| Package | smart4health.eu.core |
| Resource Type | Questionnaire |
| Id | back-pain-prevention-en.questionnaire |
| FHIR Version | R4 |
| Source | https://simplifier.net/resolve?scope=smart4health.eu.core@0.5.2&canonical=http://fhir.smart4health.eu/Questionnaire/back-pain-prevention |
| URL | http://fhir.smart4health.eu/Questionnaire/back-pain-prevention |
| Version | 1.0.0 |
| Status | draft |
| Date | 2022-03-10 |
| Name | Smart4Health_back_pain_prevention_questionnaire |
| Title | Back pain prevention questionnaire |
| Description | Back pain prevention questionnaire |
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{
"resourceType": "Questionnaire",
"language": "en",
"url": "http://fhir.smart4health.eu/Questionnaire/back-pain-prevention",
"version": "1.0.0",
"name": "Smart4Health_back_pain_prevention_questionnaire",
"title": "Back pain prevention questionnaire",
"status": "draft",
"subjectType": [
"Patient"
],
"date": "2022-03-10",
"publisher": "D4L data4life gGmbH",
"contact": [
{
"name": "ITTM Solutions",
"telecom": [
{
"system": "url",
"value": "https://www.ittm-solutions.com/"
}
]
},
{
"name": "D4L data4life gGmbH",
"telecom": [
{
"system": "url",
"value": "https://www.data4life.care"
}
]
}
],
"description": "Back pain prevention questionnaire",
"item": [
{
"linkId": "questionnaire_timing",
"text": "When is this questionnaire being administered?",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-questionnaire-timing"
},
{
"linkId": "back_pain_frequency",
"text": "How often do you suffer from back pain?",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-back-pain-frequency"
},
{
"linkId": "back_pain_duration",
"text": "How long has this pain been occurring?",
"type": "choice",
"required": true,
"enableWhen": [
{
"question": "back_pain_frequency",
"operator": "!=",
"answerCoding": {
"system": "http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency",
"code": "nev"
}
}
],
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-back-pain-duration"
},
{
"linkId": "back_pain_location",
"text": "In which body part does the pain appear?",
"type": "choice",
"required": true,
"repeats": true,
"enableWhen": [
{
"question": "back_pain_frequency",
"operator": "!=",
"answerCoding": {
"system": "http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency",
"code": "nev"
}
}
],
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-back-pain-location"
},
{
"linkId": "back_pain_impact",
"text": "What are the consequences of your back pain and how does it impact your life situation?",
"type": "choice",
"required": true,
"repeats": true,
"enableWhen": [
{
"question": "back_pain_frequency",
"operator": "!=",
"answerCoding": {
"system": "http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency",
"code": "nev"
}
}
],
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-pain-impact"
},
{
"linkId": "influence_on_health",
"text": "To what extent do you think you can influence your state of health?",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-influence-degree"
},
{
"linkId": "state_of_health",
"text": "How do you assess your state of health?",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-health-state"
},
{
"linkId": "physical_activity_freq",
"text": "How often are you physically active in your free time?",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-activity-frequency"
},
{
"linkId": "workout_reason",
"text": "What are the reasons you work out?",
"type": "choice",
"required": true,
"repeats": true,
"enableWhen": [
{
"question": "physical_activity_freq",
"operator": "!=",
"answerCoding": {
"system": "http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency",
"code": "nev"
}
}
],
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-activity-reason"
},
{
"linkId": "workout_hindrance",
"text": "What hinders you from taking part in sports activities?",
"type": "choice",
"required": true,
"repeats": true,
"enableWhen": [
{
"question": "physical_activity_freq",
"operator": "=",
"answerCoding": {
"system": "http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency",
"code": "nev"
}
}
],
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-activity-hindrance"
},
{
"linkId": "physical_burden_tense_posture",
"text": "Physical burden at your workplace: Unilateral/tense posture",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-burden-frequency"
},
{
"linkId": "physical_burden_standing",
"text": "Physical burden at your workplace: Primarily in standing position",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-burden-frequency"
},
{
"linkId": "physical_burden_sitting",
"text": "Physical burden at your workplace: Primarily in sitting position",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-burden-frequency"
},
{
"linkId": "physical_burden_leaning",
"text": "Physical burden at your workplace: Upper body leans forward",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-burden-frequency"
},
{
"linkId": "physical_burden_lifting",
"text": "Physical burden at your workplace: Heavy lifting",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-burden-frequency"
},
{
"linkId": "ergonomic_advice_impact",
"text": "Do you think ergonomic advice can reduce your physical stress at your workplace?",
"type": "choice",
"required": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-perceived-likelihood"
},
{
"linkId": "training_goals",
"text": "What are your goals in participating in the training?",
"type": "choice",
"required": true,
"repeats": true,
"answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-back-pain-prevention-goal"
}
]
}