The Changing Lives of Older Couples Study

Wave III WIDOW Follow-up Survey

CODEBOOK

 

                                   Facesheet

 

VAR #

 

  7001      FS.    Seq.#/CASE ID                                          

 

 

 

  7002      FS.    Respondent # -- 1st 4 digits (CLOC ID#)                

 

 

 

  7003      FS.    Respondent # -- last 2 digits, preprinted as 31        

 

 

 

[V7004:  BUILD 6-digit Respondent ID# (V7002+V7003)]

 

 

 

  7005      FS.    Result Code                                            

 

01.  Complete I'v

03.  Complete Telephone I'v

 

05.  Partial I'v

07.  Partial Telephone I'v

 

 

 

  7006      FS.    Respondent "history":  2 digits                        

 

Code 1st 2-digit # precoded on Facesheet

 

 

 

  7007      FS.    Matched Control ID#--1st 4 digits                      

 

 

 

  7008      FS.    Matched Control ID#--last 2 digits, preprinted as 71   

 

 

 

[V7009:  BUILD 6-digit ID# (V7007+V7008)]

 

 

 

 7010       FS.    "History" of person to whom R is matched:  2 digits    


Code last 2-digit # precoded on Facesheet

 

 

 

 7011       FS1.   INTERVIEWER's ID# (4 digits from label)                

 

 

 7012       FS2.   Interview No.: (2 digits from box)                     

 

99.  NA

 

 

 

 7013       FS3.   Date of Interview--MONTH                               

 

Code MONTH (01-12)

 

 

 

 7014       FS3.   Date of Interview--DAY                                 

 

Code DAY (01-31)

 

 

 

 7015       FS3.   Date of Interview--YEAR                                

 

Code 4-digit YEAR (1992-1995)

 

 

 

 7016       FS4.   Length of Interview                                    

 

Code # of MINS (001-240)

 

 


 

SECTION A:  HOUSEHOLD LISTING

 

 

A1.    First, I need to list all the people who live here.  I don't need names, just the age, sex and relationship to you for each person.  Let's start with you.  How old are you?

 

Now I need the age, sex and relationship to you of any other adults and children who live here.

 

7101        A1.    SUMMARY # Persons in HOUSEHOLD                         

┌──────────────┐

0 in 7105-7131├─────01.  One            ┌──────────────┐

└──────────────┘                                            Code # persons

┌──────────────┐                                            listed in grid

0 in 7108-7131├─────02.  Two                               (01-20).     

└──────────────┘                                                      └──────────────┘

┌──────────────┐

0 in 7111-7131├─────03.  Three

└──────────────┘

┌──────────────┐

0 in 7114-7131├─────04.  Four

└──────────────┘

┌──────────────┐

0 in 7117-7131├─────05.  Five

└──────────────┘

┌──────────────┐

0 in 7120-7131├─────06.  Six

└──────────────┘

┌──────────────┐

0 in 7123-7131├─────07.  Seven

└──────────────┘

┌──────────────┐

0 in 7126-7131├─────08.  Eight

└──────────────┘

┌──────────────┐

0 in 7129-7131├─────09.  Nine

└──────────────┘

  10.  Ten

    .

    .

    .

  20.  Twenty

 

  99.  NA


7102(#1)    A1(a). MEMBERS OF THE HOUSEHOLD BY RELATIONSHIP TO RESPONDENT 

7105(#2)

7108(#3)           Partner/Spouse

7111(#4)          

7114(#5)           01.   RESPONDENT

7117(#6)           02.   Spouse of R

7120(#7)           03.   Partner of R

7123(#8)

7126(#9)           Child

7129(#10)

10.   Child(ren), NA sex (incl. foster child/stepchild)

11.   Son (incl. adopted)

12.   Daughter (incl. adopted)

13.   Stepson (incl. partner's son)

14.   Stepdaughter (incl. partner's daughter)

15.   Son-in-law (incl. daughter's partner)

16.   Daughter-in-law (incl. son's partner)

17.   Foster son

18.   Foster daughter

 

Parent/Grandparent

 

20.   Parent, NA sex ("parents" code 21, 22)

21.   Father (incl. adoptive father)

22.   Mother (incl. adoptive mother)

23.   Stepfather

24.   Stepmother

25.   Father-in-law (incl. partner's father); ("my in-laws" code 25 and 26)

26.   Mother-in-law (incl. partner's mother)

27.   Grandparent; great-grandparent, NA sex

28.   Grandfather; great-grandfather

29.   Grandmother; great-grandmother

 

Sibling/Sibling-in-law

 

31.   Brother

32.   Sister

33.   Stepbrother

34.   Stepsister

35.   Brother-in-law

36.   Sister-in-law


7102(#1)    A1(a). Continued                                              

7105(#2)

7108(#3)           Other Relatives

7111(#4)          

7114(#5)           40.   Grandchild/great grandchild, NA sex

7117(#6)           41.   Grandson; great grandson

7120(#7)           42.   Granddaughter; great granddaughter

7123(#8)           43.   Nephew

7126(#9)           44.   Niece

7129(#10)          45.   Uncle; great-uncle

46.   Aunt; great-aunt

47.   Cousin

48.   Other "in-laws"

┌─────────┐

Make Card├────────49.   Other relative

└─────────┘

 

Unrelated Persons

 

62.   Housemate/roommate

63.   Household employee; live-in sitter; housekeeper

64.   Friend

66.   Person related to R's partner (exc. child or parent)

67.   Roomer; boarder

 

┌─────────┐

Make Card├────────97.   Other unrelated person

└─────────┘

98.   DK

99.   NA

 

00.   Inap, no further persons in HU

 

 

 

7103(#1)    A1(b). SEX                                                    

7106(#2)

7109(#3)           1.  Male

7112(#4)           2.  Female

7115(#5)

7118(#6)           9.  NA

7121(#7)

7124(#8)           0.  Inap, no further persons listed

7127(#9)

7130(#10)

 

 

 

7104(#1)    A1(c). AGE                                                    

7107(#2)

7110(#3)           Code AGE (01-97)

7113(#4)

7116(#5)           01.  One year or less

7119(#6)

7122(#7)           97.  97 years or more

7125(#8)

7128(#9)           98.  DK

7131(#10)          99.  NA


00.  Inap, no further persons listed


                                                                          

SECTION B:  PARENTING

 

                                      

VAR #

 

The next questions are about children.

 

7201        B1.    Do you have any children who are not living here with you at the present time?  Please include adopted children or

stepsons and stepdaughters not living here.            

 

 1.  YES

┌─────────┐

0 in 7202├─────────5.  NO, NO CHILDREN ELSEWHERE

└─────────┤

          └─────────9.  NA

        

 

 

7202        B1a.   How many do not live with you?          

 

Code NUMBER (01-20)

 

98.  DK

99.  NA

 

00.  Inap, 5 or 9 in 7201

 

 

 

7203        B2.    Altogether, how many living children do you have?  Again, please include any adopted children or stepsons and

stepdaughters you may have.                            

 

  Code NUMBER (01-20), except:

 

  98.  DK

  99.  NA

┌──────────────┐

0 in 7204-7225├─────00.  NONE

└──────────────┘

 

 

 

7204        B2a.   INTERVIEWER CHECKPOINT                                 

 

 1.  R ONLY HAS ONE CHILD             

┌─────────┐

0 in 7205├─────────2.  ALL OTHERS

└─────────┘

 0.  Inap, 00 in 7203

 

 

 

 

 

 


 

 

7205        B2b.   Is this a son or daughter?                             

 

1.  SON

2.  DAUGHTER

 

9.  NA

 

0.  Inap, 00 in 7203; 2 in 7204

 

 

 

7206        B3.    INTERVIEWER CHECKPOINT                  

┌──────────────┐

0 in 7207-7208├─────1.  R HAS NO CHILDREN LIVING ELSEWHERE

└──────────────┘

  2.  R HAS ONLY ONE CHILD LIVING ELSEWHERE

  3.  R HAS MORE THAN ONE CHILD LIVING ELSEWHERE

 

  9.  NA

 

  0.  Inap, 00 in 7203

 

 

 

7207        B4/B5. Think about your (son/daughter/children) who (does/do) not live with you.  Does (he/she/how many of your children)

live within an hour's drive of here?                   

01.  YES (to B4); One (to B5)

 

02-20.

 

96.  NO (to B4); NONE (to B5)

 

98.  DK

99.  NA

 

00.  Inap, 00 in 7203; 1 in 7206

 

 

 

7208        B4a/B5a.  (RB, P. 1) In the past 12 months, how often did you have

contact with your (son/daughter/at least one of your children) who (doesn't/do not) live with you, either in person, by phone or by mail.  Would you say more than once a week, about once a week, 1 to 3 times a month, less than

once a month or never?                                 

 

1.  MORE THAN ONCE A WEEK

2.  ABOUT ONCE A WEEK

3.  1 TO 3 TIMES A MONTH

4.  LESS THAN ONCE A MONTH

5.  NEVER

 

8.  DK

9.  NA

 


0.  Inap, 00 in 7203; 1 in 7206

 

 

 

[V7209-V7210:  BUILD = 0]

 

 

7211        B6.    INTERVIEWER CHECKPOINT                  

 

1.  R HAS ONLY ONE CHILD

2.  R HAS TWO OR MORE CHILDREN

 

0.  Inap, 00 in 7203

 

 

 

7212        B7/B16.  (RB, P. 2)  How much do your children make you feel loved

and cared for?  Would you say a great deal, quite a bit,

some, a little, or not at all?                         

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

0.  Inap, 00 in 7203

 

 

 

7213        B8/B17.  (RB, STILL ON P. 9) How much do you feel they make too

many demands on you?  (Would you say a great deal, quite a

bit, some, a little, or not at all?)                   

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

0.  Inap, 00 in 7203

 

 

 

7214        B9/B18.  (RB, STILL ON P. 2) How much do you feel you make too

many demands on your children?  (Would you say a great

deal, quite a bit, some, a little, or not at all?)     

