Post-session questionnaire
Resource status: Draft
Canonical URL: http://fhir.smart4health.eu/Questionnaire/post-session-questionnaire
Questionnaire resource representing the questionnaire used for assessment at the end of a back pain treatment session. A session is an initial assessment followed by multiple training sessions and a final assessment.
Link to raw resource: Post-session treatment questionnaire
| Questionnaire |
| language : en |
| url : http://fhir.smart4health.eu/Questionnaire/post-session-questionnaire |
| version : 1.0.0 |
| name : Smart4Health_post-session_pain_questionnaire |
| title : Post-session treatment questionnaire |
| status : draft |
| subjectType : Patient |
| date : 2021-01-28 |
| publisher : D4L data4life gGmbH |
| contact |
| name : ITTM Solutions |
| telecom |
| system : url |
| value : https://www.ittm-solutions.com/ |
| contact |
| name : D4L data4life gGmbH |
| telecom |
| system : url |
| value : https://www.data4life.care |
| description : Post-session treatment questionnaire |
| item |
| linkId : current_pain_level |
| code |
| system : http://loinc.org |
| code : 72514-3 |
| display : Pain severity 0-10 Score Reported |
| text : Please indicate your current pain level |
| type : choice |
| required : True |
| answerValueSet : http://loinc.org/vs/LL2335-9 |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl |
| value |
| coding |
| system : http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes |
| code : painscalewithlabels |
| item |
| linkId : average_pain_level |
| code |
| system : http://loinc.org |
| code : 72514-3 |
| display : Pain severity 0-10 Score Reported |
| text : Please indicate your average pain level during the past four weeks |
| type : choice |
| required : True |
| answerValueSet : http://loinc.org/vs/LL2335-9 |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl |
| value |
| coding |
| system : http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes |
| code : painscalewithlabels |
| item |
| linkId : maximimum_pain_level |
| code |
| system : http://loinc.org |
| code : 72514-3 |
| display : Pain severity 0-10 Score Reported |
| text : Please indicate your maximum pain level during the past four weeks |
| type : choice |
| required : True |
| answerValueSet : http://loinc.org/vs/LL2335-9 |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl |
| value |
| coding |
| system : http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes |
| code : painscalewithlabels |
| item |
| linkId : lower_backpain_reduced |
| text : Can you estimate (in percent %) how much your pain relieved? |
| type : decimal |
| required : True |
| item |
| linkId : treatment_success |
| text : Taken together, what is your impression on your present treatment success? |
| type : choice |
| required : True |
| answerValueSet : http://loinc.org/vs/LL1023-2 |
| item |
| linkId : taking_painkillers |
| text : Are you taking painkillers at the moment? |
| type : choice |
| required : True |
| answerValueSet : http://fhir.smart4health.eu/ValueSet/yesno |
Example questionnaire response
Example QuestionnaireResponse matching the pre-session back pain assessment questionnaire.
Link to raw resource: Response for questionnaire post-session-questionnaire|1.0.0: s4h-post-session-response-example-en
| QuestionnaireResponse |
| id : s4h-post-session-response-example |
| identifier |
| system : urn:ietf:rfc:3986 |
| value : urn:uuid:d4879af2-9925-4224-b972-3cbf3fff2124 |
| language : en |
| questionnaire : http://fhir.smart4health.eu/Questionnaire/post-session-questionnaire|1.0.0 |
| status : completed |
| authored : 2020-05-04T14:15:00-05:00 |
| subject |
| display : Marie Lux-Brennard |
| item |
| linkId : current_pain_level |
| text : Please indicate your current pain level |
| answer |
| value |
| system : http://loinc.org |
| code : LA6114-8 |
| item |
| linkId : average_pain_level |
| text : Please indicate your average pain level during the past four weeks |
| answer |
| value |
| system : http://loinc.org |
| code : LA10137-0 |
| item |
| linkId : maximimum_pain_level |
| text : Please indicate your maximum pain level during the past four weeks |
| answer |
| value |
| system : http://loinc.org |
| code : LA10140-4 |
| item |
| linkId : lower_backpain_reduced |
| text : Can you estimate (in percent %) how much your pain relieved? |
| answer |
| value : 12 |
| item |
| linkId : treatment_success |
| text : Taken together, what is your impression on your present treatment success? |
| answer |
| value |
| system : http://loinc.org |
| code : LA8967-7 |
| item |
| linkId : taking_painkillers |
| text : Are you taking painkillers at the moment? |
| answer |
| value |
| system : http://loinc.org |
| code : LA32-8 |