Non-Communicable Diseases: Risk Factors and other Health Problems 345 57 QUESTIONNAIRE National Health And Morbidity Survey 2019 Institute for Public Health Ministry of Health Malaysia MODUL CU3: PEMERIKSAAN BIOKIMIA / BIOCHEMISTRY TEST KRITERIA KELAYAKAN: RESPONDEN BERUMUR 18 TAHUN DAN KE ATAS ELIGIBILITY CRITERIA: RESPONDENTS AGED 18 YEARS AND ABOVE CU301 Dalam tempoh 8 jam yang lepas, adakah anda makan dan minum selain dari air kosong? During the past 8 hours have you had anything to eat or drink, other than water?
- Ya / Yes
- Tidak / No CU302 Paras glukosa kapilari Capillary blood glucose level . mmol/L (-9) Enggan diperiksa Refuse to be examined CU303 Bacaan paras kolestrol Blood cholesterol level measurement . mmol/L (-9) Enggan diperiksa Refuse to be examined MODUL CU4: ANAEMIA: PEMERIKSAAN HEMOGLOBIN / HAEMOGLOBIN TEST KRITERIA KELAYAKAN: RESPONDEN BERUMUR 15 TAHUN DAN KE ATAS ELIGIBILITY CRITERIA: RESPONDENTS AGED 15 YEARS AND ABOVE CU401 Bacaan Hemoglobin Haemoglobin readings . g/dl (-9) Enggan diperiksa Refuse to be examined Questionnaire
National Health and Morbidity Survey 2019 Technical Report − Volume I 346 95 QUESTIONNAIRE National Health And Morbidity Survey 2019 Institute for Public Health Ministry of Health Malaysia MODUL CL: KESIHATAN MENTAL KANAK-KANAK KRITERIA KELAYAKAN: AHLI ISIRUMAH BERUMUR 5-15 TAHUN Soal Selidik Kekuatan Dan Kesusahan (SDQ-Mall) Bagi setiap perkara dibawah, sila tandakan petak Tidak Benar, Sedikit Benar, atau Memang Benar. Anda boleh membantu kami jika anda dapat menjawab semua perkara sebaik-baiknya yang boleh walaupun anda tidak pasti atau perkara itu nampak bodoh. Sila beri jawapan anda berasaskan kelakuan kanak-kanak itu dalam masa sebulan yang lalu. Nama Kanak-Kanak Tarikh Lahir Jantina Tarikh Bulan Tahun Lelaki Perempuan Tidak Benar Sedikit Benar Memang Benar Bertimbang rasa terhadap perasaan orang lain. Gelisah, terlalu aktif, tidak dapat diam untuk masa yang panjang. Selalu mengadu sakit kepala, sakit perut, atau berpenyakit. Sedia berkongsi dengan kanak lain (belanja, permainan, pensil). Selalu naik marah atau pemarah. Bersendirian, lebih suka bermain seorang diri. Biasanya taat, melakukan apa yang dikehendaki oleh orang dewasa. Banyak kebimbangan, selalu nampak bimbang. Suka menolong jika seseorang cedera, rasa terganggu atau tidak sihat. Sentiasa bergerak dengan resah atau mengeliat-geliat. Ada sekurang-kurangnya seorang kawan baik. Selalu bergaduh dengan kanak-kanak lain atau membuli mereka. Appendix 7
Non-Communicable Diseases: Risk Factors and other Health Problems 347 96 BORANG SOAL SELIDIK Tinjauan Kebangsaan Kesihatan Dan Morbiditi 2019 Institut Kesihatan Umum Kementerian Kesihatan Malaysia Selalu tidak gembira. Susah hati atau menangis. Biasanya disukai oleh kanak-kanak lain. Mudah mengalih perhatian, penumpuan melayang-layang. Gelisah atau lekat dengan orang dalam situasi baru, mudah hilang keyakinan. Baik kepada kanak-kanak yang lebih muda. Selalu berbohong atau menipu. Dibuli oleh kanak-kanak lain. Menawarkan secara sukarela pertolongan kepada orang lain (ibu bapa, guru, kanak- kanak lain). Berfikir sebelum bertindak. Mencuri daripada rumah, sekolah atau lain-lain tempat. Mudah berbaik-baik dengan orang dewasa daripada kanak-kanak. Banyak ketakutan, mudah takut. Membuat tugas dari awal hingga ke akhir, jangka masa perhatian baik. Questionnaire