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE


5.  NOT AT ALL

 

8.  DK

9.  NA

 

0.  Inap, 00 in 7203

 

7215        B10/B19. (RB, STILL ON P. 2) How much are they willing to listen

when you need to talk about your worries or problems(--a

great deal, quite a bit, some, a little, or not at all)?      

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

0.  Inap, 00 in 7203

 

 

 

7216        B11/B20. (RB, STILL ON P. 2) How much are they critical of you or

what you do?  (Would you say a great deal, quite a bit,

some, a little, or not at all?)                        

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

0.  Inap, 00 in 7203

 

 

 

7217        B12/B21. (RB, P. 3) At this point in your life, how satisfied are

you with being a parent--are you completely, very,

somewhat, not very, or not at all satisfied?           

 

1.  COMPLETELY SATISFIED

2.  VERY SATISFIED

3.  SOMEWHAT SATISFIED

4.  NOT VERY SATISFIED

5.  NOT AT ALL SATISFIED

 

8.  DK

9.  NA

 

0.  Inap, 00 in 7203

 

 

 

 


 

 

 

 

 

 

 

 

 

7218        B13/B22. Not using the booklet--How often do you feel bothered or

upset as a parent--almost always, often, sometimes,

rarely, or never?                                      

 

1.  ALMOST ALWAYS

2.  OFTEN

3.  SOMETIMES

4.  RARELY

5.  NEVER

 

8.  DK

9.  NA

 

0.  Inap, 00 in 7203

 

 

 

7219        B14a/B23a. (RB, P. 4) How much do your children depend on you for

emotional support?  Would you say a lot, some, a little or

not at all?                                            

 

1.  A LOT            ┌───────────────┐

2.  SOME                                 USE SAME CODE 

3.  A LITTLE                             FOR V7220-7224

4.  NOT AT ALL            └───────────────┘

 

8.  DK

9.  NA

 

0.  Inap, 00 in 7203

 

 

 

7220        B14b/B23b. How much do they depend on you for help or advice with

financial and legal matters?                           

 

 

7221        B14c/B23c. How much do they depend on you for help with errands,

babysitting or other chores?                           

 

 

7222        B14d/B23d. How much do you depend on your children for emotional

support?                                               

 

 

7223        B14e/B23e. How much do you depend on them for help or advice with


financial and legal matters?                           

 

 

7224        B14f/B23f. How much do you depend on them for help with errands or

other chores?                                          

 

 

 

 

 

 

 

 

 

 

7225        B15/B24. (RB, P. 5) At this point in your life, how often do you

and any of your children have unpleasant conflicts or disagreements?  Would you say more than once a week, about once a week, 1 to 3 times a month, less than once a month,

or never?                                              

 

1.  MORE THAN ONCE A WEEK

2.  ABOUT ONCE A WEEK

3.  1 TO 3 TIMES A MONTH

4.  LESS THAN ONCE A MONTH

5.  NEVER

 

8.  DK

9.  NA

 

0.  Inap, 00 in 7203

 

 

 

7226        B25.   How many grandchildren do you have, if any?

 

 01.  ONE

 

 02-60.

 

 98.  DK

 99.  NA

┌─────────┐

0 in 7227├─────────00.  NONE

└─────────┘

 

 

 

7227        B25a/B25b. (RB,[STILL ON]P. 5) How often do you see your

(grandchild/grandchildren)?  (Would you say more than once a week, about once a week, 1 to 3 times a month, less than

once a month, or never?)                               

 

1.  MORE THAN ONCE A WEEK

2.  ABOUT ONCE A WEEK

3.  1 TO 3 TIMES A MONTH

4.  LESS THAN ONCE A MONTH

5.  NEVER


8.  DK

9.  NA

 

0.  Inap, 00 in 7226

 

 

 

 

 

 

 

 

 

 


 

SECTION C:  SOCIAL SUPPORT

 

 

Now I would like to ask you some questions about your relationships with your relatives and friends.  Please think of all your close family members, (including children,) as well as other friends and relatives.

 

7228        C1.    Is there anyone in your life with whom you can really

share your very private feelings and concerns?         

 

 1.  YES

┌─────────┐

0 in 7229├─────────5.  NO

└─────────┤

          ├─────────8.  DK

          └─────────9.  NA

 

 

 

7229        C1a.   How many such people are there?                        

 

Code NUMBER (01-95)

 

98.  DK

99.  NA

 

00.  Inap, 5, 8-9 in 7228

 

 

 

[V7230-V7237:  not used]

 

 

 

7238        C7.    The next questions are about friends and relatives (other than your children). Since becoming widowed, do you have contact with your other relatives and friends more, about

the same, or less than before?                         

 

1.  MORE

3.  SAME

5.  LESS

 

8.  DK

9.  NA

 

 

 

 

 

 

 

 

 

 

 


 

7239        C8.    Compared to when your (husband/wife) was alive, do you have more interest, about the same amount of interest, or less interest in having contact with relatives and

friends?                                               

 

1.  MORE

3.  SAME

5.  LESS

 

8.  DK

9.  NA

 

 

 

7240        C9.    Do your relatives and friends show more interest, about the same amount of interest, or less interest in having

contact with you?                                      

 

1.  MORE

3.  SAME

5.  LESS

 

8.  DK

9.  NA

 

 

 

7241        C10.   (RB, P. 6)  On the whole, how much do your friends and relatives make you feel loved and cared for?  Would you say a great deal, quite a bit, some, a little, or not at

all?                                                   

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

 

 

7242        C11.   (RB, STILL ON P. 6) How much do you feel your friends and relatives make too many demands on you?  (Would you say a

great deal, quite a bit, some, a little, or not at all?)      

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 


 

 

 

7243        C12.   (RB, STILL ON P. 6) How much are your friends and relatives willing to listen when you need to talk about your worries or problems(--a great deal, quite a bit,

some, a little, or not at all)?                        

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

 

 

7244        C13.   (RB, STILL ON P. 6) How much are they critical of you or what you do?  (Would you say a great deal, quite a bit,

some, a little, or not at all?)                        

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA


 

 

SECTION D:  GRIEF

 

 

VAR #

 

D1-D2e. ARE OMITTED.

 

 

 

D3.    (RB, P. 7) Now, I have a list of feelings and emotions that some people still experience many months after the loss of their husband or wife.  Please think about the past month.  Because of the loss of your (husband/wife) ...

 

7301        D3.    . . . have you felt afraid of what lies ahead for you?  Would you say no, never; yes, but rarely; yes, sometimes;

or yes, often?                                         

 

1.  NO, NEVER            ┌──────────────┐

2.  YES, BUT RARELY                      USE SAME CODE

3.  YES, SOMETIMES                       FOR V7302-7323

4.  YES, OFTEN            └──────────────┘

 

8.  DK

9.  NA

 

 

 

7302        D4.    (Because of the loss of your [husband/wife]) Have you felt

extremely anxious and unsettled during the past month? 

 

 

7303        D5.    During the past month, (because of the loss of your [husband/wife]) have you felt worried about how you would

manage your day-to-day affairs?                        

 

 

7304        D6.    (Because of the loss of your [husband/wife]) Has life

seemed empty?                                          

 

 

7305        D7.    During the past month, (because of the loss of your

[husband/wife]) did you feel amazed at your strength?  

 

 

 

7306        D8.    Did you feel you were coping well with the loss of your

(husband/wife)?                                        

 

 

7307        D9.    During the past month, did you feel proud of how well you


were managing?                                         

 

 

7308        D10.   (RB, STILL ON P. 7) (Because of the loss of your [husband/wife]), have you felt as though you were in a

state of shock?                                        

 

7309        D11.   During the past month, (because of the loss of your (husband/wife]) have you felt as though you couldn't

believe what was happening?                            

 

 

7310        D12.   (Because of the loss of your [husband/wife]), have you

felt emotionally numb?                                 

 

 

7311        D13.   During the past month, have you felt resentful or bitter

about your (husband's/wife's) death?                   

 

 

7312        D14.   Have you felt that the death of your (husband/wife) was

unfair?                                                

 

 

7313        D15.   In the past month, have you felt anger toward God (because

of the loss of your [husband/wife])?                   

 

 

7314        D16.   Have you felt empty inside, like an important part of you

is missing (because of the loss of your [husband/wife])?  

 

 

7315        D17.   In the past month, have you felt that life has lost its

meaning (because of the loss of your [husband/wife])?  

 

 

7316        D18.   Have you had any regrets about anything that happened between you and your (husband/wife) while (he/she) was

still alive?                                           

 

 

7317        D19.   Have you felt as though you did all you could have done

for your (husband/wife) before (his/her) death?        

 

7318        D20.   During the past month, have you had any regrets about

things you did or failed to do while (he/she) was alive?     

 

 

7319        D21.   In the past month, have you heard a sound that you thought


might be (him/her)?                                    

 

 

7320        D22.   (RB, STILL ON P. 7) In the past month, have you sensed the

presence of your (husband/wife)?                       

 

 

7321        D23.   To help you make decisions, have you thought about what

your (husband/wife) would have done?                   

 

 

7322        D24.   During the past month, have you felt drawn to places and

things that make you feel close to your (husband/wife)?

 

 

7323        D25.   Have you found yourself longing to have (him/her) with

you?                                                   

 

 

7324        D26.   (RB, STILL ON P. 7) People have different reactions to the death of a husband or wife.  During the past month, have you had painful waves of missing your (husband/wife)?  (Would you say no, never; yes, but rarely; yes, sometimes;

or yes, often)?                                        

 

 1.  NO, NEVER

┌─────────┐

0 in 7325├─────────2.  YES, BUT RARELY

└─────────┼─────────3.  YES, SOMETIMES

          └─────────4.  YES, OFTEN

 

8.  DK

9.  NA

 

 

 

7325        D26a.  (RB, STILL ON P. 7) Has it happened in the last 12 months?--(no, never; yes, but rarely; yes, sometimes; or

yes, often)?                                           

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 2-4 in 7324

 

 

 

7326        D27.   (RB, STILL ON P. 7) During the past month, have you experienced feelings of intense pain or grief over the loss of your (husband/wife)--(no, never; yes, but rarely;


yes, sometimes; or yes, often)?                        

