Table A1 Socio-demographic questionnaire
Sex | â–¡ Male â–¡ Female | |
Age | ____ years | |
Education | □ No schooling completed □ Some primary schooling □ Completed primary school □ Some secondary schooling □ Completed secondary school □ Diploma, advanced diploma, associate degree or equivalent □ Bachelor’s degree □ Master’s degree □ Doctoral degree □ Other (please specify): _____________ | |
Living status | â–¡ Live alone â–¡ Live with family â–¡ Other (please specify): _____________ | |
Perceived health status | 1 – Very strongly disagree 2 – Strongly disagree 3 – Disagree 4 – Neutral 5 – Agree 6 – Strongly agree 7 – Very strongly agree | |
You feel very healthy and great about yourself. | 1 2 3 4 5 6 7 | |
Your health is excellent. | 1 2 3 4 5 6 7 | |
Types and duration of diagnosed chronic illnesses | â–¡ Diabetes | Duration since diagnosis: ____ years ____ months |
â–¡ Hypertension | Duration since diagnosis: ____ years ____ months | |