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When? |
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Where? |
(IP) |
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(IP) |
(IP) |
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(IP) |
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Questionnaire |
Geriatric Examination pp. 29, 30, 40-46 |
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Geriatric Examination pp. 18, 19, 23-24 |
Geriatric Examination pp. 18, 19, 23-24 |
Dentistry Interview pp. 5, 6 |
Dentistry Interview pp. 5, 6 |
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SIR Data bank |
Medici rec/table 1 (I1ana1) rec/table 2 (I1ana2) rec/table 3 (I1vorerk) rec/table 4 (I1krank) rec/table 6 (I1fraktu) rec/table 14 (I1op) |
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Medici rec/table 201 (I2ana1) rec/table 202 (I2ana2) rec/table 204 (I3krank) |
Medici rec/table 301 (I3ana1) rec/table 302 (I3ana2) rec/table 304 (I4krank) |
Medici rec/table 427 (d5zahnin) |
Medici rec/table 527 (d6zahnin) |
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Literature: Linden, Gilberg, Horgas, & Steinhagen-Thiessen (1996; 1999); Maas, Borchelt, & Mayer (1996; 1999); Steinhagen-Thiessen & Borchelt (1996; 1999).
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Time 1 |
Time 3 |
Time 4 |
Time 5 |
Time 6 |
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1. |
Hatten Sie in den letzten 6 Wochen eine fieberhafte Erkrankung? 1 = ja |
Have you had an illness accompanied by fever in the last 6 weeks? 1 = yes |
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2. |
Was war das für eine Erkrankung? (ICD) |
What kind of disease was it? (ICD) |
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3. |
Leiden Sie zur Zeit unter irgendwelchen Krankheiten oder Behinderungen? 1 = ja |
Do you currently suffer from any kind of illness or disability? 1 = yes |
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4. |
An welchen Krankheiten oder Behinderungen leiden Sie zur Zeit? (ICD) |
What diseases or disabilities do you suffer from? (ICD) |
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5. |
Seit wann leiden Sie darunter? |
How long have you had this condition? |
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Monat |
Month |
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Year |
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6. |
ST z.Zt. im Krankenhaus? 1 = ja |
Participant currently hospitalized? 1 = yes |
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7. |
Waren Sie in den letzten 12 Monaten (über Nacht) in einem Krankenhaus? 1 = ja |
Have you been in hospital within the last 12 months (over night)? 1 = yes |
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Waren Sie in den letzten 12 Monaten (über Nacht) in einem Krankenhaus? 1 = ja |
Have you been in hospital within the last 12 months (over night)? 1 = yes |
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8. |
Wann waren Sie da letzte Mal (über Nacht) in einem Krankenhaus? |
When was the last time you were in the hospital (over night)? |
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Monat |
Month |
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Jahr |
Year |
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vor ca. __ Jahren __ Monaten 888 = weiß ich nicht |
approx. __ years __ months ago 888 = I don't know |
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9. |
Wie oft waren Sie in den letzten 12 Monaten (über Nacht) im Krankenhaus? |
How often have you been hospitalized within the last 12 months (overnight)? |
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Wie oft waren Sie in den letzten 12 Monaten (über Nacht) im Krankenhaus? 1 = 1x |
How often have you been hospitalized within the last 12 months (overnight)? 1 = once |
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10. |
Wie lange waren Sie das letzte Mal (über Nacht) in einem Krankenhaus? (Tage) |
How long was the last time you have been hospitalized (overnight)? (days) |
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Wie lange waren Sie das letzte Mal (über Nacht) in einem Krankenhaus? __ Tage 888 = weiß ich nicht |
How long was the last time you have been hospitalized (overnight)? __ days 888 = I don't know |
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11. |
Warum waren Sie zuletzt im Krankenhaus? |
Why have you been hospitalized the last time? |
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12. |
Wie oft waren Sie in den letzten drei Monaten bei Ihrem Hausarzt? __ pro Woche |
How often have you been to see your physician? __ per week |
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13. |
Bei welchen Fachärzten waren Sie im letzten halben Jahr? |
Which specialists did you see within the last half year? |
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Facharzt #1 |
specialist #1 |
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Facharzt #2 |
specialist #2 |
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Facharzt #3 |
specialist #3 |
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14. |
Haben Sie in Ihrem Leben jemals irgendwelche Knochenbrüche erlitten ? 1 = ja |
Have you ever suffered a broken bone? 1 = yes |
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15. |
Welche Knochen haben Sie sich schon einmal gebrochen? (ICD) |
Which bones have you broken? (ICD) |
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16. |
Wann war das? |
When was that? |
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Monat |
Month |
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Jahr |
Year |
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17. |
Nachträglich: Trauma ausreichend? 1 = ja |
Subsequently: Trauma sufficient? 1 = yes |
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18. |
Hatten Sie in Ihrem Leben irgendwelche Operationen? 1 = ja |
Have you ever had an operation of any kind? 1 = yes |
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19. |
Was für Operationen waren das? (ICD) |
What kind of operation was it? (ICD) |
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20. |
Wann war diese Operation? |
When was this operation carried out? |
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Monat |
Month |
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Jahr |
Year |
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21. |
Haben Sie in Ihrem Leben jemals einen Schlaganfall erlitten? 1 = ja Wenn mehrmals, wie viele Schlaganfälle haben sie erlitten? |
Have you ever suffered a stroke? 1 = yes If more than one, how many ? |
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22. |
Wann war das (bei mehreren: der letzte)? |
When did it occur (the last, if more than one)? |
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Monat |
Month |
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Jahr |
Year |
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23. |
Wann hatten Sie den ersten Schlaganfall? |
When did you have your first stroke? |
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Monat |
Month |
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Jahr |
Year |
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24. |
Haben Sie in Ihrem Leben jemals einen Herzinfarkt erlitten? 1 = ja Wenn mehrmals, wie viele Herzinfarkte haben sie erlitten? |
Have you ever suffered a heart attack? 1 = yes If more than one, how many ? |
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25. |
Wann war das (bei mehreren: der letzte)? |
When did it occur (the last, if more than one)? |
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Monat |
Month |
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Jahr |
Year |
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26. |
Wann hatten Sie den ersten Herzinfarkt? |
When did you have your first heart attack? |
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Monat |
Month |
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Jahr |
Year |
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27. |
Haben Sie jemals eine Tuberkulose durchgemacht? 1 = ja |
Have you ever had Tuberculosis? 1 = yes |
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28. |
Wann war das? (wenn häufiger: das letzte Mal?) |
When was that? (the last, if more than once)? |
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Monat |
Month |
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Jahr |
Year |
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29. |
Haben Sie in Ihrem Leben noch irgendwelche Krankheiten durchgemacht? 1 = ja |
Have you ever had any other kind of disease? 1 = yes |
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