 

 1.  NO, NEVER

┌─────────┐

0 in 7327├─────────2.  YES, BUT RARELY

└─────────┼─────────3.  YES, SOMETIMES

          └─────────4.  YES, OFTEN

 

 8.  DK

 9.  NA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7327        D27a.  (RB, STILL ON P. 7) Has it happened in the last 12 months?--(no, never; yes, but rarely; yes, sometimes; or

yes, often)?                                           

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 2-4 in 7326

 

 

 

7328        D29.   Considering all the things associated with your (husband's/wife's) death, from the time of the death up until now, how stressful has the death been for you?  Would you say not stressful, a little stressful, somewhat,

very, or so stressful that it was nearly unbearable?   

┌──────────────┐

0 in 7329-7331├─────1.  NOT STRESSFUL

└──────────────┘

  2.  A LITTLE

  3.  SOMEWHAT

  4.  VERY

  5.  NEARLY UNBEARABLE

 

  8.  DK

  9.  NA

 

 


7329        D30.   Is losing your (husband/wife) the most stressful thing

that has ever happened to you?                         

┌──────────────┐

0 in 7330-7331├─────1.  YES

└──────────────┤

                 5.  NO

              

               ├─────8.  DK

               └─────9.  NA

 

  0.  Inap, 1 in 7328


7330        D30a.  What was more stressful than the death of your

7331               (husband/wife)?                                        

 

01.   Relationship with spouse/partner; marriage problems; divorce/separation

02.   Worries about children; relationship with child; include caring for new baby

03.   Problem pregnancy; distress surrounding a pregnancy (exc. 30-34); pressure from loved ones to have/not have the baby

04.   Relationship with parents; worries/concerns about parents

 

 

 

 

Mental Health/Drug/Alcohol Problems or Suicide of R's:

 

20.   Self/Respondent

21.   Spouse/partner/ex-spouse

22.   Child

23.   Parent

24.   Other relative/friend/person close to R

 

 

Other Health Problems of R's (incl. accidental injuries):

 

30.   Self/Respondent

31.   Spouse/partner/ex-spouse

32.   Child

33.   Parent

34.   Other relative/friend/person close to R

 

 

48.   Death of relative/friend; threat of death--R or other person

49.   Death or loss of pet

 

 

 

80.   Financial problems; debts; unable to pay bills; reduced income

81.   Work/job related problems (exc. 83)--no mention of financial implications; unemployment/job loss; start own business

82.   School related problems

83.   Moving, including the related problems of separation from family or dealing with a new job or being in an unfamiliar place


7330        D30a.  Continued                                              

7331

91.   Gulf War: mention that R or loved one actually sent to Saudi Arabia area due to the war; actually in danger/ combat zone

92.   Gulf War: worry that R/spouse/loved one will go to war/will be killed or injured; war general worry

 

95.   (To be assigned by Supervisor only) Miscellaneous less severe or trivial problems

 

 

 

 

 

 

┌─────────┐

Make Card├────────97.  Other

└─────────┘

98.  DK

99.  NA

 

00.  Inap, 1 in 7328; 1, 8-9 in 7329; no further mention


 

 

SECTION E:  RESPONSES TO THE LOSS

 

 

VAR #

 

For the next questions, please think about the past month.

 

7601        E1.    (RB, P. 8) During the past month, how often have you had thoughts or memories of your (husband/wife)?  Would you say several times a day,  daily or almost daily, 2 to 3 times a week, about once a week, less than once a week, or

never?                                                 

┌──────────────┐

0 in 7608-7609├─────1.  SEVERAL TIMES A DAY

└──────────────┼─────2.  DAILY OR ALMOST DAILY

               ├─────3.  2 TO 3 TIMES A WEEK

               ├─────4.  ABOUT ONCE A WEEK

               └─────5.  LESS THAN ONCE A WEEK

┌──────────────┐

0 in 7602-7607├─────6.  NEVER

└──────────────┘

  8.  DK

  9.  NA

 

 

 

7602        E2.    (RB, P. 9)  During the past month, did thoughts or memories of your (husband/wife) make you feel sad or upset?  Would you say no, never; yes, but rarely; yes,

sometimes; or yes, often?                              

 

1.  NO, NEVER            ┌───────────────┐

2.  YES, BUT RARELY                      USE SAME CODE 

3.  YES, SOMETIMES                       FOR V7603-7607

4.  YES, OFTEN            └───────────────┘

 

8.  DK

9.  NA

 

0.  Inap, 6 in 7601

 

 

 

7603        E3.    Did thoughts or memories of (him/her) make you feel happy

or at peace?                                           

 

 

7604        E4.    During the past month, have you had difficulty falling asleep because thoughts relating to (him/her) kept coming

into your mind?                                        

 

 

7605        E5.    Have you tried to block out memories or thoughts of your

(husband/wife)?                                        


 

 

 

7606        E6.    During the past month, did you find that you couldn't get thoughts of your (husband/wife) out of your mind even when

you wanted to?                                         

 

 

 

7607        E7.    During the past month, have you found yourself going over

and over what happened?                                

 

 

 

7608        E8.    (RB, STILL ON P. 9)  During the past 12 months (that is, since [MONTH, YEAR]), did you ever find that you couldn't get thoughts of your (husband/wife) out of your mind even when you wanted to--(no, never; yes, but rarely; yes,

sometimes; or yes, often)?                             

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 1-5 in 7601

 

 

 

7609        E9.    (RB, STILL ON P. 9)  During the past 12 months, did you ever find yourself going over and over what happened--(no,

never; yes, but rarely; yes, sometimes; or yes, often)?

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 1-5 in 7601

 

 

 

7610        E10.   (RB, STILL ON P. 9)  During the past month, have you tried to keep busy so that you would be less likely to dwell on your (husband/wife) or (his/her) death?  (Would you say no, never; yes, but rarely; yes, sometimes; or

yes, often?)                                           

 

1.  NO, NEVER

2.  YES, BUT RARELY


3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

 

 

7611        E11.   (RB, STILL ON P. 9)  During the past month, have you avoided people or places that remind you of (him/her)?  (Would you say no, never; yes, but rarely; yes, sometimes;

or yes, often?)                                        

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

 

 

7612        E12.   (RB, STILL ON P. 9)  During the past 12 months, did you ever ask yourself "Why me?" or "Why my (husband/wife)"?  (Would you say no, never; yes, but rarely; yes, sometimes;

or yes, often?)                                        

┌─────────┐

0 in 7613├─────────1.  NO, NEVER

└─────────┤

                   2.  YES, BUT RARELY

                   3.  YES, SOMETIMES

                   4.  YES, OFTEN

         

          ├─────────8.  DK

          └─────────9.  NA

 

 

 

7613        E12a.  Were you able to answer this question?                 

 

1.  YES

5.  NO

 

8.  DK

9.  NA

 

0.  Inap, 1, 8-9 in 7612

 

 

 

7614        E13.   (RB, STILL ON P. 9)  During the past month, have you ever found yourself searching to make sense or find some meaning in your (husband's/wife's) death--(no, never; yes,

but rarely; yes, sometimes; or yes, often)?            

 

  1.  NO, NEVER


┌──────────────┐

0 in 7615-7616├─────2.  YES, BUT RARELY

└──────────────┼─────3.  YES, SOMETIMES

               └─────4.  YES, OFTEN

             

  8.  DK

  9.  NA

 

 

 

 

 

7615        E13a.  (RB, STILL ON P. 9)  Has this happened during the past 12 months? (no, never; yes, but rarely; yes, sometimes; or

yes, often)?                                           

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

             

8.  DK

9.  NA

 

0.  Inap, 2-4 in 7614

 

 

 

[V7616:  BUILD = 0]

 

 

 

7617        E14.   (RB, P. 10) Have you made any sense or found any meaning in your (husband's/wife's) death?  Would you say no, not

at all; yes, a little; yes, some; or yes, a great deal?

┌──────────────┐

0 in 7620-7622├─────1.  NO, NOT AT ALL

└──────────────┘

┌──────────────┐

0 in 7618-7619├─────2.  YES, A LITTLE

└──────────────┼─────3.  YES, SOME

               └─────4.  YES, A GREAT DEAL

┌──────────────┐

0 in 7620-7622├─────8.  DK

└──────────────┴─────9.  NA

 

 

 

7618        E14a.  Can you tell me why you feel that way?                 

7619

11.   Spouse was young; too young to die

12.   Spouse in good health; was not (seriously) ill

13.   Combination of youth and good health (11+12)

 

14.   Spouse old; had lived a long time

15.   Spouse in poor health; couldn't survive illness; had been sick a long time

16.   Combination of old age and poor health (14+15)


17.   Had poor health habits (smoked, drank, didn't get medical care, etc.)

 

19.   R blames medical personnel: doctor at fault, incompetent

 

21.   References to God or religion; God's will; prayer as means of coping

22.   Other fatalistic responses; these things just happen (to everyone); death as part of life-cycle; "it was his time"; "that's life"


7618        E14a.  Continued                                              

7619

31.   Positive aspects of death; spouse no longer suffers; at peace now

32.   Positive mentions of spouse's life in general: "he had a good life"; "we had a good marriage"

 

 

 

81.   R angry/upset/confused--n.e.c.

 

 

 

 

96.   There is no answer/meaning; have found no meaning (yet)

┌─────────┐

Make Card├────────97.   Other

└─────────┘

98.   DK

99.   NA

 

00.   Inap, 2-4 in 7617; no further mention

 

 

 

7620        E14b.  How have you done so?  (PROBE FOR A FULL RESPONSE.)

7621

Use same code as V7618-7619, except:

 

00.   Inap, 1, 8-9 in 7617; no further mention

 

 

 

7622        E14c.  (RB, STILL ON P. 10)  Are you comforted by this explanation--(no, not at all; yes, a little; yes, some; or

yes, a great deal)?                                    