National Health and Morbidity Survey 2019 Technical Report − Volume I 348 97 QUESTIONNAIRE National Health And Morbidity Survey 2019 Institute for Public Health Ministry of Health Malaysia MODULE CL: CHILDREN’S MENTAL HEALTH ELIGIBILITY CRITERIA: MEMBER OF THE HOUSEHOLD AGED 5-15 YEARS Strengths and Difficulties Questionnaire (SDQ-Mall) For each item, please mark the box for Not True, Somewhat True or Certainly True. It would help us if you answered all items as best you can even if you are not absolutely certain or the item seems daft. Please give your answers on the basis of the child’s behaviour over the last six months. Children’s Name Date of Birth Gender Date Month Year Male Female Not True Somewhat True Certainly True Considerate of each people’s feelings. Restless, overactive, cannot stay still for long. Often complaints of headaches, stomach-aches or sickness. Shares readily with other children (treats, toys, pencils etc). Often has temper tantrums or hot tempers. Rather solitary, tends to play alone. Generally obedient, usually does what adults request. Many worries, often seems worried. Helpful if someone is hurt, upset or feeling ill. Constantly fidgeting or squirming. Has at least one good friend. Often fights with other children or bullies them. Appendix 7
Non-Communicable Diseases: Risk Factors and other Health Problems 349 98 BORANG SOAL SELIDIK Tinjauan Kebangsaan Kesihatan Dan Morbiditi 2019 Institut Kesihatan Umum Kementerian Kesihatan Malaysia Often unhappy, down-hearted or tearful. Generally liked by other children. Easily distracted, concentration wanders. Nervous or clingy in new situations, easily loses confidence. Kind to younger children. Often lies or cheats. Picked on bullied by other children. Often volunteers to help others (parents, teachers, other children). Thanks things out before acting. Steals from home, school or elsewhere. Gets on better with adults than with other children. Many fears, easily scared. Sees tasks through to the end, good attention span. Questionnaire
National Health and Morbidity Survey 2019 Technical Report − Volume I 350 99 QUESTIONNAIRE National Health And Morbidity Survey 2019 Institute for Public Health Ministry of Health Malaysia MODUL CM: KEHILANGAN UPAYA / DISABILITY KRITERIA KELAYAKAN: AHLI ISIRUMAH BERUMUR 18 TAHUN DAN KE ATAS ELIGIBILITY CRITERIA: MEMBER OF THE HOUSEHOLD AGED 18 YEARS AND ABOVE Soalan seterusnya merujuk kepada kesukaran yang anda alami semasa melakukan aktiviti-aktiviti tertentu disebabkan oleh MASALAH KESIHATAN. The next questions ask about difficulties you may have doing certain activities because of a HEALTH PROBLEM. CM01 Adakah anda memakai kacamata/kanta lekap? Do you wear glasses/ spectacles / contact lenses?
- Ya / Yes
- Tidak / No (-7) TT (-9) EJ CM01a Adakah anda mengalami kesukaran untuk melihat, (walaupun memakai kacamata/kanta lekap)? Adakah… Do you have difficulty in seeing, (despite wearing glasses/spectacles / contact lenses)? Would you say…
- Tidak Sukar / No Difficulty
- Agak Sukar / Some difficulty
- Sangat Sukar / Lot of difficulty
- Tidak Berupaya / Cannot do at all (-7) TT (-9) EJ CM02 Adakah anda menggunakan alat bantu pendengaran? Do you use a hearing aid?
