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{
  "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"
        }
      ]
    }
  ]
}

name : QHajj6

{

}