 

1.  NO, NOT AT ALL

2.  YES, A LITTLE

3.  YES, SOME

4.  YES, A GREAT DEAL

 

8.  DK

9.  NA

 

0.  Inap, 1, 8-9 in 7617

 

 

 

 

 

 

 

 

 

 

 

 


 

E15.   (RB, P. 11)  Please tell me how true the following statements are as they apply to you now.

 

7623        E15.   At times, I want or need to think about my (husband/wife) or (his/her) death.  Is this very true, somewhat,

a little, or not true at all?                          

 

1.  VERY TRUE            ┌───────────────┐

2.  SOMEWHAT TRUE                        USE SAME CODE 

3.  A LITTLE TRUE                        FOR V7624-7626

4.  NOT TRUE AT ALL             └───────────────┘

 

8.  DK

9.  NA

 

 

 

7624        E16.   Almost everything I see or hear brings back painful

reminders of my (husband/wife).                        

 

 

7625        E17.   I try not to think about what happened.                

 

 

7626        E18.   I do not see any purpose in dwelling on my (husband's/

wife's) death.                                         

 

 

 

7627        E19.   (RB, STILL ON P. 11)  It is upsetting to come into contact with reminders of my (husband/wife)--(very true, somewhat,

a little, or not true at all)?                         

┌─────────┐

0 in 7628├─────────1.  VERY TRUE

└─────────┼─────────2.  SOMEWHAT TRUE

          └─────────3.  A LITTLE TRUE

 

                    4.  NOT TRUE AT ALL

 

 8.  DK

 9.  NA

 

 

 

7628        E19a.  (RB, STILL ON P. 11)  There were times in the past 12 months when it was upsetting to come into contact with reminders of (him/her)--(very true, somewhat, a little, or

not true at all)?                                      

 

1.  VERY TRUE

2.  SOMEWHAT TRUE

3.  A LITTLE TRUE

4.  NOT TRUE AT ALL

 


8.  DK

9.  NA

 

0.  Inap, 1-3 in 7627

 

 

 

7629        E20.   (RB, STILL ON P. 11) I feel the need to be with people who will let me talk about my (husband/wife) or (his/her) death.  (Is this very true of you, somewhat,

a little, or not true at all of you?)                  

 

1.  VERY TRUE

2.  SOMEWHAT TRUE

3.  A LITTLE TRUE

4.  NOT TRUE AT ALL

 

8.  DK

9.  NA

 

 

 

7630        E21.   (RB, P. 12) During the past month, how often did you actually talk about your (husband/wife) or (his/her) death with anyone?  Would you say  several times a day, daily or almost daily, 2 to 3 times a week, about once a week, less

than once a week, or never?                            

 

  1.  SEVERAL TIMES A DAY

  2.  DAILY OR ALMOST DAILY

  3.  2 TO 3 TIMES A WEEK

  4.  ABOUT ONCE A WEEK

  5.  LESS THAN ONCE A WEEK

┌──────────────┐

0 in 7631-7634├─────6.  NEVER

└──────────────┘

  8.  DK

  9.  NA

 

 

 

7631        E22.   (RB, P. 13) In general, during the past month, has talking with others about (him/her) made you feel sad or upset?  Would you say no, never; yes, but rarely; yes, sometimes;

or yes, often?                                         

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 6 in 7630

 

 

 


 

 

 

 

 

 

 

 

7632        E23.   (RB, STILL ON P. 13) Has talking about (him/her) made you feel happy or at peace during the past month--(no, never;

yes, but rarely; yes, sometimes; or yes, often)?       

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 6 in 7630

 

 

 

7633        E24.   (RB, STILL ON P. 13) During the past month, has talking about (him/her), or (his/her) death, or how you are doing seemed to make other people uncomfortable--(no, never;

yes, but rarely; yes, sometimes; or yes, often)?       

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 6 in 7630

 

 

 

7634        E25.   (RB, STILL ON P. 13)  During the past month, have you ended up talking about your (husband/wife) or (his/her) death, or how you are doing even when you didn't want to--(no, never; yes, but rarely; yes, sometimes; or yes,

often)?                                                

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 6 in 7630

 

 


 

 

 

 

 

 

 

 

 

7635        E26.   (RB, P. 14)   Please tell me how true the following statements are as they apply to you.

At times I find that I want or need to cry.  (Is this very true of you, somewhat, a little, or not true at all of

you?)                                                  

 

1.  VERY TRUE

2.  SOMEWHAT TRUE

3.  A LITTLE TRUE

4.  NOT TRUE AT ALL

 

8.  DK

9.  NA

 

 

 

7636        E27.   (RB, STILL ON P. 14) I believe that there is no point in crying over the loss of my (husband/wife) since crying will not bring (him/her) back.  (Is this very true for

you, somewhat, a little, or not true at all for you?)  

 

1.  VERY TRUE

2.  SOMEWHAT TRUE

3.  A LITTLE TRUE

4.  NOT TRUE AT ALL

 

8.  DK

9.  NA

 

 

 

7637        E28.   (RB, P. 15) During the past month, how often did you actually cry about the loss of your (husband/wife)?  Would you say several times a day, daily or almost daily, 2 to 3 times a week, about once a week, less than once a week, or

never?                                                 

┌─────────┐

0 in 7640├─────────1.  SEVERAL TIMES A DAY

└─────────┼─────────2.  DAILY OR ALMOST DAILY

          ├─────────3.  2 TO 3 TIMES A WEEK

          ├─────────4.  ABOUT ONCE A WEEK

          └─────────5.  LESS THAN ONCE A WEEK

┌───────────────┐

0 in 7638-7639,├────6.  NEVER

     7641-7643

└───────────────┼────8.  DK

                └────9.  NA

 

 


7638        E28a.  How long did these periods of crying typically last?--

MINUTES                                                

 

Code MINUTES (01-95), except:

 

98.  DK

99.  NA

 

00.  MINUTES not given; Inap, 6, 8-9 in 7637

 

 

7639        E28a.  How long did these periods of crying typically last?--

HOURS                                                  

 

Code HOURS (01-95), except:

 

98.  DK

99.  NA

 

00.  HOURS not given; Inap, 6, 8-9 in 7637

 

 

[V7640:  BUILD = 0]

 

 

 

7641        E29.   (RB, P. 16) In general, during the past month, has crying made you feel worse than you did before--no, never; yes,

but rarely; yes, sometimes; or yes, often?             

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 6, 8-9 in 7637

 

 

 

7642        E30.   (RB, STILL ON P. 16) Has crying made you feel better during the past month(--no, never; yes, but rarely; yes,

sometimes; or yes, often)?                             

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 6, 8-9 in 7637

 

 


7643        E31.   (RB, STILL ON P. 16) During the past month, did you become tearful even when you didn't want to? (Would you say no,

never; yes, but rarely; yes, sometimes; or yes, often)?

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

0.  Inap, 6, 8-9 in 7637

 

7644        E32.   (RB, P. 17) Now I have two sets of questions focusing on dreams and nightmares which many people have after their spouse's death.  First, I will ask you about dreams.  During the past 12 months, approximately how many times, if any, did you have dreams about your (husband/wife) or (his/her) death (-- once or twice, 3 or 4 times, about once a month, 2-3 times a month, once a week or more, or

none?)                                                 

 

 1.  1-2

 2.  3-4 TIMES

 3.  ONCE A MO.

 4.  2-3 TIMES/MO.

 5.  ONCE A WEEK OR MORE

┌─────────┐

0 in 7645├─────────6.  NONE

└─────────┘

 8.  DK

 9.  NA

 

 

 

7645        E32a.  How do these dreams make you feel -- very sad or upset,

somewhat sad or upset, somewhat happy, or very happy?  

 

1.  VERY SAD OR UPSET

2.  SOMEWHAT SAD/UPSET

3.  SOMEWHAT HAPPY

4.  VERY HAPPY

 

8.  DK

9.  NA

 

0.  Inap, 6 in 7644

 

 

 

7646        E33.   (RB, STILL ON P. 17) Now please think about the first couple of years after your (husband/wife) died.  Approximately how many times, if any, did you have dreams about your (husband/wife) or (his/her) death (-- once or twice, 3 or 4 times, about once a month, 2-3 times a

month, once a week or more, or none?)                  


1.  1-2

2.  3-4 TIMES

3.  ONCE A MO.

4.  2-3 TIMES/MO.

5.  ONCE A WEEK OR MORE

6.  NONE

 

8.  DK

9.  NA

 

 

 

 

 

 

 

 

7647        E34.   (RB, STILL ON P. 17) The next questions are about nightmares.  During the past 12 months, approximately how many times, if any, did you have nightmares about your       (husband/wife) or (his/her) death (-- once or twice, 3 or 4 times, about once a month, 2-3 times a month, once a

week or more, or none?)                                

 

1.  1-2

2.  3-4 TIMES

3.  ONCE A MO.

4.  2-3 TIMES/MO.

5.  ONCE A WEEK OR MORE

6.  NONE

 

8.  DK

9.  NA

 

 

 

7648        E35.   (RB, STILL ON P. 17) Now please think about the first couple of years after your (husband/wife) died.  Approximately how many times, if any, did you have nightmares about your (husband/wife) or (his/her) death     (-- once or twice, 3 or 4 times, about once a month, 2-3

times a month, once a week or more, or none?)          

 

1.  1-2

2.  3-4 TIMES

3.  ONCE A MO.

4.  2-3 TIMES/MO.

5.  ONCE A WEEK OR MORE

6.  NONE

 

8.  DK

9.  NA


 

 

SECTION F:  COPING WITH PROBLEMS OF WIDOWHOOD

 

                                      

VAR #

 

The next questions are about problems and changes facing bereaved people.

