["What is the reason forhaving a proxyrespondent answer thisquestionnaire? (Tick allthat apply)", "1. Sample person has a cognitive impairment2. Sample person is physically debilitated3. Sample person has a hearing/speech problem4. Sample person cannot speak English or Maltese5. Other (specify)______________________________"]]}, {"caption": "Table 2: CS.1) What is your gender? (Tick one circle only)", "header": ["Male", "O 1"], "rows": [["Female", "O 2"], ["Transgender Male", "O 3"], ["Transgender Female", "O 4"], ["Gender-queer/Non-binary", "O 5"], ["Other (specify) ______________________________", "O 6"]]}, {"caption": "Table 3: CS.3) Which is your country of birth? (Tick one circle only)", "header": ["Malta", "O 1"], "rows": [["United Kingdom", "O 2"], ["India", "O 3"], ["Italy", "O 4"], ["Nepal", "O 5"], ["Philippines", "O 6"], ["Serbia", "O 7"], ["China", "O 8"], ["Libya", "O 9"], ["Colombia", "O 10"], ["Other (specify) ______________________________", "O 11"]]}, {"caption": "Table 4: CS.4) What is your main citizenship? (Tick one circle only) Maltese", "header": ["Maltese", "O 1"], "rows": [["British", "O 2"], ["Indian", "O 3"], ["Italian", "O 4"], ["Nepalese", "O 5"], ["Philippine", "O 6"], ["Serbian", "O 7"], ["Chinese", "O 8"], ["Libyan", "O 9"], ["Colombian", "O 10"], ["Other (specify) ______________________________", "O 11"], ["Stateless", "O\u2081\u2082"]]}, {"caption": "Table 5: CS.5) In which country was your father born? (Tick one circle only)", "header": ["Malta", "O 1"], "rows": [["United Kingdom", "O 2"], ["India", "O 3"], ["Italy", "O 4"], ["Nepal", "O 5"], ["Philippines", "O 6"], ["Serbia", "O 7"], ["China", "O 8"], ["Libya", "O 9"], ["Colombia", "O 10"], ["Other (specify) ______________________________", "O 11"], ["Do not know", "O\u2081\u2082"]]}, {"caption": "Table 6: CS.6) In which country was your mother born? (Tick one circle only)", "header": ["Malta", "O 1"], "rows": [["United Kingdom", "O 2"], ["India", "O 3"], ["Italy", "O 4"], ["Nepal", "O 5"], ["Philippines", "O 6"], ["Serbia", "O 7"], ["China", "O 8"], ["Libya", "O 9"], ["Colombia", "O 10"], ["Other (specify) ______________________________", "O 11"], ["Do not know", "O\u2081\u2082"]]}, {"caption": "Table 7: No formal education/Pre-primary", "header": ["No formal education/Pre-primary", "O 1"], "rows": [["Primary", "O 2"], ["School for persons with a disability", "O 3"], ["Secondary (general)", "O 4"], ["Foundation or Introductory courses at MCAST of one (1) year or less", "O 5"], ["Secondary (vocational) E.g. Trade School", "O 6"], ["Post-secondary (general)", "O 7"], ["E.g. Junior College", ""], ["Post-secondary (vocational) completed before the year 2000 (excluding ITS)", ""], ["", "O 8"], ["Post-secondary (vocational) courses of less than two (2) years E.g. MCAST/MCAST National Diploma, ITS or similar institutions", "O 9"], ["Post-secondary (vocational) courses two (2) years or more E.g. MCAST/MCAST National Diploma, ITS or similar institutions", "O 10"], ["University undergraduate diploma or certificate of less than two (2) years", "O 11"], ["University level diploma/certificate or MCAST Higher National Diploma (of two", "O\u2081\u2082"], ["(2) years or more)", ""], ["Bachelor degree or equivalent University of Malta, MCAST or other tertiary level institutions", "O\u2081\u2083"], ["", "O\u2081\u2083"], ["", "O\u2081\u2083"], ["Postgraduate Diploma/Certificate", "O\u2081\u2084"], ["Master\u2019s Degree", "O\u2081\u2085"], ["Doctorate (PhD/DBA)", "O\u2081\u2086"], ["Other (specify) ______________________________", "O\u2081\u2087"]]}, {"caption": "Table 8: EmployedIncludes unpaid work for a family business, apprenticeship, paid traineeship,maternity/parental leave, sick leav", "header": ["EmployedIncludes unpaid work for a family business, apprenticeship, paid traineeship,maternity/parental leave, sick leave and holiday leave", "O1"], "rows": [["Unemployed", "O\u2082\u2192 Go to CS.14"], ["Student and/or person having an unpaid working experience", "O\u2083\u2192 Go to CS.14"], ["Retired", "O\u2084\u2192 Go to CS.14"], ["Cannot work due to illness or disability", "O\u2085\u2192 Go to CS.14"], ["Taking care of the house and/or family", "O\u2086\u2192 Go to CS.14"], ["Other (specify) ______________________________", "O\u2087\u2192 Go to CS.14"]]}, {"caption": "Table 9: CS.9) In your main job do you work full-time or part-time? (Tick one circle only)", "header": ["Full-time", "O\u2081"], "rows": [["Part-time", "O\u2082"]]}, {"caption": "Table 10: CS.10) What is your employment status in your current main job? (Tick one circle only)", "header": ["Employee", "O\u2081"], "rows": [["Self-employed (with employees)", "O\u2082"], ["Self-employed (without employees)", "O\u2083"], ["Unpaid family worker", "O\u2084"], ["Other (specify) ______________________________", "O\u2085"]]}, {"caption": "Table 11: CS.14) What is your legal marital status? (Tick one circle only)", "header": ["Single (never married or never in a registered partnership)", "", "", "O 1"], "rows": [["Married (or in a registered partnership)", "", "", "O 2"], ["Legally separated", "", "", "O 3"], ["Widowed (or persons whose registered partnership ended with the death of the partner)", "", "", "O 4"], ["Divorced (or persons whose registered partnership was legally  O dissolved)", "", "", "5"], ["Annulled", "", "", "O 6"]]}, {"caption": "Table 12: One-person household", "header": ["One-person household", "O 1"], "rows": [["Lone parent with at least one resident child aged less than 25", "O 2"], ["Lone parent with all resident children aged 25 or more", "O 3"], ["Couple without resident children", "O 4"], ["Couple with at least one resident child aged less than 25", "O 5"], ["Couple with all resident children aged 25 or more", "O 6"], ["Other (specify) ______________________________", "O 7"]]}, {"caption": "Table 13: HS.1) How is your health in general? (Tick one circle only)", "header": ["Very good", "O 1"], "rows": [["Good", "O 2"], ["Fair", "O 3"], ["Bad", "O 4"], ["Very bad", "O 5"]]}, {"caption": "Table 14: HS.2) Do you have any longstanding illness or longstanding health problem? By longstanding", "header": ["Yes", "O 1"], "rows": [["No", "O 2"]]}, {"caption": "Table 15: Yes, severely limited", "header": ["Yes, severely limited", "O 1"], "rows": [["Yes, limited but not severely", "O 2"], ["No, not limited at all", "O\u2083 \u2192 Go to CD.1"]]}, {"caption": "Table 16: HS.4) Have you been limited at least for the past 6 months? (Tick one circle only)", "header": ["Yes", "O 1"], "rows": [["No", "O 2"]]}, {"caption": "Table 17: \u2713 The option \u2018None\u2019 can only be chosen on its own", "header": ["Asthma (including allergic asthma)", "1"], "rows": [["Chronic bronchitis, chronic  obstructive pulmonary disease(COPD), emphysema", "2"], ["Myocardial infarction (heart attack) or chronic consequencesof myocardial infarction", "3"], ["Coronary heart disease (angina pectoris)", "4"], ["High blood pressure (hypertension)", "5"], ["Elevated blood cholesterol", "6"], ["Stroke (cerebral haemorrhage, cerebral thrombosis) orchronic consequences of stroke", "7"], ["Osteoarthritis (joint degeneration)", "8"], ["Lower back disorder or other chronic back defect", "9"], ["Neck disorder or other chronic neck defect", "10"], ["Diabetes", "11"], ["Allergy, such as rhinitis, hay fever, eye inflammation,dermatitis, food allergy, or other allergy (excluding asthma)", "12"], ["Urinary incontinence, problems in controlling the bladder", "13"]]}, {"caption": "Table 18: Kidney problems", "header": ["Kidney problems", "14"], "rows": [["Cancer (including leukaemia and lymphoma) i.e. received acancer diagnosis, cancer treatment or living with cancer)", "15"], ["Chronic anxiety", "16"], ["Chronic depression", "17"], ["Anorexia/Bulimia Nervosa", "18"], ["Other mental health conditions", "19"], ["Cataract", "20"], ["Osteoporosis", "21"], ["Other (specify) ______________________________Specify up tothreeonly", "22"], ["None", "O\u2082\u2083\u2192 Go to DH.1"]]}, {"caption": "Table 19: \u2713 The option \u2018none\u2019 can only be chosen on its own", "header": ["Asthma (allergic asthma included)", "1"], "rows": [["Chronic bronchitis, chronic  obstructive pulmonary disease(COPD), emphysema", "2"], ["Myocardial infarction (heart attack) or chronic consequencesof myocardial infarction", "3"], ["Coronary heart disease (angina pectoris)", "4"], ["High blood pressure (hypertension)", "5"], ["Elevated blood cholesterol", "6"], ["Stroke (cerebral haemorrhage, cerebral thrombosis) orchronic consequences of stroke", "7"], ["Osteoarthritis (joint degeneration)", "8"], ["Lower back disorder or other chronic back defect", "9"], ["Neck disorder or other chronic neck defect", "10"], ["Diabetes", "11"], ["Allergy, such as rhinitis, hay fever, eye inflammation,dermatitis, food allergy, or other allergy (excluding asthma)", "12"], ["Urinary incontinence, problems in controlling the bladder", "13"], ["Kidney problems", "14"], ["Cancer (tumour, also including leukaemia and lymphoma) i.e.received a cancer diagnosis, cancer treatment or living withcancer in the past 12 months", "15"]]}, {"caption": "Table 20: Chronic anxiety", "header": ["Chronic anxiety", "16"], "rows": [["Chronic depression", "17"], ["Anorexia/Bulimia Nervosa", "18"], ["Other mental health conditions", "19"], ["Cataract", "20"], ["Osteoporosis", "21"], ["Other (specify) ______________________________Specify up tothreeonly", "22"], ["None", "O\u2082\u2083"]]}, {"caption": "Table 21: Very good", "header": ["Very good", "O 1"], "rows": [["Good", "O 2"], ["Fair", "O 3"], ["Poor", "O 4"], ["Very Poor", "O 5"]]}, {"caption": "Table 22: \u2713 Consider filled teeth as \u2018normal\u2019 own teeth", "header": ["I have all my own teeth \u2013 none missing", "O 1"], "rows": [["I have my own teeth, no dentures/implants \u2013 but some teeth are missing", "O 2"], ["I have dentures/implants as well as some of my own teeth", "O 3"], ["I only have dentures/implants", "O 4"], ["I have no teeth/dentures/implants", "O 5"]]}, {"caption": "Table 23: Not at all", "header": ["Not at all", "O 1"], "rows": [["A little", "O 2"], ["A fair amount", "O 3"], ["A lot", "O 4"]]}, {"caption": "Table 24: DH.4) How often do you brush your teeth? (Tick one circle only)", "header": ["Never", "O 1"], "rows": [["Less than once a day", "O 2"], ["Once a day", "O 3"], ["Twice a day", "O 4"], ["More than two times a day", "O 5"]]}, {"caption": "Table 25: Full Questionnaire in English", "header": ["Yes", "O 1"], "rows": [["No", "O \u2192 Go to AC.3 2"]]}, {"caption": "Table 26: Admission to the emergency department", "header": ["Admission to the emergency department", "O1"], "rows": [["Visit to a doctor or nurse", "O\u2082"], ["No intervention was needed", "O\u2083"]]}, {"caption": "Table 27: Full Questionnaire in English", "header": ["Yes", "O 1"], "rows": [["No", "O \u2192 Go to AC.5 2"]]}, {"caption": "Table 28: Admission to the emergency department", "header": ["Admission to the emergency department", "O 1"], "rows": [["Visit to a doctor or nurse", "O\u2082"], ["No intervention was needed", "O\u2083"]]}, {"caption": "Table 29: AC.5) During the past 12 months, have you had an accident while conducting a leisure", "header": ["Yes", "O 1"], "rows": [["No", "O \u2192 Go to AW.1 2"]]}, {"caption": "Table 30: Admission to the emergency department", "header": ["Admission to the emergency department", "O1"], "rows": [["Visit to a doctor or nurse", "O\u2082"], ["No intervention was needed", "O\u2083"]]}, {"caption": "Table 31: Absence From Work Due To Health Problems", "header": ["This section is only applicable to those who are employed (Question CS.8=1)."], "rows": [["For all other respondents go to PN.1"]]}, {"caption": "Table 32: \u2713 All kinds of diseases, injuries and other health problems which resulted in absenteeism", "header": ["Yes", "O 1"], "rows": [["No", "O \u2192 Go to PN.1 2"]]}, {"caption": "Table 33: \u2713 If required, the interviewer is to ask for an approximate number", "header": ["Specify: ____________________________________", "O 1"], "rows": [["Proxy respondent", "O 2"]]}, {"caption": "Table 34: None by O\u2081\u2192 Go to PL.1", "header": ["None", "O\u2081\u2192 Go to PL.1"], "rows": [["Very mild", "O\u2082"], ["Mild", "O\u2083"], ["Moderate", "O\u2084"], ["Severe", "O\u2085"], ["Very severe", "O\u2086"]]}, {"caption": "Table 35: Full Questionnaire in English", "header": ["Not at all", "O\u2081"], "rows": [["A little", "O\u2082"], ["Moderately", "O\u2083"], ["Quite a bit", "O\u2084"], ["Extremely", "O\u2085"]]}, {"caption": "Table 36: \u2713 If respondent is blind or cannot see at all, tick option 3 and go to PL.4", "header": ["Yes", "O1"], "rows": [["No", "O\u2082\u2192 Go to PL.3"], ["I am blind", "O\u2083\u2192 Go to PL.4"]]}, {"caption": "Table 37: No difficulty by O\u2081 \u2192 Go to PL.4", "header": ["No difficulty", "O\u2081 \u2192 Go to PL.4"], "rows": [["Some difficulty", "O\u2082 \u2192 Go to PL.4"], ["A lot of difficulty", "O\u2083 \u2192 Go to PL.4"], ["Cannot do at all/Unable to do", "O\u2084 \u2192 Go to PL.4"]]}, {"caption": "Table 38: PL.3) Do you have difficulty seeing? (Tick one circle only)", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/ Unable to do", "O\u2084"]]}, {"caption": "Table 39: \u2713 If respondent is deaf, do not ask this question and tick option three (3) and go to PL.9", "header": ["Yes", "O 1"], "rows": [["No", "O \u2192 Go to PL.6 2"], ["I am profoundly deaf", "O \u2192 Go to PL.9 3"]]}, {"caption": "Table 40: No difficulty by O\u2081\u2192 Go to PL.7", "header": ["No difficulty", "O\u2081\u2192 Go to PL.7"], "rows": [["Some difficulty", "O\u2082\u2192 Go to PL.7"], ["A lot of difficulty", "O\u2083\u2192 Go to PL.7"], ["Cannot do at all/ Unable to do", "O\u2084\u2192 Go to PL.7"]]}, {"caption": "Table 41: No difficulty by O\u2081 \u2192 Go to PL.8", "header": ["No difficulty", "O\u2081 \u2192 Go to PL.8"], "rows": [["Some difficulty", "O\u2082 \u2192 Go to PL.8"], ["A lot of difficulty", "O\u2083 \u2192 Go to PL.8"], ["Cannot do at all/ Unable to do", "O\u2084 \u2192 Go to PL.8"]]}, {"caption": "Table 42: No difficulty by O\u2081\u2192 Go to PL.9", "header": ["No difficulty", "O\u2081\u2192 Go to PL.9"], "rows": [["Some difficulty", "O\u2082\u2192 Go to PL.9"], ["A lot of difficulty", "O\u2083\u2192 Go to PL.9"], ["Cannot do at all/ Unable to do", "O\u2084\u2192 Go to PL.9"]]}, {"caption": "Table 43: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/ Unable to do", "O 4"]]}, {"caption": "Table 44: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/ Unable to do", "O 4"]]}, {"caption": "Table 45: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/ Unable to do", "O 4"]]}, {"caption": "Table 46: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/ Unable to do", "O 4"]]}, {"caption": "Table 47: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/ Unable to do", "O 4"]]}, {"caption": "Table 48: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/ Unable to do", "O 4"]]}, {"caption": "Table 49: Nodifficulty by Somedifficulty, A lot ofdifficulty, Not ableto do italone", "header": ["", "Nodifficulty", "Somedifficulty", "A lot ofdifficulty", "Not ableto do italone"], "rows": [["a.  