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S:\4. Questionnaire\2014\2014NEWQUESTIONS\ENGLISHNEWQUESTIONS\MSK05Aug2013.wpd
NMS - MUSCULOSKELETAL: [INTERVIEWER: FIRST ASK ALL FIRST COLUMN QUESTIONS]
What type [If NF, ask:] What type of
Did you have this How severe was How long did you How many days did you
During the last 12
pain/discomfort
months [from XXX of last of work
TASK were you doing?
this
work with this
NOT WORK because of
were
you
for
FIVE
(5)
or
year until now (current
pain/discomfort pain/discomfort? this pain/discomfort?
doing
more consecutive
month)], have you had
?
[If FW, ask:] What type of
when this
days?
[SHOW SCALE
pain or discomfort in
TASK and CROP were you
pain/disco
[If “YES”, ask]:
BELOW]
your...
working on?
mfort
How many
began?
days?
NMS (1 TO 6)
NMS1
a.
9 FW
...BACK?
9 0 NO
91
9 NF
...HAND/WRIST/FINGER?
9 0 NO
9 NF
NO
9 1 YES:
90
NMS5
9 FW
...LEGS / FEET / TOES?
9 0 NO
9 NF
“FW”: CROP AND TASK:
NO
9 1 YES:
90
A LITTLE
A LITTLE
92
A LOT
UNBEARABLE
91
A LITTLE
92
A LOT
DAYS 9 3
“FW”: CROP AND TASK:
NO
9 1 YES:
90
UNBEARABLE
91
A LITTLE
92
A LOT
“NF”: OCCUPATION AND INDUSTRY:
DAYS 9 3
“FW”: CROP AND TASK:
NO
9 1 YES:
90
UNBEARABLE
91
A LITTLE
92
A LOT
DAYS 9 3
9 NF
“FW”: CROP AND TASK:
NO
9 1 YES:
90
“NF”: OCCUPATION AND INDUSTRY:
A LOT
UNBEARABLE
91
A LITTLE
92
A LOT
DAYS 9 3
9 NW
YES
91
“NF”: OCCUPATION AND INDUSTRY:
9 FW
...OTHER?
9 0 NO
UNBEARABLE
“NF”: OCCUPATION AND INDUSTRY:
9 NW
NMS6
A LOT
DAYS 9 3
9 NW
YES
92
“NF”: OCCUPATION AND INDUSTRY:
9 FW
91
“FW”: CROP AND TASK:
9 NF
NMS4
YES
c.
A LITTLE
DAYS 9 3
9 NW
YES
91
“NF”: OCCUPATION AND INDUSTRY:
9 FW
...ELBOW / ARM?
9 0 NO
91
NO
YES:
9 NW
YES
NMS3
91
90
91
9 NF
9 FW
...SHOULDER / NECK?
9 0 NO
91
b.
9 NW
YES
NMS2
91
f.
“FW”: CROP AND TASK:
UNBEARABLE
d.
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
e.
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
9 LESS THAN A DAY
9 DAYS:
9 WEEKS:
9 MONTHS:
9 DON’T KNOW
UNBEARABLE
1
| File Type | application/pdf |
| File Title | S:\4. Questionnaire\2014\2014NEWQUESTIONS\ENGLISHNEWQUESTIONS\MSK05Aug2013.wpd |
| Author | jnakamoto |
| File Modified | 2013-09-26 |
| File Created | 2013-08-05 |