 

7701        F1.    (RB, P. )  During the past month, have you experienced feelings of grief, loneliness or missing your (husband/wife)?   (Would you say no, never; yes, but

rarely; yes, sometimes; or yes, often?)                

 

  1.  NO, NEVER

┌──────────────┐

0 in 7702-7703├─────2.  YES, BUT RARELY

└──────────────┼─────3.  YES, SOMETIMES

               └─────4.  YES, OFTEN

             

  8.  DK

  9.  NA

 

 

 

7702        F1a.   (RB, STILL ON P. 18)  Have you had these feelings in the last 12 months? (no, never; yes, but rarely; yes,

sometimes; or yes, often)?                             

┌──────────────┐

0 in 7703-7716├─────1.  NO, NEVER

└──────────────┘

  2.  YES, BUT RARELY

  3.  YES, SOMETIMES

  4.  YES, OFTEN

             

  8.  DK

  9.  NA

 

  0.  Inap, 2-4 in 7701

 

 

 

[V7703:  BUILD = 0]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


F2.    (RB, P. 23) I am going to read you a list of things people sometimes do to handle feelings of grief, loneliness or missing their (husband/wife).  For each one, please tell me how much you have done this to help you cope with your feelings, at any time since your (husband/wife) died.

7704        F2a.   To cope with these feelings, how much have you gotten out of the house--gone somewhere, or taken a walk or drive?

Have you done this a lot, a little, or not at all?     

 

1.  A LOT            ┌───────────────┐

2.  A LITTLE                             USE SAME CODE 

3.  NOT AT ALL                           FOR V7705-7712

                  └───────────────┘

7.  IF VOLUNTEERED: DID, BUT NOT TO COPE

    WITH SPOUSE'S DEATH

 

8.  DK

9.  NA

 

0.  Inap, 1 in 7702

 

 

 

7705        F2b.   How much have you kept busy or tried to get involved in

some activity?                                         

 

 

7706        F2c.   How much have you turned to God for strength and comfort?   

 

 

7707        F2d.   How much have you tried to dull the pain you are feeling

by turning to alcohol, food or drugs, or sleeping more?

 

 

7708        F2e.   How much have you tried to think about the good things

about your life?                                       

 

 

7709        F2f.   How much have you told yourself that things will get better with time; that you have gone through the worst of

it?                                                    

 

 

7710        F2g.   How much have you tried to remember the good times that

you and your (husband/wife) had together?              

 

 

7711        F2h.   How much have you done things that help you feel close to

your (husband/wife), such as going to the cemetery?    

 

 

7712        F2j.   How much have you tried to forget about what has happened?  


 

 

 

 

 

 

 

 

F3.    For the next few questions you can just answer yes or no.  To help handle feelings of grief, loneliness or missing your (husband/wife), have you...

 

7713        F3a.   ...gone to a self-help group or support group for people

who have lost a spouse?                                

 

1.  YES            ┌───────────────┐

5.  NO                                   USE SAME CODE 

                                         FOR V7714-7716

8.  DK            └───────────────┘

9.  NA

 

0.  Inap, 1 in 7702

 

 

 

7714        F3b.   Have you seen a minister, priest or other clergy for help?      

 

 

7715        F3c.   Have you talked to your family doctor about your feelings

of grief, loneliness or missing your (husband/wife)?   

 

 

7716        F3d.   Have you gone to a mental health professional for help--                  someone like a social worker or psychologist?          

 

 

 

7717        F4.    (RB, P. 20)  During the past month, have you been bothered by having to plan or fix meals and eat on your own?  Would you say no, never; yes, but rarely; yes, sometimes; or

yes, often?                                            

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

 

 

[V7718:  BUILD = 0]

 

 


7719        F5.    (RB, STILL ON P. 20)  During the past month, have you experienced problems keeping up with things around the house such as cleaning, paying bills, maintenance of your home and car or doing laundry?  (Would you say no, never;

yes, but rarely; yes, sometimes; or yes, often?)       

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

[V7720:  BUILD = 0]

 

 

 

7721        F6.    (RB, STILL ON P. 20)  During the past month, have you been bothered by having to handle such things as your (husband's/wife's) estate, arranging for credit or dealing with insurance companies or agencies like Blue Cross or Social Security?  (Would you say no, never; yes, but

rarely; yes, sometimes; or yes, often?)                

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

 

 

[V7722:  BUILD = 0]

 

 

 

7723        F7.    (RB, STILL ON P. 20)  During the past month, have you been troubled by having to make major decisions without your (husband/wife), such as decisions about major purchases or whether or not to move?  (Would you say no, never; yes,

but rarely; yes, sometimes; or yes, often?)            

 

1.  NO, NEVER

2.  YES, BUT RARELY

3.  YES, SOMETIMES

4.  YES, OFTEN

 

8.  DK

9.  NA

 

 

 

[V7724-V7725:  BUILD = 0]

 

 

 


7726        F8.    During the past month, have you had any problems as a

result of being widowed that I haven't asked you about?

 

  1.  YES

┌──────────────┐

0 in 7727-7728├─────5.  NO

└──────────────┤

               ├─────8.  DK

               └─────9.  NA

 

 


7727        F8a.   What other problems have you experienced?

7728

11.   Emotional problems: loneliness, depression

12.   Social problems; problems with friends/other couples; "feel like a 5th wheel"

13.   Financial problems: (increased) bills or expenses; debt; financial decisions more difficult

 

 

 

21.   Upkeep/maintenance of house or car (exc. 13); no one to fix things; difficulty getting work done

 

 

 

31.   Transportation; can't/don't drive; "spouse always drove"

 

 

 

41.   Safety; no one around to watch house; fearful at night

 

 

 

 

┌─────────┐

Make Card├────────97.   Other

└─────────┘

98.   DK

99.   NA

 

00.   Inap, 5, 8-9 in 7726; no further mention

 


 

 

SECTION G:  MARRIAGE

 

                                      

VAR #

 

[V7801:  BUILD = 0]

 

 

 

7802        G1.    Did your (husband/wife) have any serious, ongoing, health

problems before (he/she) died?                         

 

1.  YES

5.  NO

 

8.  DK

9.  NA

 

 

 

[V7803-7804:  BUILD = 0]

 

 

 

G1a.   For the next questions, please think about the last few years of your marriage before your (husband/wife) became very ill.

G1b.   For the next questions, please think about the last few years of your marriage.

 

 

7805        G2.    (RB, P. 21)  How much did your (husband/wife) make you feel loved and  cared for?  Would you say a great deal,

quite a bit, some, a little, or  not at all?           

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

 

 

 

 

 

 

 

 

 

 

 

 

 


7806        G3.    (RB, STILL ON P. 21) How much do you feel (he/she) made too many demands on you in the last few years of your marriage (before (he/she) became very ill)?  (Would you say a great deal, quite a bit, some, a little, or not at

all?)                                                  

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

 

 

7807        G4.    (RB, STILL ON P. 21)  In the last few years of your marriage (before (he/she) became very ill)  how much was (he/she) willing to listen when you needed to talk about your worries or problems--(a great deal, quite a bit,

some, a little, or not at all)?                        

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

 

 

7808        G5.    (RB, STILL ON P. 21) During the last few years of your marriage (before [he/she] became ill) how much were you willing to listen when your (husband/wife) needed to talk about (his/her) worries or problems--(a great deal, quite

a bit, some, a little, or not at all)?                 

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

 

 

 

 

 

 

 

 

 


 

7809        G6.    (RB, STILL ON P. 21)  How much do you think you made your (husband/wife) feel loved and cared for--(a great deal,

quite a bit, some, a little, or not at all)?           

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

 

 

7810        G7.    (RB, P. 22) During the last few years of your marriage (before [he/she] became ill), how often would you say you and your (husband/wife) typically had unpleasant disagreements or conflicts?  Would you say more than once a week, about once a week, 1 to 3 times a month, less than

once a month, or never?                                

 

1.  MORE THAN ONCE A WEEK

2.  ABOUT ONCE A WEEK

3.  1 TO 3 TIMES A MONTH

4.  LESS THAN ONCE A MONTH

5.  NEVER

 

8.  DK

9.  NA

 

 

 

7811        G8.    (RB, P. 23)  Please tell me how true the next two statements are.  My (husband/wife) did not treat me as well as I deserved to be treated.  Is this very true,

somewhat true, a little true, or not true at all?      

 

1.  VERY TRUE

2.  SOMEWHAT TRUE

3.  A LITTLE TRUE

4.  NOT TRUE AT ALL

 

8.  DK

9.  NA

 

 

 

7812        G9.    (RB, STILL ON P. 23)  I did not treat my (husband/wife) as well as (he/she) deserved to be treated.  (Is this very

true, somewhat true, a little true, or not true at all?)      

 

1.  VERY TRUE

2.  SOMEWHAT TRUE

3.  A LITTLE TRUE

4.  NOT TRUE AT ALL


8.  DK

9.  NA


 

 

SECTION H:  SELF DESCRIPTION

 

                                      

VAR #

 

H1.    (RB, STILL ON P. 23) Please tell me how true the following statements are as they apply to you now.

 

7901        H1.    On the whole I am satisfied with myself. (Is this very true, somewhat, a little, or not true at all as it applies

to you?)                                               

 

1.  VERY TRUE            ┌───────────────┐

2.  SOMEWHAT TRUE                        USE SAME CODE 

3.  A LITTLE TRUE                        FOR V7902-7908

4.  NOT TRUE AT ALL             └───────────────┘

 

8.  DK

9.  NA

 

 

7902        H2.    At times I think I am no good at all.                  

 

 

7903        H3.    I wish I could have more respect for myself.           

 

 

7904        H4.    All in all, I am inclined to feel that I am a failure. 

 

 

7905        H5.    I feel I am a person of worth, at least equal with others.    

 

 

 

[V7906-7908:  BUILD = 0]

 

 

 


H10.   (SAB, P. 1)  Please look at page 1 of the large blue booklet where you will find a number of statements.  After each statement, put an "X" in the answer category that indicates how strongly you agree or disagree with the statement as it applies to you.  The best answer is usually the one that comes to your mind first, so try not to spend too much time on any one statement.  Continue until you see a STOP sign at the bottom of page 4.  (If you prefer, I can read the statements to you.)

