Questionnaire Text

Questionnaire form view entire document:  text  image

6. Resident characteristics


Disability - for all residents


6.15 Do you have any permanent difficulty in hearing?
(If you wear a rearing aid, make your evaluation while wearing it)

[] 1 Yes, cannot do it at all
[] 2 Yes, major trouble
[] 3 Yes, some difficulty
[] 4 No, no difficulty

Questionnaire instructions view entire document:  text  image

6.15 - Do you have hearing impairment?
(If hearing aids are used, used them to determine hearing)

Depending on the situation, record:
1 - Yes, not able to hear: A person who declares himself/herself unable to hear.
2 - Yes, has difficulty in hearing: A person that has difficulty in hearing, even when using hearing aids.


[page 199]

3 - Yes, some difficulty in hearing: A person that has some difficulty in hearing, even with the use of hearing aids.
4 - No, can hear very well: A person that can hear very well, even if he/she needs to use hearing aids.