Questionnaire Text

Questionnaire form view entire document:  text  image
11. Is the disability of [the respondent] for (answer of 10, except code 1) due to:

For each option with code 2, 3, 4, or 5, write one code

The cause of [the respondent]'s problem or condition is: _

[] 1 A birth condition?
[] 2 An illness?
[] 3 An accident?
[] 4 Old age?
[] 5 Another cause?
Questionnaire instructions view entire document:  text  image
15.3 Section III. People characteristics

In this section, information is obtained for each of the people living in the housing unit.

Before requesting data for each resident, copy the details from Section II. List people and general data, their names, gender, and age, and write them down in the spaces provided. Do not forget to correct the person number when using more than one questionnaire.

[Figure omitted: image with text]

For the respondent to know who to provide the information about, start with the sentence: "Now I'm going to ask you about...", and mention the name of the person you previously wrote down.

Apply questions 1 through 11 for all the people who are habitual residents, including children, as well as elderly people.

11. Cause of disability
The question is asked after question 10. disability and only applies if the code of some degree of difficulty was circled as two. They can do it with little difficulty, 3. It can do it with great difficulty, 4. They cannot do it in some kind of activity limitation; or when in the last question of Do you have any mental problem or condition? code 5 was recorded. Yes.

The purpose of this question is to know the main reason or motive that originates the difficulty or limitation to performing some or several activities in the daily life of the people of the housing unit and are expressed in numerical codes ranging from 1 to 5.

Read question 11 verbatim. Cause of disability along with your five response options for each limitation stated in question 10 and record the code in the space to the right of each type of limitation; including the last option, you will ask about the cause of the mental problem or condition.

[p. 314]

Note that when a person has more than one activity limitation, they must have a cause code for each of them.

To note the cause code, consider the following:

- Because they were born that way. When the cause of the difficulty is from birth, as well as causes originated during pregnancy or at the time of birth.
- Due to illness. When the difficulty was acquired by diseases after birth. It also includes limitations or disabilities caused by addictions.
- Due to an accident. When it originated or derived from fortuitous situations or unforeseen events such as: vehicular accidents, accidental poisoning, fires, falls, etc. that caused damage or injury to the body structure and functioning of the person.
- Due to old age. t includes those who present physical or mental difficulties or limitations whose main cause is related to aging processes, which deteriorate the level of development of activities and autonomy of the person.
- For other cause. It refers to causes that are not expressed within the above categories, but are known to those reporting the difficulty or limitation.
Example 1:
Interviewer: Now I am going to ask you about your son Eduardo (a one and a half year old baby). In your daily life, How much difficulty does Eduardo have seeing, even when wearing glasses? He has no difficulty, he can do it with little difficulty, he does it with great difficulty, or he is unable to do it.

Respondent: He does not appear to have any difficulty. When he was one month old, he had a test and the doctor said he was fine.

Interviewer: In your daily life, How much difficulty does Eduardo have hearing, even using a hearing aid? He has no difficulty, he can do it with little difficulty, he does it with great difficulty, or he is unable to do it.

Respondent: He has no difficulty either, he had a study done and he listens well.
[p. 315]
Interviewer: In your daily life, How much difficulty does Eduardo have walking, going up or down? He has no difficulty, he can do it with little difficulty, he does it with great difficulty, or he is unable to do it.

Respondent: He is unable to do so because he was born with a health problem.
Interviewer: Is Eduardo's difficulty in walking, climbing or descending due to being born that way, because of an illness, an accident, or some other cause?

Respondent: That's how he was born, he immediately underwent a study and the doctor said that he had "Dysplasia in the development of the hip", which in the future will cause him problems walking or crawling, so he uses a special device and soon he will need an operation so he can move and it will take him longer to walk.

Interviewer: In his daily life, How much difficulty has Eduardo remembering or concentrating? He has no difficulty, he can do it with little difficulty, he does it with great difficulty, or he is unable to do it.

Respondent: Yes, he can do it with little difficulty.