         ┌───────────────────────────────────────────────────────────────┐

         NOTE:  ITEMS H11 - H54 are reproduced by special permission of

         the publisher, Psychological Assessment Resources, Inc.,      

         16102 North Florida Avenue, Lutz, Florida, 33549, from the NEO

         Personality Inventory, by Paul Costa, and Robert McCrae,      

         Copyright 1978, 1985.  Further reproduction is prohibited     

         without permission of PAR, Inc.                                

         └───────────────────────────────────────────────────────────────┘

 

 

7909        H11.   I have a very active imagination.   Do you strongly agree,

agree, feel neutral, disagree or strongly disagree?    

 

1.  STRONGLY AGREE            ┌───────────────┐

2.  AGREE                                USE SAME CODE 

3.  NEUTRAL                              FOR V7910-7952

4.  DISAGREE            └───────────────┘

5.  STRONGLY DISAGREE

 

8.  DK

9.  NA

 

 

7910        H12.   I keep my belongings neat and clean.                   

 

 

7911        H13.   I'm an even-tempered person.                           

 

 

7912        H14.   I am dominant, forceful, and assertive.                

 

 

7913        H15.   I'm pretty good about pacing myself so as to get things

done on time.                                          

 

 

7914        H16.   I don't get much pleasure from chatting with people.   

 

 

7915        H17.   I like to have a lot of people around me.              

 

7916        H18.   I am sometimes completely absorbed in music I am listening

to.                                                    

 


7917        H19.   I have a clear set of goals and work toward them in an

orderly fashion.                                       

 

 

7918        H20.   I rarely experience strong emotions.                   

 

 

7919        H21.   I work hard to accomplish my goals.                    

 

 

7920        H22.   I am easily frightened.                                

 

 

7921        H23.   I tend to blame myself when anything goes wrong.       

 

 

7922        H24.   I waste a lot of time before settling down to work.    

 

 

7923        H25.   I often worry about things that might go wrong.        

 

 

7924        H26.   Sometimes I'm not as dependable or reliable as I should

be.                                                    

 

 

7925        H27.   Poetry has little or no effect on me.                  

 

 

7926        H28.   It takes a lot to get me mad.                          

 

 

7927        H29.   I experience a wide range of emotions or feelings.     

 

 

7928        H30.   I have strong emotional attachments to my friends.

 

 

7929        H31.   I never seem to be able to get organized.              

 

 

7930        H32.   I prefer jobs that let me work alone without being

bothered by other people.                              

 

 

7931        H33.   I strive for excellence in everything I do.            

 


7932        H34.   I am seldom sad or depressed.                          

 

 

7933        H35.   I'm pretty set in my ways.                             

 

 

7934        H36.   I have trouble resisting my cravings.                  

 

 

7935        H37.   I have sometimes done things just for "kicks" or

"thrills".                                             

 

 

7936        H38.   I enjoy solving problems or puzzles.                   

 

 

7937        H39.   It would not bother me if I had to punish a child or pet.       

 

 

7938        H40.   Once I find the right way to do something, I stick to it.        

 

7939        H41.   At times I have been so ashamed I just wanted to hide. 

 

 

7940        H42.   Some people think I'm selfish and egotistical.         

 

 

7941        H43.   I tend to be cynical and skeptical of others' intentions.

 

 

7942        H44.   I often feel inferior to others.                       

 

 

7943        H45.   I would rather cooperate with others than compete with

them.                                                  

 

 

7944        H46.   I believe that most people will take advantage of you if

you let them.                                          

 

 

7945        H47.   Some people think of me as cold and calculating.       

 

 

7946        H48.   I am a cheerful, high-spirited person.                 

 


7947        H49.   I consider myself broad-minded and tolerant of other

people's lifestyles.                                   

 

7948        H50.   I'm hard-headed and tough-minded in my attitudes.      

 

 

7949        H51.   I generally try to be thoughtful and considerate.      

 

 

7950        H52.   When everything seems to be going wrong, I can still make

good decisions.                                        

 

 

7951        H53.   I am a very active person.                             

 

 

7952        H54.   I have a wide range of intellectual interests.         


 

 

SECTION J:  HEALTH AND LIMITATION OF ACTTIVITIES

                                      

 

VAR #

 

 

8001        J1.    The next questions are about your health.  In general, how satisfied are you with  your health‑‑completely, very,

somewhat, not very, or not at all satisfied?           

 

1.  COMPLETELY SATISFIED

2.  VERY SATISFIED

3.  SOMEWHAT SATISFIED

4.  NOT VERY SATISFIED

5.  NOT AT ALL SATISFIED

 

8.  DK

9.  NA

 

 

 

J2.    We'd like to know if you have experienced any of the following health problems during the last 6 months.

 

8002        J2a.   Have you had arthritis or rheumatism?   

 

1.  YES            ┌──────────────┐

5.  NO                                   USE SAME CODE

                                         FOR V8003-8009

8.  DK            └──────────────┘

9.  NA

 

 

 

8003        J2b.   During the last 6 months, have you had a lung disease? 

 

 

8004        J2c.   Have you had hypertension, sometimes called high blood

pressure, or have you taken medication for it?         

 

 

8005        J2d.   Have you had a heart attack or other heart trouble during

the last 6 months?                                     

 

 

8006        J2e.   Have you had diabetes or high blood sugar, or have you

taken medication for it?                               

 

 

8007        J2f.   Have you had a stroke during the last 6 months?        

 

 


8008        J2g.   Have you had any broken or fractured bones?            

 

 

8009        J2h.   Have you lost any amount of urine beyond your control

during the last 6 months?                              

 

 

8010        J3.    Have you had cancer or a malignant tumor of any kind, or

have you been treated for it in the past 6 months?     

 

1.  YES

┌──────────────┐

0 in 8011-8013├───5.  NO

└──────────────┤

               ├───8.  DK

               └───9.  NA

 

 

 

8011        J3a.   What kind of cancer or malignant tumor did you have? (In

8012               what part of your body did it start?)                  

8013

01.  "Abdomen"--NFS          33.  Melanoma

02.  Adrenal gland           95.  Metastasized; "all over"

03.  "Arm"--NFS              34.  Mouth; oral

04.  "Back"--NFS             08.  Myeloma (multiple)

05.  Bladder                 35.  "Neck"--NFS

06.  "Blood"--NFS            36.  Nose; nasal

07.  Bone; cartilage         37.  Ovary

08.  Bone marrow             38.  Pancreas; ampulla of

09.  Brain; astrocytoma           Vater

10.  Breast                  39.  "Pelvis"--NFS

11.  Bronchia; bronchus      40.  Penis

12.  Bowel                   41.  Prostate

12.  Rectum

13.  Cervix                  33.  Skin--melanoma; black

12.  Colon                        mole

14.  Ear                     42.  Skin--basal cell

15.  Endometrium             43.  Skin (other or NA which)

16.  Esophagus                    incl. any body part with

17.  "Extremities"--NFS           skin cancer

18.  Eye                     44.  Spine

19.  "Face"--NFS             45.  Spleen

20.  "Female organs"--NFS    46.  Stomach

21.  Gallbladder

22.  Gastrointestinal        47.  Testicles

48.  Throat

23.  "Head"--NFS             49.  Thyroid; goiter on neck

24.  Hip                     50.  Tongue

25.  Hodgkins                51.  Trachea

26.  Jaw                     52.  Urethra/ureter

27.  Kidney; renal           15.  Uterus/womb

28.  Larynx; vocal cords     53.  Vagina

29.  "Leg"--NFS              54.  Vulva; labia

06.  Leukemia    ┌─────────┐

30.  Lip         Make Card├─97.  Other

31.  Liver       └─────────┘

11.  Lung; "chest"--NFS      98.  DK


32.  Lymph nodes/glands;     99.  NA

     "glands behind the

     ear"; "nodes";          00.  Inap, 5, 8-9 in 8010;

     lymphoma (exc. 25)           no further mentions

 

 

 

 

 

8014        J4.    In the past 6 months, have you had any major health

problems that I haven't asked you about?

 

1.  YES

┌──────────────┐

0 in 8015-8017├───5.  NO

└──────────────┤

               ├───8.  DK

               └───9.  NA

 

 

 

8015        J4a.  What are they?                                          

8016

8017               Use HEALTH CONDITION MASTER CODE

 

000.  Inap, 5, 8-9 in 8014; no further mention

 

 

 

8018        J5.    INTERVIEWER CHECKPOINT                  

┌──────────────┐

0 in 8201-8255├───1.  R ANSWERS "NO" TO ALL QUESTIONS IN J2a-h,J3 AND J4

└──────────────┘

2.  ALL OTHERS


 

SECTION J:  HEALTH AND LIMITATION OF ACTIVITIES

 

                                      

VAR #

 

MARK THE BOX NEXT TO ALL PREPRINTED CONDITIONS IN THE GRID TO WHICH R ANSWERED "YES" IN J2a-h,J3 AND J4. IF MORE THAN 5, ASK J6-9a ONLY FOR FIRST 5 CONDITIONS.

 

8201        J5.    SUMMARY                                                

 

Code # of columns filled in for J2a-h, J3a and J4a, including supplement pages, if any (01-14).

┌──────────────┐

0 in 8211-8255├───01.  One

└──────────────┘

┌──────────────┐

0 in 8220-8255├───02.  Two

└──────────────┘

┌──────────────┐

0 in 8229-8255├───03.  Three

└──────────────┘

┌──────────────┐

0 in 8238-8255├───04.  Four

└──────────────┘

┌──────────────┐

0 in 8247-8255├───05.  Five

└──────────────┘

06.  Six

  .

  .

  .

