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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[ ]
7.
Yes
No
(continue)
(skip to question #11)
How long were you sick?
CHECK CATEGORY
1-3 days
4-7 days
8-14 days
15 or more days
8.
Is that the only time you were seriously sick?
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Could you tell me how you felt when you were last sick?
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CHECK SYMPTOMS AS THEY TALK. DON'T PROBE TOO DEEPLY BUT ENCOUNAGE THEM TO
TALK FREELY. AFTER EACH RESPONSE SAY: "CAN YOU REMEMBER
ING ELSE?”
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Vm
9.
Yes
No (please specify)
Blurry vision
Fever (hot feeling)
Gain or loss of weight (more or less than 10 pounds in on@
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)
Other (please specify)
month)