CDEs
Forms
Because of your eyesight, how much difficulty do you have seeing and enjoying programs on TV [PhenX]
Because of your eyesight, how much difficulty do you have entertaining friends and family in your home [PhenX]
Do you have more help from others because of your vision [PhenX]
Are you limited in how long you can work or do other activities because of your vision?
Atrial fibrillation
Date of 1st episode atrial fibrillation
Name Provider
If yes, Year done:
Anticoagulants for treatment of AF
Antiarrhythmics for treatment of AF
How much does your spouse or partner really care about you [MIDUS II]
How much does he or she understand the way you feel about things [MIDUS II]
How much does he or she appreciate you [MIDUS II]
How much can you rely on him or her for help if you have a serious problem [MIDUS II]
How much can you open up to him or her if you need to talk about your worries [MIDUS II]
How much can you relax and be yourself around him or her [MIDUS II]
How often does your spouse or partner make too many demands on you [MIDUS II]
How often does he or she make you feel tense [MIDUS II]
How often does he or she argue with you [MIDUS II]
How often does he or she criticize you [MIDUS II]
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