European Health Survey 
(EHS - 2009)
Spain
Questionnaire Overview sections first level Overview sections second level Linking to the ICF Items on disability? Capacity & Performance specified? Time frame (only disability questions) Response options (only disability questions) Any known instrument included? Filter (for the whole section) Checked (x) Relevant Comment
(e. g. household, individual, etc)     Only chapter level None Capacity   Frequency SF-36     0=no  
        1 to 5 Performance   Intensity WHODAS     1=yes  
        5 to 10 Both   Statement WG-6        
        10 to 20 Not clearly stated   Others Others (please specify)        
        More than 20     Yes/No None        
Household Questionnaire Characteristics of the household   PF, nc, d8, e1         None all x 0  
Individual Questionnaire (Personal characteristics)   PF, nc, d8         Others (EHIS template) all x 0  
  European Health Status Module Introduction 1 gh, HC         SF-36 (first item) + others all x 1 Asking to what extent sb has been limited in activities people usually do because of a health problem.
    Introduction 2 HC, e5, d8         Others (EHIS template) all x 0 List of health conditions, use of health services, impact on work
    Introduction 3 b2, d4, d5, e1 10 to 20 Both   Intensity Others (EHIS template) all x 1  
    Introduction 4 d4, d5, e1, e3 5 to 10 Performance   Intensity Others (EHIS template) all x 1 Disability question + use of help + need for help
    Introduction 5 d5, d6, d8, e1, e3 10 to 20 Both   Intensity Others (EHIS template) all x 1 Disability question + use of help + need for help
    Introduction 6 b2 1 to 5   past four weeks Frequency SF-36 (item on pain) all x 1  
    Introduction 7 b1 5 to 10   past four weeks Frequency SF-36 all x 1  
  European Health Care Module Introduction 8 e5         Others (EHIS template) all x 0 Use of health services: hospital stays
    Introduction 9 e5         Others (EHIS template) all x 0 Use of health services: dentist
    Introduction 10 e5         Others (EHIS template) all x 0 Use of health services: GP
    Introduction 11 e5         Others (EHIS template) all x 0 Use of health services: others
    Introduction 12 e1         Others (EHIS template) all x 0 Medication
    Introduction 13 e5         Others (EHIS template) all x 0 Use of health services: Vaccinations
    Introduction 14 e5         Others (EHIS template) all x 0 Use of health services: Blood pressure
    Introduction 15 e5         Others (EHIS template) all x 0 Use of health services: Blood cholesterol
    Introduction 16 e5         Others (EHIS template) all x 0 Use of health services: Blood sugar
    Introduction 17 e5         Others (EHIS template) only women x 0 Use of health services: Mammography
    Introduction 18 e5         Others (EHIS template) only women x 0 Use of health services: Cervical smear test
    Introduction 19 e5         Others (EHIS template) all x 0 Use of health services: Faecal occult blood test
    Introduction 20 nc, e5         Others (EHIS template) all x 0 Use of health services: satisfaction
  European Health Determinants Module Introduction 21 PF         Others (EHIS template) all x 0 Risk factors: weight
    Introduction 22 d5         Others (EHIS template) all x 0 Risk factors: physical activities
    Introduction 23 d5         Others (EHIS template) all x 0 Risk factors: eating patterns
    Introduction 24 e2; e3         Others (EHIS template) all x 0 Risk factors: environmental factors
Self-Completion Form
"Out-Of-Pocket Expenses"
    e1         Others (EHIS template) all x 0  
Self-Completion
Form Health Determinants
    d5; e1; e2; e3         Others (EHIS template) all x 0 Smoking, use of alcohol and drugs
Interview Second Part European Background Variables Module   e1, e5         Others (EHIS template) all x 0 Household income
General impressions
The English template of the EHIS is a health survey focusing on health and disability of individuals, as well as on the use of health services and risk factors. There are no filter questions for the different modules; thus, individuals without chronic disease(s) are consequently asked questions about impariments of BFs and limitations of A&Ps. Participation questions are not asked.

Example standard questionnaire: Do you usually have difficulty doing any of these activities by yourself? - Preparing meals
No difficulty = 1
Yes, some difficulty = 2
Yes, a lot of difficulty = 3
I can't achieve it by myself = 4
don't know = 8
refusal = 9