Feed myself", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["b.  Get in and out of bed/chair", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["c.  Dress and undress myself", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["d.  Use the toilet", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["e.  Bathing/showering myself", "O\u2081", "O\u2082", "O\u2083", "O\u2084"]]}, {"caption": "Table 50: Yes, with at least one activity", "header": ["Yes, with at least one activity", "O\u2081"], "rows": [["No", "O\u2082\u2192 Go to PC.4"], ["If questionnaire is answered by aproxy, go to HA.1", ""]]}, {"caption": "Table 51: Yes, with at least one activity by O\u2081 \u2192 Go to HA.1", "header": ["Yes, with at least one activity", "O\u2081 \u2192 Go to HA.1"], "rows": [["No", "O\u2082 \u2192 Go to HA.1"]]}, {"caption": "Table 52: Yes, with at least one activity", "header": ["Yes, with at least one activity", "O\u2081"], "rows": [["No", "O\u2082"]]}, {"caption": "Table 53: Nodifficulty by Somedifficulty, A lot ofdifficulty, Not ableto do italone", "header": ["", "Nodifficulty", "Somedifficulty", "A lot ofdifficulty", "Not ableto do italone", "NotApplicable(nevertried it ordo notneed to doit)"], "rows": [["a. Preparing meals", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["b. Using the telephone", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["c. Shopping", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["d. Managing medication", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["e. Light housework", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["f. Occasional heavyhousework", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["g. Managing finances andeverydayadministrative tasks", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"]]}, {"caption": "Table 54: Full Questionnaire in English", "header": ["Yes, with at least one activity", "", "", "O\u2081"], "rows": [["No", "", "", "O\u2082 \u2192 Go to HA.4"], ["If questionnaire is answered by a proxy , go to BA.1 questions", "", "", ""]]}, {"caption": "Table 55: HA.3) Would you require more help/assistance? (Tick one circle only)", "header": ["Yes, with at least one activity", "O\u2081  \u2192 Go to BA.1"], "rows": [["No", "O\u2082\u2192 Go to BA.1"]]}, {"caption": "Table 56: Yes, with at least one activity", "header": ["Yes, with at least one activity", "O\u2081"], "rows": [["No", "O\u2082"]]}, {"caption": "Table 57: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/Unable to do", "O\u2084"], ["No interest in this activity/don\u2019t want to do it", "O\u2085"]]}, {"caption": "Table 58: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/Unable to do", "O\u2084"], ["No interest in this activity/don\u2019t want to do it", "O\u2085"]]}, {"caption": "Table 59: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/Unable to do", "O\u2084"], ["No interest in this activity/don\u2019t want to do it", "O\u2085"]]}, {"caption": "Table 60: Lack of money, cannot afford it", "header": ["Lack of money, cannot afford it", "", "", "O 1"], "rows": [["Lack of self-confidence", "", "O 2", ""], ["Attitudes of other people", "", "O 3", ""], ["Lack of convenient or available transport", "", "O\u2084", ""], ["Difficulties travelling on transport (such as getting on and off transport, no seats available, too uncomfortable)", "", "", "O\u2085"], ["Difficulty parking (not enough spaces)", "", "O 6", ""], ["Poor buildings\u2019 infrastructure and accessibility (lack of  O elevators, ramps, signs, doors too narrow, toilets nota adapted, etc.)", "", "7", ""], ["Other reasons", "", "O\u2088", ""], ["None", "", "O\u2089", ""]]}, {"caption": "Table 61: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/ Unable to do", "O\u2084"], ["No interest in this activity/don\u2019t want to do it", "O\u2085"]]}, {"caption": "Table 62: If BA.5 = 2, 3 or 4 GO TO BA.6", "header": ["", "If BA.5 = 2, 3 or 4 GO TO BA.6"], "rows": [["", "Otherwise GO TO BA.7"]]}, {"caption": "Table 63: Too busy (with work, family, caring or other responsibilities)", "header": ["Too busy (with work, family, caring or other responsibilities)", "O 1"], "rows": [["Lack of money, can\u2019t afford it", "O 2"], ["lack of self-confidence", "O 3"], ["Attitudes of other people", "O\u2084"], ["Lack of knowledge or information", "O\u2085"], ["Environmental barriers/ no friendly environment (for O", "6"], ["instance, difficulties with access and use of public", ""], ["transportation, accessing or using buildings, shops, easy", ""], ["movement along streets, parking etc.)", ""], ["Other reasons", "O 7"], ["None", "O\u2088"]]}, {"caption": "Table 64: No difficulty", "header": ["No difficulty", "O 1"], "rows": [["Some difficulty", "O 2"], ["A lot of difficulty", "O 3"], ["Cannot do at all/ Unable to do", "O\u2084"], ["No interest in this activity/don\u2019t want to do it", "O\u2085"]]}, {"caption": "Table 65: MH.1) During the past 2 weeks did you \u2026? (Tick one circle per row)", "header": ["", "All ofthetime", "Most ofthetime", "Morethanhalf ofthetime", "Lessthanhalf ofthetime", "Some ofthe time", "At notime"], "rows": [["a. Feeland in goospirits", "cheerfuld  O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"], ["b. Feel calm andrelaxed", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"], ["c.  Feel active andvigorous", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"], ["d. Wake upfeelingand rested", "fresh  O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"], ["e. Feel your dailylife was filledwith things ofinterest to you", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"]]}, {"caption": "Table 66: HC.1) During the past 12 months, have you been in hospital as an inpatient? (Tick one circle", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082 \u2192 Go to HC.4"]]}, {"caption": "Table 67: \u2713 Examples of diagnostic treatments are colonoscopy, gastroscopy, operation for", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082\u2192 Go to HC.6"]]}, {"caption": "Table 68: Less than 6 months ago", "header": ["Less than 6 months ago", "O\u2081"], "rows": [["6 months ago, or before, but less than 12 months ago", "O\u2082"], ["12 months ago, or before", "O\u2083"], ["Never", "O\u2084"]]}, {"caption": "Table 69: Less than 6 months ago", "header": ["Less than 6 months ago", "O\u2081"], "rows": [["6 months ago, or before, but less than 12 months ago", "O\u2082"], ["12 months ago, or before", "O\u2083"], ["Never", "O\u2084\u2192 Go to HC.9"]]}, {"caption": "Table 70: HC.8) What was the reason for your last visit to the dentist? (Tick one circle only)", "header": ["Pain/trouble with teeth, gums or mouth", "O\u2081"], "rows": [["Treatment/follow-up treatment", "O\u2082"], ["Routine check-up", "O\u2083"], ["Do not know/do not remember", "O\u2084"], ["Other (specify) ______________________________", "O\u2085"]]}, {"caption": "Table 71: Less than 12 months ago", "header": ["Less than 12 months ago", "O\u2081"], "rows": [["12 months ago, or before", "O\u2082 \u2192 Go to HC.11"], ["Never", "O\u2083 \u2192 Go to HC.11"]]}, {"caption": "Table 72: Less than 12 months ago", "header": ["Less than 12 months ago", "O\u2081"], "rows": [["12 months ago, or before", "O\u2082"], ["Never", "O\u2083"]]}, {"caption": "Table 73: If HC.11=1 go to HC.12", "header": ["", "If HC.11=1 go to HC.12"], "rows": [["", "Otherwise, go to instruction box after HC.12"]]}, {"caption": "Table 74: Yes, definitely by Yes, to some extent, No, not really, No, definitely not", "header": ["", "", "Yes, definitely", "Yes, to some extent", "No, not really", "No, definitely not", "Do not know"], "rows": [["a.", "Government GP/Health Centre doctor", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["b.", "Private Family doctor", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"]]}, {"caption": "Table 75: Yes,definitely by Yes, tosomeextent, No, notreally, No,definitelynot", "header": ["", "Yes,definitely", "Yes, tosomeextent", "No, notreally", "No,definitelynot", "Noneed toexplainthings", "Do notknow"], "rows": [["a.   