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National Health and Morbidity Survey 2019 Technical Report − Volume I 354 103 QUESTIONNAIRE National Health And Morbidity Survey 2019 Institute for Public Health Ministry of Health Malaysia CN107 Adakah (nama) menggunakan sebarang peralatan atau menerima bantuan untuk berjalan? Does (name) use any equipment or receive assistance for walking?

  1. Ya / Yes ... ke soalan CN108
  2. Tidak / No ... ke soalan CN110 (-7) TT (-9) EJ CN108 Tanpa peralatannya atau bantuan, adakah (nama) mengalami kesukaran untuk berjalan? Without his/her equipment or assistance, does (name) have difficulty walking?
  3. Sedikit kesukaran / Some difficulty
  4. Banyak kesukaran / A lot of difficulty
  5. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN109 Dengan peralatannya atau bantuan, adakah (nama) mengalami kesukaran untuk berjalan? With his/her equipment or assistance, does (name) have difficulty walking?
  6. Tiada kesukaran / No difficulty
  7. Sedikit kesukaran / Some difficulty
  8. Banyak kesukaran / A lot of difficulty
  9. Tidak mampu sama sekali / Cannot do at all Ke soalan CN111 (-7) TT (-9) EJ CN110 Berbanding dengan kanak-kanak yang sama umur, adakah (nama) mengalami kesukaran untuk berjalan? Compared with children of the same age, does (name) have difficulty walking?
  10. Tiada kesukaran / No difficulty
  11. Sedikit kesukaran / Some difficulty
  12. Banyak kesukaran / A lot of difficulty
  13. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN111 Berbanding dengan kanak-kanak yang sama umur, adakah (nama) mengalami kesukaran mengutip objek kecil dengan tangan? Compared with children of the same age, does (name) have difficulty picking up small objects with his/her hand? [Sila tunjuk kad imbasan/ Please show flashcard]
  14. Tiada kesukaran / No difficulty
  15. Sedikit kesukaran / Some difficulty
  16. Banyak kesukaran / A lot of difficulty
  17. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN112 Adakah (nama) mengalami kesukaran untuk memahami anda? Does (name) have difficulty understanding you?
  18. Tiada kesukaran / No difficulty
  19. Sedikit kesukaran / Some difficulty
  20. Banyak kesukaran / A lot of difficulty
  21. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN113 Apabila (nama) bercakap, adakah anda mengalami kesukaran untuk memahaminya? When (name) speaks, do you have difficulty understanding him/her?
  22. Tiada kesukaran / No difficulty
  23. Sedikit kesukaran / Some difficulty
  24. Banyak kesukaran / A lot of difficulty
  25. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ Appendix 7

Non-Communicable Diseases: Risk Factors and other Health Problems 355 104 BORANG SOAL SELIDIK Tinjauan Kebangsaan Kesihatan Dan Morbiditi 2019 Institut Kesihatan Umum Kementerian Kesihatan Malaysia CN114 Berbanding dengan kanak-kanak yang sama umur, adakah (nama) mengalami kesukaran untuk mempelajari sesuatu? Compared with children of the same age, does (name) have difficulty learning things?

  1. Tiada kesukaran / No difficulty
  2. Sedikit kesukaran / Some difficulty
  3. Banyak kesukaran / A lot of difficulty
  4. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN115 Berbanding dengan kanak-kanak yang sama umur, adakah (nama) mengalami kesukaran untuk bermain? Compared with children of the same age, does (name) have difficulty playing?
  5. Tiada kesukaran / No difficulty
  6. Sedikit kesukaran / Some difficulty
  7. Banyak kesukaran / A lot of difficulty
  8. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN116 Berbanding dengan kanak-kanak yang sama umur, berapa banyak (nama) menendang, menggigit atau memukul kanak-kanak atau orang dewasa yang lain? Compared with children of the same age, how much does (name) kick, bite or hit other children or adults?
  9. Tidak sama sekali / Not at all
  10. Sama atau kurang / The same or less
  11. Lebih / More
  12. Lebih banyak / A lot more (-7) TT (-9) EJ

Questionnaire

National Health and Morbidity Survey 2019 Technical Report − Volume I 356 105 QUESTIONNAIRE National Health And Morbidity Survey 2019 Institute for Public Health Ministry of Health Malaysia MODUL CN2: KEFUNGSIAN KANAK-KANAK (BERUMUR 5 - 17) / CHILD FUNCTIONING (AGE 5 - 17) KRITERIA KELAYAKAN: IBUBAPA ATAU PENJAGA YANG MEMPUNYAI ANAK BERUMUR 5 - 17 TAHUN ELIGIBILITY CRITERIA: PARENTS OR GUARDIANS WHO HAVE CHILDREN AGED 5 - 17 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. CN201 Adakah (nama) memakai cermin mata atau kanta lekap? Does (name) wear glasses or contact lenses?