14.  Fourteen

 

99.  NA (see Supervisor before using)

 

00.  Inap, 1 in 8018


┌────────────────────────────────────────────────────────────┐

NOTE:  The name of a "SPECIFY" condition must be matched to

its order of mention at J4a (p.43).  E.g., if "gout" was the

3rd condition coded at J4a, and it appears as a "SPECIFY" on

a supplement page, the code for condition type is 13.      

└────────────────────────────────────────────────────────────┘

 

8202(#1)           CONDITION TYPE (from top of column)                    

8211(#2)

8220(#3)           01.   (J2a) ARTHRITIS/RHEUMATISM

8229(#4)           02.   (J2b) LUNG DISEASE

8238(#5)           03.   (J2c) HYPERTENSION/HIGH BLOOD PRESSURE

8247(#6)           04.   (J2d) HEART TROUBLE

05.   (J2e) DIABETES/HIGH BLOOD SUGAR

06.   (J2f) STROKE

07.   (J2g) BROKEN OR FRACTURED BONES

08.   (J2h) LOSS OF URINE BEYOND CONTROL

09.   (J3a) CANCER

 

11.   (J4a) SPECIFY--1st mention at J4a, p.43

12.   (J4b) SPECIFY--2nd mention at J4a, p.43

13.   (J4c) SPECIFY--3rd mention at J4a, p.43

 

 

00.   Inap, 1 in 8018; no further conditions

 

 

 

8203(#1)    J6.    Were you hospitalized during the last 6 months for

8212(#2)           (CONDITION)?                                           

8221(#3)

8230(#4)           1.  YES

8239(#5)           5.  NO

8248(#6)

8.  DK

9.  NA

 

0.  Inap, 1 in 8018; no further conditions

 

 

 

8204(#1)    J7.    Did (CONDITION) start in the last 12 months or was it

8213(#2)           going on before that?                                  

8222(#3)  ┌─────────┐

8231(#4)  0 in J8  ├───1.  STARTED IN LAST 6 MONTHS

8240(#5)  for this

8249(#6)  condition

          └─────────┘

          ┌─────────┐

          0 in next├───2.  GOING ON BEFORE

          2 vars  

          └─────────┼───8.  DK

                    └───9.  NA

 

     0.  Inap, 1 in 8018; no further conditions

 

 

 


 

8205(#1)    J7a.   In what month did it start? (RECORD YEAR, ALSO.)--MONTH

8214(#2)

8223(#3)           Code MONTH (01-12)

8232(#4)

8241(#5)           98.  DK

8250(#6)           99.  NA

 

00.  Inap, 1 in 8018; 2, 8-9 in J7 for this condition;

     no further conditions

 

 

 

8206(#1)    J7a.   In what month did it start? (RECORD YEAR, ALSO.)--YEAR 

8215(#2)

8224(#3)           Code YEAR (1987-1995)

8233(#4)

8242(#5)           9998.  DK

8251(#6)           9999.  NA

 

0000.  Inap, 1 in 8018; 2, 8-9 in J7 for this condition;

       no further conditions

 

 

 

8207(#1)    J8.    In the past 12 months, has your (CONDITION) become better,

8216(#2)           stayed about the same, or become worse?                

8225(#3)

8234(#4)           1.  BETTER

8243(#5)           2.  SAME

8252(#6)           3.  WORSE

 

8.  DK

9.  NA

 

0.  Inap, 1 in 8018; 1 in J7 for this condition;

    no further conditions

 

 

 

[BUILD = 0 for the following vars:  8208-8210

                       8217-8219

                       8226-8228

                       8235-8237

                       8244-8246

                       8253-8255]


 

                                      

SECTION J:  HEALTH AND LIMITATION OF ACTIVITIES

 

 

VAR #

 

 

8301        J10.   Are you currently in bed or in a chair for most or all of

the day because of your health?                        

 

1.  YES

5.  NO

 

9.  NA

 

 

 

8302        J11.   Do you currently have any difficulty bathing by yourself?

 

1.  YES

┌─────────┐

0 in 8303├────────5.  NO

└─────────┤

          └────────9.  NA

          

 

 

8303        J11a.  How much difficulty do you have bathing by yourself--a

little, some, a lot, or can't you do this on your own? 

 

1.  A LITTLE

2.  SOME

┌──────────────┐

0 in 8304-8311├───3.  A LOT

└──────────────┴───4.  CANNOT DO

 

8.  DK

9.  NA

 

0.  Inap, 5 or 9 in 8302

 

 

 

8304        J12.   INTERVIEWER CHECKPOINT                                 

┌──────────────┐

0 in 8305-8311├───1.  R ANSWERED "YES" (BOX WITH DOUBLE LINE) TO J10

└──────────────┘

                   2.  ALL OTHERS

 

0.  Inap, 3-4 in 8303

 

 

 

 

 

 

 


 

8305        J13.   Do you currently have any difficulty climbing a few

flights of stairs because of your health?              

 

1.  YES

3.  VOLUNTEERED: AGE IS ONLY LIMITATION

┌─────────┐

0 in 8306├────────5.  NO

└─────────┤

          ├────────8.  DK

          └────────9.  NA

 

0.  Inap, 3-4 in 8303; 1 in 8304

 

 

 

8306        J13a.  How much difficulty do you have--a little, some, a lot, or

can't you do this at all?                              

 

1.  A LITTLE

2.  SOME

3.  A LOT

4.  CANNOT DO

 

8.  DK

9.  NA

 

0.  Inap, 3-4 in 8303; 1 in 8304; 5, 8-9 in 8305

 

 

 

8307        J14.   Do you currently have any difficulty walking several

blocks because of your health?                         

 

1.  YES

3.  VOLUNTEERED: AGE IS ONLY LIMITATION

┌─────────┐

0 in 8308├────────5.  NO

└─────────┤

          ├────────8.  DK

          └────────9.  NA

 

0.  Inap, 3-4 in 8303; 1 in 8304

 

 

 

8308        J14a.  How much difficulty do you have--a little, some, a lot, or

can't you do this at all?                              

 

1.  A LITTLE

2.  SOME

3.  A LOT

4.  CANNOT DO

 

8.  DK

9.  NA

 


0.  Inap, 3-4 in 8303; 1 in 8304; 5, 8-9 in 8307

 

 

 

8309        J15.   INTERVIEWER CHECKPOINT                                 

┌──────────────┐

0 in 8310-8311├───1.  R ANSWERED "A LOT" OR "CANNOT DO" (BOXES WITH DOUBLE

└──────────────┘       LINES) TO EITHER J13a OR J14a

 

2.  ALL OTHERS

 

0.  Inap, 3-4 in 8303; 1 in 8304

 

 

 

8310        J16.   Would you currently have any difficulty doing heavy work around the house such as shoveling snow or washing walls,

because of your health?                                

 

1.  YES

3.  VOLUNTEERED: AGE IS ONLY LIMITATION

┌─────────┐

0 in 8311├────────5.  NO

└─────────┤

          ├────────8.  DK

          └────────9.  NA

 

0.  Inap, 3-4 in 8303; 1 in 8304 or 8309

 

 

 

8311        J16a.  How much difficulty would you have--a little, some, a lot,

or couldn't you do this at all?                        

 

1.  A LITTLE

2.  SOME

3.  A LOT

4.  COULD NOT DO

 

8.  DK

9.  NA

 

0.  Inap, 3-4 in 8303; 1 in 8304 or 8309; 5, 8-9 in 8310

 

 

 

8312        J17.   How would you rate your health at the present time?  Would

you say it is excellent, very good, good, fair, or poor?      

 

1.  EXCELLENT

2.  VERY GOOD

3.  GOOD

4.  FAIR

5.  POOR

 

8.  DK

9.  NA


 

 

 

 

 

 

8313        J18.   How much are your daily activities limited in any way by your health or health-related problems--a great deal,

quite a bit, some, a little, or not at all?            

 

1.  A GREAT DEAL

2.  QUITE A BIT

3.  SOME

4.  A LITTLE

5.  NOT AT ALL

 

8.  DK

9.  NA

 

 

 

8314        J19.   Have you taken any non-prescription medications in the

last 30 days to help you sleep?                        

 

1.  YES

┌─────────┐

0 in 8315├────────5.  NO

└─────────┤  

          ├────────8.  DK

          └────────9.  NA

 

 

 

8315        J19a.  On how many days out of the past 30 did you take non-

prescription medication to help you sleep?             

 

Code DAYS (01-30)

 

98.  DK

99.  NA

 

00.  Inap, 5, 8-9 in 8314

 

 

 

8316        J20.   (RB, P. 25)  The next questions are about prescription-type medications taken with or without a doctor's prescription.  Here is a list of medications people sometimes take to help them sleep or stay calm during the day.  Are you taking any of these medications now?  [LISTED IN RB:  AMYTAL, AMOBARBITAL, BARBITURATE, BUTICAP, BUTISOL, CHLORAL HYDRATE, DALMANE, DORIDEN, HALCION, MEBARAL, METHAQUALONE, NEMBUTAL, NOLUDAR, PENTOBARBITAL, PHENOBARBITAL, PLACIDYL, QUAALUDE, RESTORIL, SECOBARBITAL,

SECONAL, SOPOR, TUINAL]                                

┌─────────┐

0 in 8318├────────1.  YES


└─────────┘

┌─────────┐

0 in 8317├────────5.  NO

└─────────┤  

          ├────────8.  DK

          └────────9.  NA

 

 

 

8317        J20a.  (RB, STILL ON P. 25)  On how many days out of the past 30

did you take any of these medications at least once?   

 

Code DAYS (01-30)

 

98.  DK

99.  NA

 

00.  Inap, 5, 8-9 in 8316

 

 

 

8318        J20b.  (RB, STILL ON P. 25)  Have you taken any of these

medications at any time since your (husband/wife's) death?

 

1.  YES

5.  NO

 

8.  DK

9.  NA

 

0.  Inap, 1 in 8316

 

 

 

8319        J21.   (RB, STILL ON P. 25)  Did you ever take any of these

medications before your (husband/wife's) death?        

