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