Page 82 - Development of Questionnaires for Quantitative Medical Research

providing an option for each possible co-

morbidity, as shown in Figure 3.1.

Question:

Please mark “x” to indicate your status of
having (or not having) co-morbidities in the
bracket provided.

● Hypertension Yes ( ) No ( )

● Diabetes mellitus Yes ( ) No ( )

● Dyslipidemia Yes ( ) No ( )

● Others (Please state: ____)

Figure 3.1: Examples of questions with multiple

responses