  1. Ya / Yes ... ke soalan CN202
  2. Tidak / No ... ke soalan CN203 (-7) TT (-9) EJ CN202 Apabila memakai cermin mata atau kanta lekap, adakah (nama) mengalami kesukaran untuk melihat? When wearing his/ her glasses or contact lenses, does (name) have difficulty seeing?
  3. Tiada kesukaran / No difficulty
  4. Sedikit kesukaran / Some difficulty
  5. Banyak kesukaran / A lot of difficulty
  6. Tidak mampu sama sekali / Cannot do at all Ke soalan CN204 (-7) TT (-9) EJ CN203 Adakah (nama) mengalami kesukaran untuk melihat? Does (name) have difficulty seeing?
  7. Tiada kesukaran / No difficulty
  8. Sedikit kesukaran / Some difficulty
  9. Banyak kesukaran / A lot of difficulty
  10. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN204 Adakah (nama) menggunakan alat bantu pendengaran? Does (name) use a hearing aid? [Sila tunjuk kad imbasan/ Please show flashcard]
  11. Ya / Yes ... ke soalan CN205
  12. Tidak / No ... ke soalan CN206 (-7) TT (-9) EJ CN205 Apabila dia menggunakan alat bantuan 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?
  13. Tiada kesukaran / No difficulty
  14. Sedikit kesukaran / Some difficulty
  15. Banyak kesukaran / A lot of difficulty
  16. Tidak mampu sama sekali / Cannot do at all Ke soalan CN207 (-7) TT (-9) EJ CN206 Adakah (nama) mengalami kesukaran mendengar bunyi seperti suara orang atau muzik? Does (name) have difficulty hearing sounds like peoples’ voices or music?
  17. Tiada kesukaran / No difficulty
  18. Sedikit kesukaran / Some difficulty
  19. Banyak kesukaran / A lot of difficulty
  20. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ Appendix 7

Non-Communicable Diseases: Risk Factors and other Health Problems 357 106 BORANG SOAL SELIDIK Tinjauan Kebangsaan Kesihatan Dan Morbiditi 2019 Institut Kesihatan Umum Kementerian Kesihatan Malaysia CN207 Adakah (nama) menggunakan sebarang peralatan atau menerima bantuan untuk berjalan? Does (name) use any equipment or receive assistance for walking?

  1. Ya / Yes ... ke soalan CN208

  2. Tidak / No ... ke soalan CN212 (-7) TT (-9) EJ CN208 Tanpa peralatannya atau bantuan, adakah (nama) mengalami kesukaran untuk berjalan 100 ela/meter di tanah rata? Itu adalah lebih kurang panjang sebuah padang bola sepak. Without his/her equipment or assistance, does (name) have difficulty walking 100 yards/meters on level ground? That would be about the length of 1 football field.

  3. Sedikit kesukaran / Some difficulty

  4. Banyak kesukaran / A lot of difficulty

  5. Tidak mampu sama sekali / Cannot do at all Ke soalan CN210 (-7) TT (-9) EJ CN209 Tanpa peralatannya atau bantuan, adakah (nama) mengalami kesukaran untuk berjalan 500 ela/meter di tanah rata? Itu adalah lebih kurang panjang 5 buah padang bola sepak. Without his/her equipment or assistance, does (name) have difficulty walking 500 yards/meters on level ground? That would be about the length of 5 football field.

  6. Sedikit kesukaran / Some difficulty

  7. Banyak kesukaran / A lot of difficulty

  8. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN210 Dengan peralatannya atau bantuan, adakah (nama) mengalami kesukaran untuk berjalan 100 ela/meter di tanah rata? Itu adalah lebih kurang panjang sebuah padang bola sepak. With his/her equipment or assistance, does (name) have difficulty walking 100 yards/meters on level ground? That would be about the length of 1 football field.

  9. Tiada kesukaran / No difficulty

  10. Sedikit kesukaran / Some difficulty

  11. Banyak kesukaran / A lot of difficulty

  12. Tidak mampu sama sekali / Cannot do at all Ke soalan CN214 (-7) TT (-9) EJ CN211 Dengan peralatannya atau bantuan, adakah (nama) mangalami kesukaran untuk berjalan 500 ela/meter di tanah rata? Itu adalah lebih kurang panjang 5 buah padang bola sepak. With his/her equipment or assistance, does (name) have difficulty walking 500 yards/meters on level ground? That would be about the length of 5 football field.

  13. Tiada kesukaran / No difficulty ke soalan CN214

  14. Sedikit kesukaran / Some difficulty

  15. Banyak kesukaran / A lot of difficulty

  16. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN212 Berbanding dengan kanak-kanak yang sama umur, adakah (nama) mengalami kesukaran untuk berjalan 100 ela/meter di tanah rata? Itu adalah lebih kurang panjang sebuah padang bola sepak. Compared with children of the same age, does (name) have difficulty walking 100 yards/meters on level ground? That would be about the length of 1 football field.

  17. Tiada kesukaran / No difficulty

  18. Sedikit kesukaran / Some difficulty

  19. Banyak kesukaran / A lot of difficulty

  20. Tidak mampu sama sekali / Cannot do at all Ke soalan CN214 (-7) TT (-9) EJ CN213 Berbanding dengan kanak-kanak yang sama umur, adakah (nama) mempunyai masalah untuk berjalan 500 ela/meter di tanah rata? Itu adalah lebih kurang panjang 5 buah padang bola sepak. Compared with children of the same age, does (name) have difficulty walking 500 yards/meters on level ground? That would be about the length of 5 football field.