Interviewer: Is Eduardo's difficulty in remembering or concentrating because he was born that way, because of an illness, an accident, or some other cause?

Respondent: He was born this way.

Interviewer: In his daily life, How much difficulty does Eduardo have bathing, dressing, or eating?

Respondent: He does have a lot of difficulties because he was born with a health problem.

Interviewer: Is Eduardo's difficulty in bathing, dressing, or eating because he was born that way, because of an illness, an accident, or some other cause?

Respondent: Because of his illness.

Interviewer: In his daily life, How much difficulty does Eduardo have in speaking or communicating? He has no difficulty, he can do it with little difficulty, or is unable to do so.

Respondent: Yes, although he is starting to say "mama", he does have little difficulty; doctors say it will take longer for him to learn to speak well.

Interviewer: Is Eduardo's difficulty in speaking or communicating because he was born that way, because of an illness, because of an accident, or for another reason

Respondent: Because he was born that way.

Interviewer: Does she have any mental problems or conditions? Respondent: Yes, he has Down syndrome.

Interviewer: Is the cause of Eduardo's problem or mental condition because he was born like this, because of an illness, because of an accident, or for another reason?
[p. 316]
Respondent: He was born with Down syndrome.

[Figure omitted: image with text]

Example 2:

Interviewer: Now I am going to ask you about Penelope (75-year-old woman, mother of the respondent).
In her daily life, how difficult is it for Ms. Penelope to see, even when wearing glasses? He has no difficulty, he can do it with little difficulty, he does it with great difficulty, or he is unable to do it.

Respondent: She has little difficulty seeing well.

Interviewer: Is Mrs. Penelope's visual difficulty, even with glasses, because she was born that way because of an illness, because of an accident, because of old age, or for another reason?

Respondent: Because of her old age, she already has cataracts.

Interviewer: In her daily life, how difficult is it for Ms. Penelope to hear, even when wearing a hearing aid? He has no difficulty, he can do it with little difficulty, he does it with great difficulty, or he is unable to do it.

Respondent: It is very difficult for her.

Interviewer: Does Mrs. Penelope have hearing difficulty, even with a hearing aid because she was born that way, because of an illness, because of an accident, because of old age, or for another reason?

Respondent: Due to her old age.

Interviewer: In her daily life, how much difficulty does Ms. Penelope have in walking, climbing, or going downstairs? He has no difficulty, he can do it with little difficulty, he does it with great difficulty, or he is unable to do it.

Respondent: Well, she walks with little difficulty.

Interviewer: Does Mrs. Penelope have difficulty walking up or down because she was born that way, because of an illness, because of an accident, because of old age, or for another reason?

Respondent: Due to her old age.
[p. 317]
Interviewer: In her daily life, how much difficulty does Ms. Penelope have in remembering or concentrating? He has no difficulty, he can do it with little difficulty, he does it with great difficulty, or he is unable to do it.

Respondent: It is very difficult for her.

Interviewer: Is Mrs. Penelope's remembering or concentrating difficulty because she was born that way, because of an illness, because of an accident, because of old age, or for another reason?

Respondent: Due to her old age.

Interviewer: In her daily life, how much difficulty does Mrs. Penelope have to bathe, dress or eat? He has no difficulty, he can do it with little difficulty, he does it with great difficulty, or he is unable to do it.

Respondent: Much difficulty.

Interviewer: Is Mrs. Penelope's difficulty bathing, dressing, or eating because she was born that way, because of an illness, because of an accident, because of old age, or for another reason?

Respondent: Because of an illness, she has a very strong arthritis problem and she has all her fingers crooked. Although she can bathe herself, I help her dress and eat because she can no longer hold a spoon.

Interviewer: In her daily life, how much difficulty does Mrs. Penelope have speaking or communicating? He has no difficulty, he can do it with little difficulty, he does it with great difficulty, or he is unable to do it.

Respondent: She has no difficulty.

Interviewer: Does she have any mental problems or conditions? Respondent: No, none.

[Figure omitted: image with text]

[p. 318]

The questions disability and cause of disability are presented in the census manager as shown below:

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