FHIR IG analytics| Package | tw.iii.ltc |
| Resource Type | Questionnaire |
| Id | Questionnaire-ltc-questionnaire-adl-assessment-example.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/Lorex/TWLongTermCare_IG_Build/Questionnaire-ltc-questionnaire-adl-assessment-example.html |
| URL | http://ltc-ig.fhir.tw/Questionnaire/ltc-questionnaire-adl-assessment-example |
| Version | 1.0.0 |
| Status | active |
| Date | 2026-04-03T13:32:05+00:00 |
| Name | ADLAssessment |
| Title | 日常生活能力評估量表 |
| Realm | tw |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire ltc-questionnaire-adl-assessment-example
Profile: 長期照顧－問卷
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  ADLAssessment | Questionnaire | http://ltc-ig.fhir.tw/Questionnaire/ltc-questionnaire-adl-assessment-example#1.0.0 | ||
  E1 | 1.. 吃飯 | 1..1 | choice | Options: 3 options |
| E2 | 2.. 洗澡 | 1..1 | choice | Options: 2 options |
| E3 | 3.. 穿脫衣物 | 1..1 | choice | Options: 3 options |
| E4 | 4.. 個人修飾 | 1..1 | choice | Options: 2 options |
| E5 | 5.. 大便控制 | 1..1 | choice | Options: 3 options |
| E6 | 6.. 小便控制 | 1..1 | choice | Options: 3 options |
| E7 | 7.. 上廁所 | 1..1 | choice | Options: 3 options |
| E8 | 8.. 移位 | 1..1 | choice | Options: 4 options |
| E9 | 9.. 走路 | 1..1 | choice | Options: 4 options |
| E10 | 10.. 上下樓梯 | 1..1 | choice | Options: 3 options |
 E11 | 11.. 床椅移位 | 1..1 | choice | Options: 3 options |
| Documentation for this format | ||||
Options Sets
Answer options for E1
Answer options for E2
Answer options for E3
Answer options for E4
Answer options for E5
Answer options for E6
Answer options for E7
Answer options for E8
Answer options for E9
Answer options for E10
Answer options for E11
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "ltc-questionnaire-adl-assessment-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/LTCQuestionnaire"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "http://ltc-ig.fhir.tw/Questionnaire/ltc-questionnaire-adl-assessment-example",
"identifier": [
{
"use": "official",
"system": "http://ltc-ig.fhir.tw/questionnaire-id",
"value": "ADL-001"
}
],
"version": "1.0.0",
"name": "ADLAssessment",
"title": "日常生活能力評估量表",
"status": "active",
"date": "2026-04-03T13:32:05+00:00",
"publisher": "經濟部產業發展署",
"contact": [
{
"name": "經濟部產業發展署",
"telecom": [
{
"system": "url",
"value": "https://www.ida.gov.tw/"
}
]
}
],
"item": [
{
"linkId": "E1",
"prefix": "1.",
"text": "吃飯",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "自已在合理時間內可用筷子取食或需用輔具時應自行穿脫"
}
],
"valueInteger": 10
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "偶爾需他人在旁協助或口頭提醒"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "無法自行取食或需他人餵食"
}
],
"valueInteger": 0
}
]
},
{
"linkId": "E2",
"prefix": "2.",
"text": "洗澡",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "可獨立完成，不需他人在旁"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "需他人協助"
}
],
"valueInteger": 0
}
]
},
{
"linkId": "E3",
"prefix": "3.",
"text": "穿脫衣物",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "可自行穿脫衣褲及鞋襪等"
}
],
"valueInteger": 10
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "在別人協助下可自行完成一半"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "需別人協助"
}
],
"valueInteger": 0
}
]
},
{
"linkId": "E4",
"prefix": "4.",
"text": "個人修飾",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "可自行洗臉、洗手、刷牙及梳頭等"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "需別人協助"
}
],
"valueInteger": 0
}
]
},
{
"linkId": "E5",
"prefix": "5.",
"text": "大便控制",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "不會失禁，並可自行使用塞劑"
}
],
"valueInteger": 10
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "偶而會失禁或需協助使用塞劑"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "完全依賴"
}
],
"valueInteger": 0
}
]
},
{
"linkId": "E6",
"prefix": "6.",
"text": "小便控制",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "無失禁（控）"
}
],
"valueInteger": 10
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "偶爾失禁（控）"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "完全依賴"
}
],
"valueInteger": 0
}
]
},
{
"linkId": "E7",
"prefix": "7.",
"text": "上廁所",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "可自行上下馬桶並整理衣物等"
}
],
"valueInteger": 10
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "需部分協助或提醒"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "完全依賴"
}
],
"valueInteger": 0
}
]
},
{
"linkId": "E8",
"prefix": "8.",
"text": "移位",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "可獨立完成含輪椅之基本移轉"
}
],
"valueInteger": 15
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "需少部分協助"
}
],
"valueInteger": 10
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "需大部分協助"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "完全依賴"
}
],
"valueInteger": 0
}
]
},
{
"linkId": "E9",
"prefix": "9.",
"text": "走路",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "使用或不使用輔具可行走≥50公尺"
}
],
"valueInteger": 15
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "需扶持可行走≥50公尺"
}
],
"valueInteger": 10
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "可操縱輪椅50公尺"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "無法步行且無法操縱輪椅"
}
],
"valueInteger": 0
}
]
},
{
"linkId": "E10",
"prefix": "10.",
"text": "上下樓梯",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "可安全上下樓梯"
}
],
"valueInteger": 10
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "需協助或監督"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "無法上下樓"
}
],
"valueInteger": 0
}
]
},
{
"linkId": "E11",
"prefix": "11.",
"text": "床椅移位",
"type": "choice",
"required": true,
"answerOption": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "可自行由床至椅或相反方向移位"
}
],
"valueInteger": 10
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "需部分協助"
}
],
"valueInteger": 5
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/rendering-style",
"valueString": "完全依賴"
}
],
"valueInteger": 0
}
]
}
]
}