| Package | MyHIE.v4-test |
| Resource Type | Questionnaire |
| Id | q-hajj-6 |
| FHIR Version | R4 |
| Source | https://simplifier.net/resolve?scope=MyHIE.v4-test@2.1.0-alpha&canonical=http://fhir.hie.moh.gov.my/Questionnaire/q-hajj-6 |
| URL | http://fhir.hie.moh.gov.my/Questionnaire/q-hajj-6 |
| Version | 1.0.0 |
| Status | active |
| Date | 2023-12-08T21:49:01.1801787+00:00 |
| Name | QHajj6 |
| Title | Pengakuan Kesihatan Bakal Haji |
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FHIR{
"resourceType": "Questionnaire",
"id": "q-hajj-6",
"url": "http://fhir.hie.moh.gov.my/Questionnaire/q-hajj-6",
"version": "1.0.0",
"name": "QHajj6",
"title": "Pengakuan Kesihatan Bakal Haji",
"status": "active",
"date": "2023-12-08T21:49:01.1801787+00:00",
"item": [
{
"linkId": "hajj-6.1",
"text": "Pernahkan tuan/puan menerima rawatan bagi penyakit-penyakit berikut",
"type": "group",
"item": [
{
"linkId": "hajj-6.1.1",
"text": "Lelah / Asthma",
"type": "boolean"
},
{
"linkId": "hajj-6.1.2",
"text": "Batuk Kering / Tibi",
"type": "boolean"
},
{
"linkId": "hajj-6.1.3",
"text": "Sakit Jantung",
"type": "boolean"
},
{
"linkId": "hajj-6.1.4",
"text": "Darah Tinggi",
"type": "boolean"
},
{
"linkId": "hajj-6.1.5",
"text": "Kencing Manis / Diabetes",
"type": "boolean"
},
{
"linkId": "hajj-6.1.6",
"text": "Gastrik",
"type": "boolean"
},
{
"linkId": "hajj-6.1.7",
"text": "Sakit Buah Pinggang / Dialisis",
"type": "boolean"
},
{
"linkId": "hajj-6.1.8",
"text": "Batu Karang",
"type": "boolean"
},
{
"linkId": "hajj-6.1.9",
"text": "Barah / Kanser",
"type": "boolean"
},
{
"linkId": "hajj-6.1.10",
"text": "Leukemia",
"type": "boolean"
},
{
"linkId": "hajj-6.1.11",
"text": "Lumpuh / Angin Ahmar / Strok",
"type": "boolean"
},
{
"linkId": "hajj-6.1.12",
"text": "Penyakit Mental / Psikiatri",
"type": "boolean"
},
{
"linkId": "hajj-6.1.13",
"text": "Demensia / Nyanyuk / mudah lupa",
"type": "boolean"
},
{
"linkId": "hajj-6.1.14",
"text": "Sawan / Epilepsi",
"type": "boolean"
},
{
"linkId": "hajj-6.1.15",
"text": "Penyakit Hati / Hepatitis",
"type": "boolean"
},
{
"linkId": "hajj-6.1.16",
"text": "Penyakit kulit yang kronik",
"type": "boolean"
},
{
"linkId": "hajj-6.1.17",
"text": "Sakit sendi / Arthritis",
"type": "boolean"
},
{
"linkId": "hajj-6.1.18",
"text": "Penyakit-penyakit lain, nyatakan",
"type": "text"
}
]
},
{
"linkId": "hajj-6.2",
"text": "Adakah tuan/puan mempunyai gejala-gejala kesihatan seperti berikut",
"type": "group",
"item": [
{
"linkId": "hajj-6.2.1",
"text": "Sesak nafas apabila berjalan (> 30 meter) atau ketika menaiki tangga bangunan dua tingkat",
"type": "boolean"
},
{
"linkId": "hajj-6.2.2",
"text": "Sakit dada semasa aktiviti cergas",
"type": "boolean"
},
{
"linkId": "hajj-6.2.3",
"text": "Batuk berdarah",
"type": "boolean"
},
{
"linkId": "hajj-6.2.4",
"text": "Batuk berpanjangan (> dua minggu)",
"type": "boolean"
},
{
"linkId": "hajj-6.2.5",
"text": "Selalu pitam",
"type": "boolean"
},
{
"linkId": "hajj-6.2.6",
"text": "Selalu pening kepala / Sakit kepala",
"type": "boolean"
},
{
"linkId": "hajj-6.2.7",
"text": "Bengkak kaki (sembab)",
"type": "boolean"
},
{
