Nr.

Item as appeared Perspective Linking Unit 1 - FINAL ICF Relationship Response Modality of
in the questionnaire code(s) options response options
as appears in
the item
The number Which perspective does the If …. then What are the response
of the item item address? Not options about?
as it appears Disability (problem; And Use *NN* in case of
in the difficulty; capacity or Or following terms
questionnaire performance restriction) If and only if Intensity/Extensity
QoL / Satisfaction Frequency
Needs Statements
Dependency Others
Impact

H1 How do you rate your overall overall health nd-gh very good - Intensity
health in the past 30 days? good -
moderate - bad
- very bad
In the last 30 days, how much
difficulty did you have in:

SELF CARE
D3.1 Washing your whole body? disability Washing your whole body d5101 none - mild - Intensity
moderate -
severe - very
severe
D3.2 Getting dressed? disability Getting dressed d540 none - mild - Intensity
moderate -
severe - very
severe
D3.3 Eating? disability Eating d550 none - mild - Intensity
moderate -
severe - very
severe
D3.4 Staying by yourself for a few disability Self-sufficiency for a d230 none - mild - Intensity
days? couple of days moderate -
severe - very
severe
GETTING ALONG WITH
PEOPLE
D4.1 Dealing with people you do disability Dealing with extrangers d730
not know?
D4.2 Maintaining a friendship? disability Maintaining a friendship d7500

D4.3 Getting along with people disability Getting along with people d779
who are close to you? who are close to you

D4.4 Making new friends? disability Making new friends d7500

D4.5 Sexual activities? disability Sexual activities d7702

In the last 30 days: disability Dealing with extrangers d730

PARTICIPATION IN
SOCIETY
D6.1 How much of a problem did disability joining community d9
you have in joining in activities in the sameway
community activities (for as anyone else
example: festivities, religious
or other activities) in the
same way as anyone else
can
D6.2 How much of a problem did disability problems because barriers d, e
you have because of barriers or hindrances in the world
or hindrances in the world around you
around you?

D6.3 How much of a problem did disability living with dignity because d940, e4
you have living with dignity of attitudes of others
because of the attitudes and
actions of others

disability Living with dignity because d940, e3 and

of actions of others
 disability time spent on the nc, nd or
consequencies of the
health condition

D6.4 How much time did you impact on time time spent on the health nc, hc
spend on your health condition
condition, or its
consequences

D6.5 How much have you been impact emotionally affected by the b152, hc
emotionally affected by your health condition
health condition

D6.6 How much has your health impact health is a drain on own gh, e165
been a drain on the financial financial resources
resources of you or your
family

impact health is a drain on gh, nc or

financial resources of your
family

D6.7 How much of a problem did impact problem the family has gh, nc
your family have because of because of your health
your health problems problems

D6.8 How much of a problem did disability doing things by yourself for nc, d920
you have in doing things by relaxation or pleasure
yourself for relaxation or
pleasure

H2 Overall, in the past 30 days, impact interference of difficulties nd

how much did these with life
difficulties interfere with your
life?

H3 Overall, in the past 30 days, Impact presence of difficulties nd

how many days were these
difficulties present?
H4 In the past 30 days, for how Impact ability to carry out usual d, hc
many days were you totally activities because of health
unable to carry out your condition
usual activities or work
because of any health
condition?
ability to carry out work d859, hc or

H5 In the past 30 days, not Impact reduction of usual activities d, hc

counting the days that you because of health
were totally unable, for how condition
many days did you cut back
or reduce your usual
activities or work because of
any health condition?
reduction of work because d859, hc or
of health condition