  21. Tiada kesukaran / No difficulty

  22. Sedikit kesukaran / Some difficulty

  23. Banyak kesukaran / A lot of difficulty

  24. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ Questionnaire

National Health and Morbidity Survey 2019 Technical Report − Volume I 358 107 QUESTIONNAIRE National Health And Morbidity Survey 2019 Institute for Public Health Ministry of Health Malaysia CN214 Adakah (nama) mengalami kesukaran dengan jagaan diri seperti menyuap makanan atau memakai sendiri pakaian dan sebagainya? Does (name) have difficulty with self-care such as feeding or dressing him/herself?

  1. Tiada kesukaran / No difficulty
  2. Sedikit kesukaran / Some difficulty
  3. Banyak kesukaran / A lot of difficulty
  4. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN215 Apabila (nama) bercakap, adakah dia mengalami kesukaran untuk difahami oleh orang yang tinggal bersama di rumahnya? When (name) speaks, does he/she have difficulty being understood by people inside of this household?
  5. Tiada kesukaran / No difficulty
  6. Sedikit kesukaran / Some difficulty
  7. Banyak kesukaran / A lot of difficulty
  8. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN216 Apabila (nama) bercakap, adakah dia mengalami kesukaran untuk difahami oleh orang yang tidak tinggal bersama di rumahnya? When (name) speaks, does he/she have difficulty being understood by people outside of this household?
  9. Tiada kesukaran / No difficulty
  10. Sedikit kesukaran / Some difficulty
  11. Banyak kesukaran / A lot of difficulty
  12. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN217 Berbanding dengan kanak-kanak yang sama umur, adakah (nama) mengalami kesukaran untuk mempelajari sesuatu? Compared with children of the same age, does (name) have difficulty learning things?
  13. Tiada kesukaran / No difficulty
  14. Sedikit kesukaran / Some difficulty
  15. Banyak kesukaran / A lot of difficulty
  16. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN218 Berbanding dengan kanak-kanak yang sama umur, adakah (nama) mengalami kesukaran untuk mengingati sesuatu? Compared with children of the same age, does (name) have difficulty remembering things?
  17. Tiada kesukaran / No difficulty
  18. Sedikit kesukaran / Some difficulty
  19. Banyak kesukaran / A lot of difficulty
  20. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN219 Adakah (nama) mengalami kesukaran menumpukan perhatian pada satu aktiviti yang dia seronok lakukan? Does (name) have difficulty concentrating on an activity that he/she enjoys doing?
  21. Tiada kesukaran / No difficulty
  22. Sedikit kesukaran / Some difficulty
  23. Banyak kesukaran / A lot of difficulty
  24. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ Appendix 7

Non-Communicable Diseases: Risk Factors and other Health Problems 359 108 BORANG SOAL SELIDIK Tinjauan Kebangsaan Kesihatan Dan Morbiditi 2019 Institut Kesihatan Umum Kementerian Kesihatan Malaysia CN220 Adakah (nama) mengalami kesukaran untuk menerima perubahan dalam rutinnya (aktiviti kebiasaannya)? Does (name) have difficulty accepting changes in his/her routine?

  1. Tiada kesukaran / No difficulty
  2. Sedikit kesukaran / Some difficulty
  3. Banyak kesukaran / A lot of difficulty
  4. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN221 Berbanding dengan kanak-kanak yang sama umur, adakah (nama) mengalami kesukaran untuk mengawal tingkah lakunya? Compared with children of the same age, does (name) have difficulty controlling his/her behavior?
  5. Tiada kesukaran / No difficulty
  6. Sedikit kesukaran / Some difficulty
  7. Banyak kesukaran / A lot of difficulty
  8. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN222 Adakah (nama) mengalami kesukaran untuk berkawan? Does (name) have difficulty making friends?
  9. Tiada kesukaran / No difficulty
  10. Sedikit kesukaran / Some difficulty
  11. Banyak kesukaran / A lot of difficulty
  12. Tidak mampu sama sekali / Cannot do at all (-7) TT (-9) EJ CN223 Berapa kerapkah (nama) kelihatan sangat cemas, gementar atau bimbang? How often does (name) seem very anxious, nervous or worried?
  13. Setiap hari / Daily
  14. Setiap minggu / Weekly
  15. Setiap bulan / Monthly
  16. Beberapa kali dalam setahun / A few times a year
  17. Tidak pernah / Never (-7) TT (-9) EJ CN224 Berapa kerapkah (nama) kelihatan sangat sedih atau murung? How often does (name) seem very sad or depressed?
  18. Setiap hari / Daily
  19. Setiap minggu / Weekly
  20. Setiap bulan / Monthly
  21. Beberapa kali dalam setahun / A few times a year
  22. Tidak pernah / Never (-7) TT (-9) EJ Questionnaire
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