GovernmentGP/Health Centredoctor", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"], ["b.   Private Familydoctor", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"]]}, {"caption": "Table 76: Yes,definitely by Yes,tosomeextent, No,notreally, No,definitelynot", "header": ["", "Yes,definitely", "Yes,tosomeextent", "No,notreally", "No,definitelynot", "No need toask questionsor raiseconcernsaboutrecommendedtreatment", "Donotknow"], "rows": [["a.  GovernmentGP/HealthCentre doctor", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"], ["b.  Private Familydoctor", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"]]}, {"caption": "Table 77: Yes,definitely by Yes, tosomeextent, No,notreally, No,definitelynot", "header": ["", "Yes,definitely", "Yes, tosomeextent", "No,notreally", "No,definitelynot", "Did notwant tobeinvolved", "Nodecisionsaboutcare andtreatmentweremade", "Do notknow"], "rows": [["a.  GovernmentGP/Health Centredoctor", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087"], ["b.  Private Familydoctor", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087"]]}, {"caption": "Table 78: GP/family doctor? (Tick one circle per row)", "header": ["", "VeryGood", "Good", "Fair", "Bad", "Very Bad", "Do notknow"], "rows": [["a.   GovernmentGP/Health Centredoctor", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"], ["b.  Private Familydoctor", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"]]}, {"caption": "Table 79: Less than 12 months ago", "header": ["Less than 12 months ago", "O\u2081"], "rows": [["12 months ago, or before", "O\u2082 \u2192 Go to HC.20"], ["Never", "O\u2083 \u2192 Go to HC.20"]]}, {"caption": "Table 80: Less than 12 months ago", "header": ["Less than 12 months ago", "O\u2081"], "rows": [["12 months ago, or before", "O\u2082"], ["Never", "O\u2083"]]}, {"caption": "Table 81: If HC.20=1 go to HC.21", "header": ["", "If HC.20=1 go to HC.21"], "rows": [["", "Otherwise, go to instruction box after HC.21"]]}, {"caption": "Table 82: Yes,definitely by Yes, tosomeextent, No, notreally, No,definitelynot", "header": ["", "Yes,definitely", "Yes, tosomeextent", "No, notreally", "No,definitelynot", "Do notknow"], "rows": [["a.  Governmentspecialist", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["b.  Privatespecialist", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"]]}, {"caption": "Table 83: Yes,definitely by Yes, tosomeextent, No,notreally, No,definitelynot", "header": ["", "Yes,definitely", "Yes, tosomeextent", "No,notreally", "No,definitelynot", "No needtoexplainthings", ""], "rows": [["", "Yes,definitely", "Yes, tosomeextent", "No,notreally", "No,definitelynot", "No needtoexplainthings", "Do notknow"], ["a.  Governmentspecialist", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"], ["b.  Privatespecialist", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"]]}, {"caption": "Table 84: Yes,definitely by Yes, tosomeextent, No,notreally, No,definitelynot", "header": ["", "Yes,definitely", "Yes, tosomeextent", "No,notreally", "No,definitelynot", "No need to askquestions or raiseconcerns aboutrecommendedtreatment", "Do notknow"], "rows": [["a.  Governmentspecialist", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"], ["b.  Privatespecialist", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"]]}, {"caption": "Table 85: Yes,definitely by Yes, tosomeextent, No,notreally, No,definitelynot", "header": ["", "Yes,definitely", "Yes, tosomeextent", "No,notreally", "No,definitelynot", "Did notwant tobeinvolved", "No decisionsabout careandtreatmentwere made", "Do notknow"], "rows": [["a.  Governmentspecialist", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087"], ["b.  Privatespecialist", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087"]]}, {"caption": "Table 86: Full Questionnaire in English", "header": ["", "Very Good", "Good", "Fair", "Bad", "Very Bad", "Do not know"], "rows": [["a.  Governmentspecialist", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"], ["b.  Privatespecialist", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086"]]}, {"caption": "Table 87: \u2713 The option \u2018None\u2019 can only be chosen on its own", "header": ["Physiotherapist", "1"], "rows": [["Chiropractor/Osteopath", "2"], ["Dietician/Nutritionist", "3"], ["Optometrist/Ophthalmic nurse", "4"], ["Psychologist or psychotherapist", "5"], ["Psychiatrist", "6"], ["Podiatrist/podologist", "7"], ["Acupuncturist", "8"], ["Other (specify) ______________________________", "9"], ["None", "O\u2081\u2080"]]}, {"caption": "Table 88: Yes, mainly from a family member", "header": ["Yes, mainly from a family member", "O\u2081"], "rows": [["Yes, mainly from a non-family member", "O\u2082"], ["No", "O\u2083"]]}, {"caption": "Table 89: Full Questionnaire in English", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082\u2192 Go to LT4"]]}, {"caption": "Table 90: Less than 5 hours per week", "header": ["Less than 5 hours per week", "O\u2081"], "rows": [["5 hours to less than 10 hours per week", "O\u2082"], ["10 hours to less than 20 hours per week", "O\u2083"], ["20 hours to less than 30 hours per week", "O\u2084"], ["30 hours to less than 40 hours per week", "O\u2085"], ["40 hours per week or more", "O\u2086"]]}, {"caption": "Table 91: LT.4) During the past 12 months, have you yourself used any of the following home care", "header": ["", "Yes", "No"], "rows": [["a.  Home care service provided by a nurse", "O\u2081", "O\u2082"], ["b.  Home help by a carer (non-nursing services)", "O\u2081", "O\u2082"], ["c.  \u201cMeals on wheels\u201d", "O\u2081", "O\u2082"], ["d.  Handyman service", "O\u2081", "O\u2082"], ["e.  Telecare", "O\u2081", "O\u2082"], ["f.   Other (specify)_____________________", "O\u2081", "O\u2082"]]}, {"caption": "Table 92: LT.5) During the past 12 months, have you yourself used any of the following home care", "header": ["", "Yes", "No"], "rows": [["a.  Home care service provided by a nurse", "O\u2081", "O\u2082"], ["b.  Home help by a carer (non-nursing services)", "O\u2081", "O\u2082"], ["c.  \u201cMeals on wheels\u201d", "O\u2081", "O\u2082"], ["d.  Handyman service", "O\u2081", "O\u2082"], ["e.  Telecare", "O\u2081", "O\u2082"], ["f.   