 

1.  YES

5.  NO

 

8.  DK

9.  NA

 

 

 

8320        J22.   (RB, P. 26)  Here is a list of medications people sometimes take to help them relax their muscles or calm down.  They are sometimes called "nerve pills."  Are you taking any of these medications now?  [LISTED IN RB:  ATARAX, ATIVAN, BUSPAR, CENTRAX, DEPROL, DIAZEPAM, DURAX, EQUANIL, LIBRIUM, LIMBITROL, MENRIUM, MEPROBAMATE, MILTOWN, PAXIPAM, SERAX, SK-LYGEN, TRANXENE, VALIUM,

VISTARIL, XANAX]                                       

┌─────────┐

0 in 8322├────────1.  YES

└─────────┘

┌─────────┐

0 in 8321├────────5.  NO


└─────────┤  

          ├────────8.  DK

          └────────9.  NA

 

 

 

 

 

 

 

 

8321        J22a.  (RB, STILL ON P. 26)  On how many days out of the past 30

did you take any of these medications at least once?   

 

Code DAYS (01-30)

 

98.  DK

99.  NA

 

00.  Inap, 5, 8-9 in 8320

 

 

 

8322        J22b.  (RB, STILL ON P. 26)  Have you taken any of these

medications at any time since your (husband/wife's) death?

 

1.  YES

5.  NO

 

8.  DK

9.  NA

 

0.  Inap, 1 in 8320

 

 

 

8323        J23.   (RB, STILL ON P. 26)  Did you ever take any of these

medications before your (husband/wife's) death?        

 

1.  YES

5.  NO

 

8.  DK

9.  NA

 

 

 

8324        J24.   (RB, P. 27)  Here is a list of medications people sometimes take to help them relieve feelings of depression or sadness.  Are you taking any of these medications now?

[LISTED IN RB:  PAMELOR, PROZAC, TRAZADONE]            

┌─────────┐

0 in 8326├────────1.  YES

└─────────┘

┌─────────┐

0 in 8325├────────5.  NO

└─────────┤  

          ├────────8.  DK


          └────────9.  NA

 

 

 

8325        J24a.  (RB, STILL ON P. 27)  On how many days out of the past 30

did you take any of these medications at least once?   

 

Code DAYS (01-30)

 

98.  DK

99.  NA

 

00.  Inap, 5, 8-9 in 8324

 

8326        J24b.  (RB, STILL ON P. 27)  Have you taken any of these

medications at any time since your (husband/wife's) death?

 

1.  YES

5.  NO

 

8.  DK

9.  NA

 

0.  Inap, 1 in 8324

 

 

 

8327        J25.   (RB, STILL ON P. 27)  Did you ever take any of these

medications before your (husband/wife's) death?        

 

1.  YES

5.  NO

 

8.  DK

9.  NA

 

 

 

 

 

 


8328        J26.   How many hours of sleep do you usually get in a 24-hour

period, including naps?                                

 

Code number of HOURS (01-16)

 

98.  DK

99.  NA

 

 

 

8329        J27.   About how much do you weigh?            

 

Code number of POUNDS (060-399)

 

998.  DK

999.  NA

 

 

 

8330        J28.   Do you smoke cigarettes now?                           

 

1.  YES

┌─────────┐

0 in 8331├────────5.  NO

└─────────┤

          └────────9.  NA

 

 

 

8331        J28a.  On the average, how many cigarettes or packs do you

usually smoke in a day?                                

 

Code number of CIGARETTES (01-95)            ┌───────────────┐

                                         Convert #     

95.  95 or more                          packs: 1 pack 

                                         = 20 cigarettes

98.  DK            └───────────────┘

99.  NA

 

00.  Inap, 5 or 9 in 8330

 

 

 

8332        J29.   (RB, P. 28)  How often does someone remind or tell you to do things to protect your health?  Would you say often,

sometimes, rarely or never?                            

 

1.  OFTEN

2.  SOMETIMES

3.  RARELY

┌──────────────┐

0 in 8333-8338├───4.  NEVER

└──────────────┤

               ├───8.  DK

               └───9.  NA

 

 


J29a.  Who reminds you?  (CHECK ALL THAT APPLY)

 

8333        J29a.  A. CHILD                                               

 

1.  Checked            ┌──────────────┐

5.  Not checked                          USE SAME CODE

                                         FOR V8334-8338

9.  NA to entire question             └──────────────┘

 

0.  Inap, 4, 8-9 in 8332

 

 

 

8334        J29a.  B. OTHER RELATIVE                                      

 

8335        J29a.  C. FRIEND OR NEIGHBOR                                  

 

8336        J29a.  D. PROFESSIONAL                                        

 

8337        J29a.  E. OTHER(S)                                            

 

8338        J29a.  F. SPOUSE                                              

 

 

 

 

8339        J30.   (RB, STILL ON P. 28)  How often do you take walks for exercise or pleasure?  (Would you say often, sometimes,

rarely or never?)                                      

 

1.  OFTEN

2.  SOMETIMES

3.  RARELY

┌──────────────┐

0 in 8340-8346├───4.  NEVER

└──────────────┤

               ├───8.  DK

               └───9.  NA

 

 

 

8340        J31.   (RB, STILL ON P. 28)  How often do you take walks or get any kind of exercise with a pet or with someone you know

--(often, sometimes, rarely or never)?                 

 

1.  OFTEN

2.  SOMETIMES

3.  RARELY

┌──────────────┐

0 in 8341-8346├───4.  NEVER

└──────────────┤

               ├───8.  DK

               └───9.  NA


0.  Inap, 4, 8-9 in 8339

 

 

 

 

 

 

 

J31a.  Who do you take walks or exercise with?  (CHECK ALL THAT APPLY)

8341        J31a.  A. CHILD                                               

 

1.  Checked            ┌──────────────┐

5.  Not checked                          USE SAME CODE

                                         FOR V8342-8346

9.  NA to entire question             └──────────────┘

 

0.  Inap, 4, 8-9 in 8339 or 8340

 

 

 

8342        J31a.  B. OTHER RELATIVE                                      

 

8343        J31a.  C. FRIEND OR NEIGHBOR                                  

 

8344        J31a.  D. PET                                                 

 

8345        J31a.  E. OTHER(S)                                            

 

8346        J31a.  F. SPOUSE                                              

 

 

 

8347        J32.   (RB, STILL ON P. 28)  How often do you participate in active sports or exercise--(often, sometimes, rarely or

never)?                                                

 

1.  OFTEN

2.  SOMETIMES

3.  RARELY

4.  NEVER

 

8.  DK

9.  NA

 

 

 

8348        J33.   Do you have to take medications regularly, eat a special diet for health reasons, or use other health care

treatments at home on a regular basis?                 

 

1.  YES

┌──────────────┐


0 in 8349-8355├───5.  NO

└──────────────┤

               ├───8.  DK

               └───9.  NA

 

 

 

 

 

 

 

 

 

 

 

 

8349        J33a.  (RB, STILL ON P. 28) How often does someone else help you do this?  (Would you say often, sometimes, rarely, or

never?)                                                

 

1.  OFTEN

2.  SOMETIMES

3.  RARELY

┌──────────────┐

0 in 8350-8355├───4.  NEVER

└──────────────┤

               ├───8.  DK

               └───9.  NA

 

0.  Inap, 5, 8-9 in 8348

 

 

 

J33b.  Who helps you do this?   (CHECK ALL THAT APPLY)

8350        J33b.  A. CHILD                                               

 

1.  Checked            ┌──────────────┐

5.  Not checked                          USE SAME CODE

                                         FOR V8351-8355

9.  NA to entire question             └──────────────┘

 

0.  Inap, 5, 8-9 in 8348; 4, 8-9 in 8349

 

 

 

8351        J33b.  B. OTHER RELATIVE                                      

 

8352        J33b.  C. FRIEND OR NEIGHBOR                                  

 

8353        J33b.  D. VOLUNTEER AGENCY                                    

 

8354        J33b.  E. OTHER(S)                                            

 

8355        J33b.  F. SPOUSE                                              


 


 

 

SECTION J:  HEALTH AND LIMITATION OF ACTIVITIES

 

 

VAR #

 

 

8401        J34.   Does anyone come into your home on a regular basis to help you with such things as bathing, getting dressed, or

eating your food?                                      

 

1.  YES

┌──────────────┐

0 in 8402-8407├───5.  NO

└──────────────┤  

               ├───8.  DK

               └───9.  NA

 

 

 

J34a.  Who helps you?  (CHECK ALL THAT APPLY)

8402        J24a.  A. FRIEND                                              

 

1.  Checked            ┌──────────────┐

5.  Not checked                          USE SAME CODE

                                         FOR V8403-8405

9.  NA to entire question            └──────────────┘

 

0.  Inap, 5, 8-9 in 8401

 

 

 

8403        J24a.  B. RELATIVE                                            

 

8404        J24a.  C. VOLUNTEER SERVICE                                   

 

8405        J24a.  D. PAID SERVICE                                        

 

 

 

8406        J34b.  How many days per week does (this person/these people)

come into your home?                                   

 

Code # of days/week (1-7) except:

 

1.  One day/week or less often

 

8.  DK

9.  NA

 

0.  Inap, 5, 8-9 in 8401

 

 

 


 

 

 

 

8407        J34c.  How may hours per day do they usually stay?            

 

Code # of hours/day (01-24) except:

 

01.  One hour or less

 

98.  DK

99.  NA

 

00.  Inap, 5, 8-9 in 8401

 

 

 

8408        J35.   [ASK IF NECESSARY, BUT MARK BOX]  Have you ever been in a

nursing home?                                          

 

1.  YES

 

3.  CURRENTLY IN NURSING HOME

┌──────────────┐

0 in 8409-8417├───5.  NO

└──────────────┤  

               ├───8.  DK

               └───9.  NA

 

 

8409        J35a.  In what month and year did you enter a nursing home most

recently?--MONTH                                       

 

Code MONTH (01-12)</