知情同意书在前中英文双语版.doc

CHINA HEALTH AND RETIREMENT LONGITUDINAL STUDY – BASELINE QUESTIONNAIRE 中国健康与养老追踪调查 全国问卷 August 2011 中国经济研究中心 CHINA CENTER FOR ECONOMIC RESEARCH PEKING UNIVERSITY CONTENTS 目 录 COVERSCREEN 过滤问卷 2 A HOUSEHOLD ROSTER 家户登记表 8 B 基本信息 15 C FAMILY 家庭 26 C1 PARENT CHILDREARING AND SIBLING INFORMATION 父母、子女、兄弟姐妹信息 26 CA PARENT INFORMATION 父母信息 26 CB CHILDREARING INFORMATION 子女信息 30 CC SIBLINGS 兄弟姐妹 42 C2 TIME TRANSFER AND TRANSFERS 家庭交往与经济帮助 44 CD TIME TRANSFER 与父母、子女间的交往 44 CE TRANSFERS 家庭得到及提供的经济帮助 46 CF TIME SPENT PROVIDING CARE 提供照料时间 56 D HEALTH STATUS AND FUNCTIONING 健康状况和功能 59 DA HEALTH STATUS 健康状况 59 DB FUNCTIONAL LIMITATIONS AND HELPERS 身体功能障碍以及辅助者 76 DC COGNITION? DEPPRESSION 认知和抑郁 83 DE SELF-REPORTED HEALTH VIGNETTES 自我评价健康和情景选择题 87 E HEALTH CARE AND INSURANCE 医疗保健与保险 94 PART I MEDICAL INSURANCE 第一部分：医疗保险 94 PART II HEALTH CARE COSTS AND UTILIZATION 第二部分：医疗成本与使用情况 98 F WORK, RETIREMENT AND PENSION 工作、退休和养老金 112 FA JOB STATUS 就业状况 112 FB WORK HISTORY 工作史 113 FC CURRENT PRIMARY JOB/OCCUPATION 当前、主要工作 115 FK UNEMPLOYMENT AND JOB SEARCH ACTIVITIES 失业，求职经历 131 FL MOST RECENT JOB 最近一份工作 132 FM RETIREMENT 退休与退职 136 FN PENSION INSURANCE 养老保险 143 G H INCOME, EXPENDITRUES AND ASSETS 收入、支出与资产 156 G1 VIGNETTS ON INCOME 情景选择题 156 G2 HOUSEHOLD INCOME AND EXPENDITURES 家户收入与支出 156 HA HOUSEHOLD ASSETS 家户资产 165 HB INDIVIDUAL ASSETS 个人资产 176 I. HOUSING CHARACTERISTICS 住房情况 184 HOUSEHOLD CONTACTS 家户联系信息表 187 J. INTERVIEWER OBSERVATION 访问员观察 189 APPENDIX 附表 191  COVERSCREEN 过滤问卷 [IWER: Find a respondent (he/she does not have to be 45+ years of age, but could not be nanny, short workers or visitors) from the house.] [访员注意：在这个房子中找一人（这人可以不到45岁，但不能是保姆、做工的人或者客人等）回答下列问题.] . Did the household receive “a letter to the resident”? 该户是否收到 “致居民的一封信” ？ （1）Yes 是 （2）No 否 . How many households live in this dwelling? 你们这座房子里住了几户人？一户人是指一起吃饭并且共同承担其它生活费用的人。_____0..25Households 户 [PROCEDURE: Ask each household the following ques