Other (specify)_____________________", "O\u2081", "O\u2082"]]}, {"caption": "Table 93: \u2713 Exclude contraceptives pills/hormones used solely for contraception", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082\u2192 Go to MD.3"]]}, {"caption": "Table 94: MD.2) What were the medicines for? (Tick all that apply)", "header": ["Asthma", "1"], "rows": [["Chronic bronchitis, chronic obstructive pulmonary disease,emphysema", "2"], ["High blood pressure", "3"], ["Lowering the blood cholesterol level", "4"], ["Pain relief", "5"], ["Heart disease", "6"], ["Diabetes", "7"], ["Allergic symptoms (eczema, rhinitis, hay fever)", "8"], ["Heart burn", "9"], ["Cancer treatment", "10"], ["Depression", "11"], ["Tension/anxiety", "12"], ["Osteoporosis", "13"], ["Sleeping tablets", "14"], ["Antibiotics (such as penicillin)", "15"], ["Hypothyroidism", "16"], ["Other (specify)______________________________", "17"]]}, {"caption": "Table 95: MD.2) What were the medicines for? (Tick all that apply)", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082\u2192 Go to PA.1"]]}, {"caption": "Table 96: MD.4) What were the medicines/supplements for? (Tick all that apply)", "header": ["Pain relief", "1"], "rows": [["Cold, flu or sore throat", "2"], ["Allergic symptoms (Eczema, rhinitis, hay fever)", "3"], ["Heart burn", "4"], ["Bone/joint care supplements", "5"], ["Omega-3/fish oils", "6"], ["Any other vitamins, minerals or tonics", "7"]]}, {"caption": "Table 97: PA.1) When was the last time you were vaccinated against influenza? (Tick one circle only)", "header": ["Specify month ____________________________Specify year _______________________________", "O\u2081"], "rows": [["Too long ago (before the year 2020)", "O\u2082"], ["Never", "O\u2083\u2192 Go to PA.3"]]}, {"caption": "Table 98: Bought it", "header": ["Bought it", "O\u2081"], "rows": [["Got it for free", "O\u2082"]]}, {"caption": "Table 99: PA.3) When was the last time a health professional \u2026? (Tick one circle per row)", "header": ["", "Less than 12months ago", "12 monthsor more,but lessthan 3 yearsago", "Between3 and 5years ago", "Morethan 5 yearsago", ""], "rows": [["", "Less than 12months ago", "12 monthsor more,but lessthan 3 yearsago", "Between3 and 5years ago", "Morethan 5 yearsago", "Never"], ["a. Measured yourblood pressure", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["b. Measured yourbloodcholesterol", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["c. Measured yourblood glucose", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"]]}, {"caption": "Table 100: Less than 12 months ago", "header": ["Less than 12 months ago", "O\u2081"], "rows": [["12 months or more, but less than 2 years ago", "O\u2082"], ["2 years or more but, less than 3 years ago", "O\u2083"], ["3 years or more", "O\u2084\u2192 Go to PA.6"], ["Never", "O\u2085\u2192 Go to PA.6"]]}, {"caption": "Table 101: PA.5) Who ordered the latest stool sample (FOB) test? (Tick one circle only)", "header": ["National Screening Centre", "O\u2081"], "rows": [["Mater Dei Hospital/Gozo General Hospital", "O\u2082"], ["Private Hospital/Private Clinic", "O\u2083"]]}, {"caption": "Table 102: PA.6) When was the last time you had a colonoscopy? (Tick one circle only)", "header": ["Less than 12 months ago", "O\u2081"], "rows": [["12 months or more, but less than 5 years ago", "O\u2082"], ["5 years or more but less than 10 years ago", "O\u2083"], ["10 years ago, or more", "O\u2084"], ["Never", "O\u2085"]]}, {"caption": "Table 103: PA.7) When was the last time you had a mammogram (breast X-ray)? (Tick one circle only)", "header": ["Within the past 12 months", "O\u2081"], "rows": [["More than 12 months ago, but not more than 2 years ago", "O\u2082"], ["More than 2 years ago, but not more than 3 years ago", "O\u2083"], ["3 years ago, or more", "O\u2084\u2192 Go to PA.10"], ["Never", "O\u2085\u2192 Go to PA.10"], ["Not applicable", "O\u2086\u2192 Go to PA.10"]]}, {"caption": "Table 104: PA.8) During your last mammogram, was an ultrasound of the breast also conducted? (Tick", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082"]]}, {"caption": "Table 105: PA.9) Where did your most recent mammogram take place? (Tick one circle only)", "header": ["National Screening Programme, Malta Centre", "O\u2081"], "rows": [["National Screening Programme, Gozo Centre", "O\u2082"], ["Breast Clinic Mater Dei Hospital/Gozo General Hospital", "O\u2083"], ["Private Hospital/Private Clinic", "O\u2084"]]}, {"caption": "Table 106: PA.10) When was the last time you had a cervical smear test? (Tick one circle only)", "header": ["Within the past 12 months", "O\u2081"], "rows": [["More than 12 months ago, but not more than 2 years ago", "O\u2082"], ["More than 2 years ago, but not more than 3 years ago", "O\u2083"], ["3 years ago, or more", "O\u2084\u2192 Go to SA.1"], ["Never", "O\u2085\u2192 Go to SA.1"], ["Not applicable", "O\u2086\u2192 Go to SA.1"]]}, {"caption": "Table 107: National Screening Programme-Health Centre", "header": ["National Screening Programme-Health Centre", "O\u2081"], "rows": [["Mater Dei Hospital/Gozo General Hospital", "O\u2082"], ["Private Hospital/Private Clinic", "O\u2083"], ["Government Polyclinic (Health Centre), referred by doctor", "O\u2084"]]}, {"caption": "Table 108: SA.1) Are you covered by a private health insurance? (Tick one circle only)", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082\u2192 Go to BMI.1"]]}, {"caption": "Table 109: SA.2) Who pays for this insurance? (Tick one circle only)", "header": ["Myself", "O\u2081"], "rows": [["Employer", "O\u2082"], ["Both (myself and the employer)", "O\u2083"], ["Do not know", "O\u2084"], ["Other (specify)_____________________________", "O\u2085"]]}, {"caption": "Table 110: SA.3) What does this insurance cover? (Tick all that apply)", "header": ["Consultations/outpatient", "1"], "rows": [["Hospital treatment, local", "2"], ["Hospital treatment, abroad", "3"]]}, {"caption": "Table 111: BMI.1) How tall are you without shoes? (Tick one circle only)", "header": ["Specify _________________________________ cm", "", "O\u2081"], "rows": [["Do not know", "", "O\u2082"]]}, {"caption": "Table 112: BMI.2) How much do you weigh without clothes and shoes? (Tick one circle only)", "header": ["Specify _________________________________ kg", "O\u2081"], "rows": [["Do not know", "O\u2082"]]}, {"caption": "Table 113: Mostly sitting or standing", "header": ["Mostly sitting or standing", "O\u2081"], "rows": [["Mostly walking or tasks of moderate physical effort", "O\u2082"], ["Mostly heavy labour or physically demanding work", "O\u2083"], ["Not performing any working tasks", "O\u2084"]]}, {"caption": "Table 114: Specify days", "header": ["Specify ________________________________ days", "O\u2081"], "rows": [["I never carry out such physical activities", "O\u2082\u2192 Go to PE.4"]]}, {"caption": "Table 115: 10 minutes or more but less than 30 minutes per day", "header": ["10 minutes or more but less than 30 minutes per day", "O\u2081"], "rows": [["30 minutes or more but less than 1 hour per day", "O\u2082"], ["1 hour or more, but less than 2 hours per day", "O\u2083"], ["2 hours or more, but less than 3 hours per day", "O\u2084"], ["3 hours or more per day", "O\u2085"]]}, {"caption": "Table 116: Specify days", "header": ["Specify ________________________________ days", "", "", "O\u2081"], "rows": [["I never carry out such physical activities", "", "", "O\u2082 \u2192 Go to PE.6"]]}, {"caption": "Table 117: \u2713 Include electric bicycles", "header": ["10 minutes or more but less than 30 minutes per day", "O\u2081"], "rows": [["30 minutes or more but less than 1 hour per day", "O\u2082"], ["1 hour or more, but less than 2 hours per day", "O\u2083"], ["2 hours or more, but less than 3 hours per day", "O\u2084"], ["3 hours or more per day", "O\u2085"]]}, {"caption": "Table 118: \u2713 Any fruit juices should be excluded", "header": ["Once or more a day", "O\u2081"], "rows": [["4 to 6 times a week", "O\u2082 \u2192 Go to FV.3"], ["1 to 3 times a week", "O\u2083 \u2192 Go to FV.3"], ["Less than once a week", "O\u2084 \u2192 Go to FV.3"], ["Never", "O\u2085 \u2192 Go to FV.3"]]}, {"caption": "Table 119: \u2713 Any kind of vegetable juices or soups (warm and cold) should be excluded", "header": ["Once or more a day", "O\u2081"], "rows": [["4 to 6 times a week", "O\u2082 \u2192 Go to FV.5"], ["1 to 3 times a week", "O\u2083 \u2192 Go to FV.5"], ["Less than once a week", "O\u2084 \u2192 Go to FV.5"], ["Never", "O\u2085 \u2192 Go to FV.5"]]}, {"caption": "Table 120: Once or more a day", "header": ["Once or more a day", "O\u2081"], "rows": [["4 to 6 times a week", "O\u2082"], ["1 to 3 times a week", "O\u2083"], ["Less than once a week", "O\u2084"], ["Never", "O\u2085"]]}, {"caption": "Table 121: NU.1) Is salt added to your meals during cooking (excluding cubes)? (Tick one circle only)", "header": ["Almost always", "O\u2081"], "rows": [["Occasionally", "O\u2082"], ["Never (or low salt alternative)", "O\u2083"], ["Do not know", "O\u2084"]]}, {"caption": "Table 122: NU.2) Do you add salt to your meals whilst eating? (Tick one circle only)", "header": ["Almost always", "O\u2081"], "rows": [["Occasionally", "O\u2082"], ["Never (or low salt alternative)", "O\u2083"]]}, {"caption": "Table 123: NU.3) How often do you drink sugar free soft drinks? (Tick one circle only)", "header": ["Once or more a day", "O\u2081"], "rows": [["4 to 6 times a week", "O\u2082 \u2192 Go to NU.5"], ["1 to 3 times a week", "O\u2083 \u2192 Go to NU.5"], ["Less than once a week", "O\u2084 \u2192 Go to NU.5"], ["Never", "O\u2085 \u2192 Go to NU.5"]]}, {"caption": "Table 124: Once or more a day", "header": ["Once or more a day", "O\u2081"], "rows": [["4 to 6 times a week", "O\u2082 \u2192 Go to NU.7"], ["1 to 3 times a week", "O\u2083 \u2192 Go to NU.7"], ["Less than once a week", "O\u2084 \u2192 Go to NU.7"], ["Never", "O\u2085 \u2192 Go to NU.7"]]}, {"caption": "Table 125: NU.7) How often do you drink energy drinks? (Tick one circle only)", "header": ["Once or more a day", "O\u2081"], "rows": [["4 to 6 times a week", "O\u2082 \u2192 Go to NU.9"], ["1 to 3 times a week", "O\u2083 \u2192 Go to NU.9"], ["Less than once a week", "O\u2084 \u2192 Go to NU.9"], ["Never", "O\u2085 \u2192 Go to NU.9"]]}, {"caption": "Table 126: NU.9) How often do you consume the following foods? (Tick one circle per row)", "header": ["", "Onceormorea day", "4-6times aweek", "1-3times aweek", "Lessthanonce aweek", "Never"], "rows": [["a.  Chicken/rabbit", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["b. Fish", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["c.  Red Meat (including beef,veal, pork, lamb, etc)", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["d. Processed meat productse.g. salami, ham, sausages,hotdogs", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["e. Sweet pastries (Includingbiscuits, cakes, fancy cakes,gateaux etc.)", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["f.  Sweets", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"]]}, {"caption": "Table 127: EN.1) State whether you have any of the following problems/issues in your current", "header": ["", "Yes", "No"], "rows": [["a.  Overcrowding", "O\u2081", "O\u2082"], ["b.  Leaking roof, damp floors/walls/foundation, or rot inwindow frames/floor", "O\u2081", "O\u2082"], ["c.  Too dark/not enough light", "O\u2081", "O\u2082"], ["d.  Noise from neighbours or noise from outsideE.g. Traffic, business, factories, etc.", "O\u2081", "O\u2082"], ["e.  Pollution, grime or other environmental problems inthe area", "O\u2081", "O\u2082"], ["f.  Crime, violence or vandalism in the area", "O\u2081", "O\u2082"], ["g.  Insufficient ventilation", "O\u2081", "O\u2082"], ["h.  Insufficient privacy", "O\u2081", "O\u2082"]]}, {"caption": "Table 128: SS.1) How many people in your life are so close to you that you can count on them if you", "header": ["None", "O\u2081"], "rows": [["1 or 2", "O\u2082"], ["3 to 5", "O\u2083"], ["6 or more", "O\u2084"]]}, {"caption": "Table 129: SS.2) How much concern and positive interest do you feel people show you? (Tick one", "header": ["A lot of concern and interest", "O\u2081"], "rows": [["Some concern and interest", "O\u2082"], ["Not sure", "O\u2083"], ["Little concern and interest", "O\u2084"], ["No concern and interest", "O\u2085"]]}, {"caption": "Table 130: Very easy", "header": ["Very easy", "O\u2081"], "rows": [["Easy", "O\u2082"], ["Possible", "O\u2083"], ["Difficult", "O\u2084"], ["Very difficult", "O\u2085"]]}, {"caption": "Table 131: \u2713 Respondent should exclude any care provided as part of their profession", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082 \u2192 Go to SK.1"]]}, {"caption": "Table 132: \u2713 Respondent is to answer in relation to whom they are providing most care", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082"]]}, {"caption": "Table 133: Less than 5 hours per week by O1\u2192 Go to SK.1", "header": ["Less than 5 hours per week", "O1\u2192 Go to SK.1"], "rows": [["5 hours to less than 10 hours per week", "O\u2082\u2192 Go to SK.1"], ["10 hours or more, but less than 20 hours per week", "O\u2083\u2192 Go to SK.1"], ["20 hours or more, but less than 30 hours per week", "O\u2084\u2192 Go to SK.1"], ["30 hours to less than 40 hours per week", "O\u2085\u2192 Go to SK.1"], ["40 hours per week or more", "O\u2086\u2192 Go to SK.1"]]}, {"caption": "Table 134: Yes, daily", "header": ["Yes, daily", "O 1"], "rows": [["Yes, occasionally", "O 2"], ["Not at all", "O\u2083 \u2192 Go to SK.5"]]}, {"caption": "Table 135: \u2713 Choose the one product you smoke most often", "header": ["Cigarettes", ""], "rows": [["Manufactured and/or hand rolled", "O \u2192 Go to SK.3 1"], ["Cigars", "O \u2192 Refer to note SK.2A 2"], ["Pipe/tobacco", "O\u2083 \u2192 Refer to note SK.2A"], ["Shisha", "O\u2084 \u2192 Refer to note SK.2A"], ["Other (specify)______________________________", "O\u2085 \u2192 Refer to note SK.2A"]]}, {"caption": "Table 136: SK.3) How often do you smoke cigarettes? (Tick one circle only)", "header": ["Daily", "O 1"], "rows": [["Occasionally", "O \u2192 Go to SK.5 2"]]}, {"caption": "Table 137: SK.5) Have you ever smoked cigarettes, cigars, pipes, or shishas daily, or almost daily, for", "header": ["Yes", "O 1"], "rows": [["No", "O \u2192 Go to SK.7 2"]]}, {"caption": "Table 138: 1 hourormoreper day by Lessthan 1hourper day, At leastonce aweek,but noteveryday, Lessthanonce aweek", "header": ["", "1 hourormoreper day", "Lessthan 1hourper day", "At leastonce aweek,but noteveryday", "Lessthanonce aweek", "Neveroralmostnever"], "rows": [["a.  Indoors at home", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["b.  In indoor public spacesand/or in transport (E.g.bars, restaurants, shoppingmalls, arenas, bingo halls,bus, etc.)", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"], ["c.  