- Ya / Yes
- Tidak / No (-7) TT (-9) EJ CM02a Adakah anda mendapati sukar untuk mendengar, (walaupun menggunakan alat bantu pendengaran)? Adakah… Do have difficulty in hearing/listening, (despite using hearing aid)? Would you say…
- Tidak Sukar / No Difficulty
- Agak Sukar / Some difficulty
- Sangat Sukar / Lot of difficulty
- Tidak Berupaya / Cannot do at all (-7) TT (-9) EJ CM02b Adakah anda mempunyai masalah untuk mendengar perbualan dengan seseorang di dalm bilik/tempat yang senyap, walaupun dengan memakai alat bantu pendengaran? Adakah… Do you have difficulty hearing what is said in a conversation with one other person in a quiet room even when using hearing aid? Would you say…
- Tidak Sukar / No Difficulty
- Agak Sukar / Some difficulty
- Sangat Sukar / Lot of difficulty
- Tidak Berupaya / Cannot do at all (-7) TT (-9) EJ CM02c Adakah anda mempunyai masalah untuk mendengar perbualan dengan seseorang di dalm bilik/tempat yang bising, walaupun dengan memakai alat bantu pendengaran? Adakah… Do you have difficulty hearing what is said in a conversation with one other person in a noisier room even when using hearing aid? Would you say…
- Tidak Sukar / No Difficulty
- Agak Sukar / Some difficulty
- Sangat Sukar / Lot of difficulty
- Tidak Berupaya / Cannot do at all (-7) TT (-9) EJ CM03 Adakah anda mendapati sukar untuk berjalan atau naik/turun tangga? Adakah… Do have difficulty in walking or going up and down stairs? Would you say…
- Tidak Sukar / No Difficulty
- Agak Sukar / Some difficulty
- Sangat Sukar / Lot of difficulty
- Tidak Berupaya / Cannot do at all (-7) TT (-9) EJ Appendix 7
Non-Communicable Diseases: Risk Factors and other Health Problems 351 100 BORANG SOAL SELIDIK Tinjauan Kebangsaan Kesihatan Dan Morbiditi 2019 Institut Kesihatan Umum Kementerian Kesihatan Malaysia CM03a Adakah anda menggunakan sebarang alat bantuan untuk membantu anda bergerak atau menjaga diri sendiri? Adakah anda menggunakan… Do you use any assistive devices to help you get around or for selfcare? Do you use… (Boleh pilih lebih dari satu / Allow multiple responses)
- Kasut ortopedik /Orthopedic footwear
- Anggota palsu (tangan/kaki) / Artificial limb (leg/foot)
- Tongkat/A cane or walking stick
- Topang/Crutches
- Kerusi roda /A wheelchair
- Alat bantuan berjalan atau skuter / A walker or a scooter
- Pendakap/Braces
- Kenderaan yang diubahsuai / An adapted motor vehicle
- Alatan untuk mudah capai/ Extenders or grasping tools
- Alat bantuan lain/Another aid
- Tidak menggunakan sebarang alat bantuan / Do no use any assistive device CM04 Adakah anda mendapati sukar untuk mengingat atau menumpukan perhatian pada aktiviti harian? Adakah… Do you have any difficulty in remembering or paying attention/ concentrating in your daily activity? Would you say…
- Tidak Sukar / No Difficulty
- Agak Sukar / Some difficulty
- Sangat Sukar / Lot of difficulty
- Tidak Berupaya / Cannot do at all (-7) TT (-9) EJ CM04a Adakah anda menggunakan sebarang alat bantuan untuk membantu anda mengingat atau menumpukan perhatian pada aktiviti harian? Adakah anda menggunakan… Do you use any assistive devices to help you in remembering or paying attention/ concentrating in your daily activity? Do you use… (Boleh pilih lebih dari satu / Allow multiple responses)
- Produk pengurusan masa / Time management product
- Alat perakam / Recorder
- Pembantu digital peribadi / Personal Digital Assistant (PDA)
- Tidak menggunakan sebarang alat bantuan / Do no use any assistive device (-7) TT (-9) EJ CM05 Adakah anda mendapati sukar untuk menjaga diri sendiri (seperti membersihkan diri atau memakai pakaian)? Adakah… Do you have any difficulty in caring for yourself (such as cleaning yourself or wearing clothes)? Would you say…
- Tidak Sukar / No Difficulty
- Agak Sukar / Some difficulty
- Sangat Sukar / Lot of difficulty
- Tidak Berupaya / Cannot do at all (-7) TT (-9) EJ CM05a Adakah anda menggunakan sebarang alat bantuan untuk menjaga diri sendiri (seperti membersihkan diri atau memakai pakaian)? Adakah anda menggunakan… Do you use any assistive devices to help you in caring for yourself (such as cleaning yourself or wearing clothes)? Do you use… (Boleh pilih lebih dari satu / Allow multiple responses)
