Health Needs Assessment of the Marshall Islands - Page 3
6.
Were you sick or hurt very badly during the past year?
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(skip to question #11)
Ser ees
a ol
How long were you sick?
CHECK CATEGORY
1-3 days
4-7 days
8-14 days
15 or more days
Is that the only time you were seriously sick?
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( ]
Yes
No
(please specify)
Could you tell me how you felt when you were last sick?
rer Peso eo ee Pswe sec ee ees ees een es eee ee ese soe
Remora emer five lene emmt fhm) treme Mesvred! Sermmel temreenh femeee fed teed bed freed ed bere beeeed bed bee eed
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CHECK SYMPTOMS AS THEY TALK. DON'T PROBE TOO DEEPLY BUT ENCOURAGE THEM TO
TALK FREELY. AFTER EACH RESPONSE SAY:
"CAN YOU REMEMBER ANYTHING ELSE?"
V—_
8.
(continue)
Blurry vision
Fever (hot feeling)
Gain or loss of weight (more or less than 10 pounds in one month)
deme
7.
Yes
No
Other (please specify)
Shortness of breath
Chest pain
Chills (cold feeling)
Cough that won't go away
Upset stomach
Vomitting
Diarrhea
Abnormal bleeding
Fainting spells
Dizziness
Rash on skin
Abnormal mass
Excessive loss of hair
Excessive urination
Jaundice
Excessive thirst
Sores that won't heal
Other (please specify)