Indoors at the workplace", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085"]]}, {"caption": "Table 139: Yes, daily", "header": ["Yes, daily", "O\u2081"], "rows": [["Yes, occasionally", "O\u2082"], ["No, but I have used them in the past", "O\u2083"], ["Never used them", "O\u2084"]]}, {"caption": "Table 140: Yes, daily vaping", "header": ["Yes, daily vaping", "O\u2081"], "rows": [["Yes, occasional vaping", "O\u2082"], ["No, but I did in the past", "O\u2083 \u2192If  being answered by a proxy, go to OP.1, otherwise Go to AL. 1"], ["Never vaped", "O\u2084 \u2192If  being answered by a proxy, go to OP.1, otherwise Go to AL. 1"]]}, {"caption": "Table 141: SK.10) How often do you use the following devices for e-cigarettes? (Tick one circle per row)", "header": ["", "Daily", "At leastonce a", "Less thanonce a", "", "Less", "Never", ""], "rows": [["", "Daily", "At leastonce a", "Less thanonce a", "", "Less", "Never", ""], ["", "Daily", "week,but noteveryday", "week butmorethan oncea month", "", "", "or", ""], ["", "Daily", "week,but noteveryday", "week butmorethan oncea month", "", "almostnever", "", ""], ["a. A reusable device that can berecharged with a single-usecartridge that is thrown awayafter use (pod-system)", "O\u2081", "O\u2082", "O\u2083", "", "O\u2084", "O\u2085", ""], ["b.  A refillable device which containsa tank that is refilled with an e-liquid from a separate container", "O\u2081", "O\u2082", "O\u2083", "", "O\u2084", "O\u2085", ""], ["c. A disposable device which isthrown away after use", "O\u2081", "O\u2082", "O\u2083", "", "O\u2084", "O\u2085", ""]]}, {"caption": "Table 142: Every day/almost every day", "header": ["Every day/almost every day", "O 1", "", ""], "rows": [["5 \u2013 6 days per week", "O 2", "", ""], ["3 \u2013 4 days per week", "O 3", "", ""], ["1 \u2013 2 days per week", "O\u2084", "", ""], ["2 \u2013 3 days per month", "O\u2085 \u2192 Go to AL.6", "", ""], ["", "O\u2085 \u2192 Go to AL.6", "", ""], ["Once a month", "O\u2086 \u2192 Go to AL.6", "", ""], ["Less than once a month", "O\u2087 \u2192 Go to AL.6", "", ""], ["Not in the past 12 months (but I have consumed  O\u2088 before)", "\u2192 Go to before UN.1.", "instruction box", ""], ["Never consumed alcohol/only a few sips in my whole life", "O\u2089 \u2192 before UN.1.", "Go to instruction box", ""]]}, {"caption": "Table 143: All 4 days", "header": ["All 4 days", "O 1"], "rows": [["3 days", "O 2"], ["2 days", "O 3"], ["1 day", "O\u2084"], ["On none of the mentioned days", "O\u2085 \u2192 Go to AL.4"]]}, {"caption": "Table 144: 16 or more drinks per day", "header": ["16 or more drinks per day", "O\u2081"], "rows": [["10 \u2013 15 drinks per day", "O 2"], ["6 \u2013 9 drinks per day", "O 3"], ["4 \u2013 5 drinks per day", "O\u2084"], ["3 drinks per day", "O\u2085"], ["2 drinks per day", "O\u2086"], ["1 drink per day", "O\u2087"], ["Less than 1 drink per day", "O\u2088"]]}, {"caption": "Table 145: All 3 days", "header": ["All 3 days", "O\u2081"], "rows": [["2 days", "O 2"], ["1 day", "O\u2083"], ["On none of the mentioned days", "O\u2084 \u2192 Go to AL.6"]]}, {"caption": "Table 146: 16 or more drinks per day", "header": ["16 or more drinks per day", "O 1"], "rows": [["10 \u2013 15 drinks per day", "O 2"], ["6 \u2013 9 drinks per day", "O 3"], ["4 \u2013 5 drinks per day", "O\u2084"], ["3 drinks per day", "O\u2085"], ["2 drinks per day", "O\u2086"], ["1 drink per day", "O\u2087"], ["Less than 1 drink per day", "O\u2088"]]}, {"caption": "Table 147: Every day or almost every day", "header": ["Every day or almost every day", "O 1"], "rows": [["5 \u2013 6 days a week", "O 2"], ["3 \u2013 4 days a week", "O 3"], ["1 \u2013 2 days a week", "O\u2084"], ["2 \u2013 3 days a month", "O\u2085"], ["Once a month", "O\u2086"], ["Less than once a month", "O\u2087"], ["Not in the past 12 months", "O\u2088"], ["Never in my whole life", "O\u2089"]]}, {"caption": "Table 148: Alone(specify number of days) At a bar, pub or caf\u00e9(specify number of days)", "header": ["Alone(specify number of days) _________________At a bar, pub or caf\u00e9(specify number of days) _________________", "1"], "rows": [["Alone(specify number of days) _________________At a bar, pub or caf\u00e9(specify number of days) _________________", "2"], ["At a sports or entertainment event(specify number of days) _________________", "3"], ["At lunch (home/restaurant)(specify number of days) _________________", "4"], ["At dinner (home/restaurant)(specify number of days) _________________", "5"], ["Before driving a vehicle (e.g. car, motorcycle, etc.)(specify number of days) _________________", "6"]]}, {"caption": "Table 149: UN.1) During the past 12 months, did you need any health care services? (Tick one circle", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082 \u2192 if answered by proxy , go to OP.1, otherwise Go to MH.2"]]}, {"caption": "Table 150: UN.2) During the past 12 months, have you experienced delay in getting health care", "header": ["", "", "Yes", "No"], "rows": [["a.", "Date of appointment given was too far off", "O\u2081", "O\u2082"], ["b.", "Distance/transporting problems", "O\u2081", "O\u2082"], ["c.", "Family related commitments", "O\u2081", "O\u2082"], ["d.", "Work related commitments", "O\u2081", "O\u2082"]]}, {"caption": "Table 151: UN3.a) Was there any time in the past 12 months when you needed a mental health", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082"]]}, {"caption": "Table 152: If UN3.a = 1 GO TO UN3.b", "header": ["", "If UN3.a = 1 GO TO UN3.b"], "rows": [["", "Otherwise GO TO UN.5"]]}, {"caption": "Table 153: Full Questionnaire in English", "header": ["Yes", "O\u2081"], "rows": [["No", "O\u2082"]]}, {"caption": "Table 154: If UN3.b = 2 GO TO UN.4", "header": ["", "If UN3.b = 2 GO TO UN.4"], "rows": [["", "Otherwise GO TO UN.5"]]}, {"caption": "Table 155: Could not afford it", "header": ["Could not afford it", "O\u2081"], "rows": [["Waiting list, don\u2019t have a referral letter", "O\u2082"], ["Could not take time because of work, care for children or forothers", "O\u2083"], ["Too far to travel/ no means of transportation", "O\u2084"], ["Having concerns about confidentiality and trust", "O\u2085"], ["Being afraid of negative reaction or comments from family,friends or colleagues", "O\u2086"], ["Fear about the consultation or treatment (for instance, fear ofnegative outcome or fear of side-effects of medication)", "O\u2087"], ["Not knowing where to seek help", "O\u2088"], ["Other reason", "O\u2089"]]}, {"caption": "Table 156: Yes by No need for thistype of care in past12 months", "header": ["", "Yes", "No", "No need for thistype of care in past12 months"], "rows": [["a.  Medical examination otreatment", "r O\u2081", "O\u2082", "O\u2083"], ["b.  Dental examination otreatment", "r  O\u2081", "O\u2082", "O\u2083"], ["c.  Prescribed medicines", "O\u2081", "O\u2082", "O\u2083"]]}, {"caption": "Table 157: MH.2) During the past 2 weeks did you \u2026? (Tick one circle per row)", "header": ["", "Not at all", "SeveralDays", "Morethan halfthe days", "Nearlyeveryday"], "rows": [["a. Have little interest or pleasure in doingthings", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["b. Feel down, depressed or hopeless", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["c.  