- Kerusi untuk mandi/ tandas / Chairs for shower or bath/ toilet
- Produk untuk masalah kawalan kencing/berak (contohnya lampin pakaibuang dewasa) / Incontinent products/absorbant (eg.adult pampers)
- Tidak menggunakan sebarang alat bantuan / Do no use any assistive device (-7) TT (-9) EJ Questionnaire
National Health and Morbidity Survey 2019 Technical Report − Volume I 352 101 QUESTIONNAIRE National Health And Morbidity Survey 2019 Institute for Public Health Ministry of Health Malaysia CM06 Adakah anda mendapati sukar untuk berkomunikasi (contohnya memahami atau difahami oleh orang lain) disebabkan keadaan kesihatan fizikal, mental atau emosi? Adakah… Do you have any difficulty in communicating, (such as understanding or being understood by others) due to issues with physical, mental or emotional health? Would you say…
- Tidak Sukar / No Difficulty
- Agak Sukar / Some difficulty
- Sangat Sukar / Lot of difficulty
- Tidak Berupaya / Cannot do at all (-7) TT (-9) EJ CM06a Adakah anda menggunakan sebarang alat bantuan untuk berkomunikasi (contohnya memahami atau difahami oleh orang lain)? Adakah anda menggunakan… Do you use any assistive devices to help you in communicating, (such as understanding or being understood by others)? Do you use… (Boleh pilih lebih dari satu / Allow multiple responses)
- Papan komunikasi/buku/kad Communication boards/books/ cards
- Perisian komunikasi/ Communication software
- Alat komunikasi untuk pekak / buta /Deaf /blind communicators
- Pemainan audio/Audioplayers with DAISY capability
- Paparan Braille/ Braille displays (note taker)
- Teknologi isyarat ke suara / Gesture to voice technology
- Tidak menggunakan sebarang alat bantuan / Do no use any assistive device (-7) TT (-9) EJ Appendix 7
Non-Communicable Diseases: Risk Factors and other Health Problems 353 102 BORANG SOAL SELIDIK Tinjauan Kebangsaan Kesihatan Dan Morbiditi 2019 Institut Kesihatan Umum Kementerian Kesihatan Malaysia MODUL CN1: KEFUNGSIAN KANAK-KANAK (BERUMUR 2 - 4) CHILD FUNCTIONING (AGE 2 - 4) KRITERIA KELAYAKAN: IBUBAPA ATAU PENJAGA YANG MEMPUNYAI ANAK BERUMUR 2 - 4 TAHUN ELIGIBILITY CRITERIA: PARENTS OR GUARDIANS WHO HAVE CHILDREN AGED 2 - 4 YEARS OLD Bulatkan jawapan yang bersesuaian / Please circle the appropriate answer. Soalan seterusnya merujuk kepada kesukaran yang mungkin ada pada anak anda. The next question asks about difficulties your child may have. CN101 Adakah (nama) memakai cermin mata? Does (name) wear glasses?
-
Ya / Yes ... ke soalan CN102
-
Tidak / No ... ke soalan CN103 (-7) TT (-9) EJ CN102 Apabila dia memakai cermin mata, adakah (nama) mengalami kesukaran untuk melihat? When wearing his/ her glasses, does (name) have difficulty seeing?
-
Tiada kesukaran / No difficulty
-
Sedikit kesukaran / Some difficulty
-
Banyak kesukaran / A lot of difficulty
-
Tidak mampu sama sekali / Cannot do at all Ke soalan CN104 (-7) TT (-9) EJ CN103 Adakah (nama) mengalami kesukaran untuk melihat? Does (name) have difficulty seeing?
-
Tiada kesukaran / No difficulty
-
Sedikit kesukaran / Some difficulty
-
Banyak kesukaran / A lot of difficulty
-
Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN104 Adakah (nama) menggunakan alat bantu pendengaran? Does (name) use a hearing aid? [Sila tunjuk kad imbasan/ Please show flashcard]
-
Ya / Yes ... ke soalan CN105
-
Tidak / No ... ke soalan CN106 (-7) TT (-9) EJ CN105 Apabila dia menggunakan alat bantu pendengaran, adakah (nama) mengalami kesukaran mendengar bunyi seperti suara orang atau muzik? When using his/her hearing aid, does (name) have difficulty hearing sounds like peoples’ voices or music?
-
Tiada kesukaran / No difficulty
-
Sedikit kesukaran / Some difficulty
-
Banyak kesukaran / A lot of difficulty
-
Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN106 Adakah (nama) mengalami kesukaran mendengar bunyi seperti suara orang atau muzik? Does (name) have difficulty hearing sounds like peoples’ voices or music?
-
Tiada kesukaran / No difficulty
-
Sedikit kesukaran / Some difficulty
-
Banyak kesukaran / A lot of difficulty
-
Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ Questionnaire