Questionnaire Text

Questionnaire form view entire document:  text  image
B. For all persons in the household

Do you have any difficulty with the following activities?

Q14. Remember/concentrate
[] 1. No difficulty
[] 2. Yes, some difficulty
[] 3. Yes, a lot of difficulty
[] 4. Cannot do at all
Questionnaire instructions view entire document:  text  image
Questions Q11, Q12, Q13, Q14, Q15, Q16: Do you have the following difficulties?
The purpose of the question is to know the difficulties in seeing, hearing, walking or moving, remembering or concentrating, self-caring, speaking, and communicating in the daily life of the household members (except in the case of injury that prevents movement from time to time).
 
The data collection is divided according to categories of disabilities as follows:

Q14: Difficulties in remembering or concentrating:
Refers to people with mental and intellectual disabilities in remembering or concentrating to work for a long period of time, which is an obstacle in their daily life and living with others in society.