Have trouble falling or staying asleep,or sleeping too much", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["d. Feel tired or have little energy", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["e. Have a poor appetite or overate", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["f.  Feel bad about yourself or feel like afailure", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["g. Have trouble concentrating on things,such as reading the newspaper orwatching television", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["h. Move or speak slowly/restlessly, thatother people took notice", "O\u2081", "O\u2082", "O\u2083", "O\u2084"]]}, {"caption": "Table 158: Amount \u20ac", "header": ["Amount \u20ac__________________________________", "O 1"], "rows": [["Does not apply", "O 2"]]}, {"caption": "Table 159: Amount \u20ac", "header": ["Amount \u20ac__________________________________", "O 1"], "rows": [["Does not apply", "O 2"]]}, {"caption": "Table 160: Amount \u20ac", "header": ["Amount \u20ac__________________________________", "O 1"], "rows": [["Does not apply", "O 2"]]}, {"caption": "Table 161: \u2713 The total is the amount left after tax, National Insurance etc. have been deducted", "header": ["Yes (specify amount) \u20ac________________________", "O \u2192Go to CW.1 1"], "rows": [["No", "O 2"]]}, {"caption": "Table 162: Below \u20ac1,222", "header": ["Below \u20ac1,222", "O\u2081"], "rows": [["Between \u20ac1,222 and \u20ac2,000", "O2"], ["Between \u20ac2,000 and \u20ac3,087", "O\u2083"], ["Between \u20ac3,087 and \u20ac4,428", "O\u2084"], ["Above \u20ac4,428", "O\u2085"], ["Do not know", "O\u2086"]]}, {"caption": "Table 163: CW.1) Would you like to answer these questions on your own, or would you prefer that I", "header": ["I want to answer the questions online myself", "O 1"], "rows": [["I want the interviewer to ask me the questions over the phone", "O -> go to CN.1 2"]]}, {"caption": "Table 164: CW.1) Would you like to answer these questions on your own, or would you prefer that I", "header": ["By email.  Specify ____________________________", "O -> go to TS.1. 1 Contact with respondent ends here."], "rows": [["By post.  Specify _____________________________", "O -> go to TS.1. 2 Contact with respondent ends here."]]}, {"caption": "Table 165: CN.1) Have you ever tried any of the substances listed below? (Tick one circle per row)", "header": ["", "Yes,", "Yes,within the", "Yes,previously", "No, I havenevertried thesubstance"], "rows": [["", "Yes,", "past 12", "Yes,previously", "No, I havenevertried thesubstance"], ["", "within", "months(but notwithin thepastmonth)", "(but notwithin thepast 12months)", "No, I havenevertried thesubstance"], ["", "the pastmonth", "months(but notwithin thepastmonth)", "(but notwithin thepast 12months)", "No, I havenevertried thesubstance"], ["a. Tranquilisers/Sedativeswithadoctor\u2019s prescription", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["b. Tranquilisers/Sedativeswithoutadoctor\u2019s prescription", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["c. Medical Cannabis", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["d. Recreational Cannabis(hashish/marijuana)", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["e. Synthetic cannabinoids", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["f.  Ecstasy", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["g. Cocaine (including crack andpowder)", "O\u2081", "O\u2082", "O\u2083", "O\u2084"], ["h. Heroin", "O\u2081", "O\u2082", "O\u2083", "O\u2084"]]}, {"caption": "Table 166: Under10years by 35yearsandover, Never", "header": ["", "Under10years", "10-13years", "14-16years", "17-19years", "20-24years", "25-29years", "30-34years", "35yearsandover", "Never"], "rows": [["a. Tranquilisers/Sedativeswitha doctor\u2019sprescription", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087", "O\u2088", "O\u2089"], ["b. Tranquilisers/Sedativeswithouta doctor\u2019sprescription", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087", "O\u2088", "O\u2089"], ["c.  Medical Cannabis", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087", "O\u2088", "O\u2089"], ["d. Recreational Cannabis(hashish/marijuana)", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087", "O\u2088", "O\u2089"], ["e. Synthetic cannabinoids", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087", "O\u2088", "O\u2089"], ["f.  Ecstasy", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087", "O\u2088", "O\u2089"], ["g. Cocaine (includingcrack and powder)", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O", "O\u2086", "O\u2087", "O\u2088", "O\u2089"], ["h. Heroin", "O\u2081", "O\u2082", "O\u2083", "O\u2084", "O\u2085", "O\u2086", "O\u2087", "O\u2088", "O\u2089"]]}, {"caption": "Table 167: DS.1) What is your sexual orientation? (Tick one circle only)", "header": ["Straight/Heterosexual", "O 1"], "rows": [["Bisexual", "O 2"], ["Lesbian/Gay", "O 3"], ["Questioning/Unsure", "O\u2084"], ["Other (specify)______________________________", "O\u2085"]]}, {"caption": "Table 168: \u2713 Vaginal and/or anal sex", "header": ["________________________________________years", "", "O 1"], "rows": [["Never", "", "O \u2192 Go to DS.11 2"]]}, {"caption": "Table 169: DS.3) If you have been sexually active in the past 12 months, how often did you and/or your", "header": ["I have not been active in the past 12 months", "O \u2192 Go to DS.8 1"], "rows": [["Never", "O \u2192 Go to DS.6 2"], ["Rarely", "O 3"], ["Sometimes", "O\u2084"], ["Frequently", "O\u2085"], ["Always", "O\u2086"]]}, {"caption": "Table 170: Natural family planningE.g. Temperature & safe period", "header": ["Natural family planningE.g. Temperature & safe period", "1"], "rows": [["Withdrawal", "2"], ["Contraceptive pill", "3"], ["Cap/diaphragm", "4"], ["Coil", "5"], ["Intra Uterine SystemE.g. Mirena", "6"], ["Condom", "7"], ["Other (specify)______________________________", "8"]]}, {"caption": "Table 171: DS.5) Of the times you had sexual intercourse in the past 12 months did you use condoms", "header": ["Never", "O\u2081"], "rows": [["Rarely", "O2"], ["Sometimes", "O\u2083"], ["Frequently", "O\u2084"], ["Always", "O\u2085"]]}, {"caption": "Table 172: DS.6) How many sexual partners have you had in the past 12 months?", "header": ["Male", "1"], "rows": [["Female", "2"], ["Other (specify)______________________________", "3"]]}, {"caption": "Table 173: DS.8) Have you ever sought help from a professional person about any problems related to", "header": ["Yes", "O 1"], "rows": [["No", "O \u2192 Go to DS.10 2"]]}, {"caption": "Table 174: DS.9) What was the profession of this person? (Tick all that apply)", "header": ["GP/family doctor", "1"], "rows": [["Gynaecologist", "2"], ["Sex therapist", "3"], ["Psychologist", "4"], ["Other (specify)______________________________", "5"]]}, {"caption": "Table 175: DS.10) Have you ever been told by a nurse/doctor/midwife that you have a sexually", "header": ["Yes", "O 1"], "rows": [["No", "O 2"]]}, {"caption": "Table 176: DS.11) Are you aware that there are free services for the testing and treatment of sexually", "header": ["Yes", "O 1"], "rows": [["No", "O 2"]]}, {"caption": "Table 177: TS.1) Were there any difficulties in answering any of the questions? (Tick one circle only)", "header": ["Yes", "O 1"], "rows": [["No", "O 2"], ["If yes, specify here:", ""]]}, {"caption": "Table 178: Full Questionnaire in English", "header": ["Yes", "O 1"], "rows": [["No", "O 2"], ["If yes, specify here:", ""]]}]}