"linkId": "hajj-6.2.8",
"text": "Selalu dahaga dan kerap kencing",
"type": "boolean"
},
{
"linkId": "hajj-6.2.9",
"text": "Kencing kurang lawas",
"type": "boolean"
},
{
"linkId": "hajj-6.2.10",
"text": "Kencing tidak boleh kawal",
"type": "boolean"
},
{
"linkId": "hajj-6.2.11",
"text": "Kencing sakit",
"type": "boolean"
},
{
"linkId": "hajj-6.2.12",
"text": "Kencing berdarah",
"type": "boolean"
},
{
"linkId": "hajj-6.2.13",
"text": "Sakit sendi",
"type": "boolean"
},
{
"linkId": "hajj-6.2.14",
"text": "Sakit gigi",
"type": "boolean"
},
{
"linkId": "hajj-6.2.15",
"text": "Mudah lupa",
"type": "boolean"
},
{
"linkId": "hajj-6.2.16",
"text": "Alahan (Allergy)",
"type": "boolean"
},
{
"linkId": "hajj-6.2.17",
"text": "Hidung berdarah",
"type": "boolean"
},
{
"linkId": "hajj-6.2.18",
"text": "Senak perut dan muntah",
"type": "boolean"
},
{
"linkId": "hajj-6.2.19",
"text": "Buasir (Haemorrhoid)",
"type": "boolean"
},
{
"linkId": "hajj-6.2.20",
"text": "Burut/ Angin pasang/ Hernia",
"type": "boolean"
},
{
"linkId": "hajj-6.2.21",
"text": "Kurang selera makan",
"type": "boolean"
},
{
"linkId": "hajj-6.2.22",
"text": "Susut berat badan",
"type": "boolean"
},
{
"linkId": "hajj-6.2.23",
"text": "Demam berterusan/berpanjangan",
"type": "boolean"
},
{
"linkId": "hajj-6.2.24",
"text": "Muntah darah",
"type": "boolean"
},
{
"linkId": "hajj-6.2.25",
"text": "Bengkak pada leher",
"type": "boolean"
},
{
"linkId": "hajj-6.2.26",
"text": "Ketulan pada payu dara",
"type": "boolean"
},
{
"linkId": "hajj-6.2.27",
"text": "Adakah anda merokok?",
"type": "boolean",
"item": [
{
"linkId": "hajj-6.2.27.1",
"text": "Jika Ya, berapa batang rokok sehari",
"type": "choice",
"answerOption": [
{
"valueCoding": {
"code": "00",
"display": "1-20"
}
},
{
"valueCoding": {
"code": "01",
"display": "21-30"
}
},
{
"valueCoding": {
"code": "02",
"display": ">30"
}
}
]
}
]
},
{
"linkId": "hajj-6.2.28",
"text": "Adakah anda pernah terlibat dalam penyalahgunaan dadah?",
"type": "boolean"
},
{
"linkId": "hajj-6.2.29",
"text": "Adakah anda menjalani Rawatan Terapi Gantian Opiat (methadone atau buprenorphine/naloxone)",
"type": "boolean"
},
{
"linkId": "hajj-6.2.30",
"text": "Pernahkah anda menjalani pembedahan?",
"type": "boolean",
"item": [
{
"linkId": "hajj-6.2.30.1",
"text": "Jika Ya, nyatakan jenis pembedahan/tahun",
"type": "text"
}
]
},
{
"linkId": "hajj-6.2.31",
"text": "Adakah tuan / puan menghidap alergi / alahan ubat-ubatan / makanan / bahan-bahan lain?",
"type": "boolean",
"item": [
{
"linkId": "hajj-6.2.31.1",
"text": "Jika Ya, nyatakan jenis ubat/makanan/bahan-bahan lain",
"type": "text"
}
]
}
]
},
{
"linkId": "hajj-6.3",
"text": "Pengakuan Khas Bakal Haji Wanita",
"type": "group",
"item": [
{
"linkId": "hajj-6.3.1",
"text": "Adakah anda mengandung sekarang?",
"type": "boolean",
"item": [
{
"linkId": "hajj-6.3.1.1",
"text": "Jika Ya, tarikh haid terakhir",
"type": "date"
}
]
},
{
"linkId": "hajj-6.3.2",
"text": "Adakah anda menghadapi masalah sakit puan",
"type": "boolean"
},
{
"linkId": "hajj-6.3.3",
"text": "Pernahkah anda mengalami rahim / peranakan turun (\"Uterine prolapse\")?",
"type": "boolean"
}
]
}
]
}