<status value="draft" /> <subjectType value="Patient" /> <date value="2021-04-13" /> <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> <item> <linkId value="training_no" /> <text value="Training Number" /> <type value="integer" /> <required value="true" /> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes" /> <code value="painscalewithlabels" /> </coding> </valueCodeableConcept> </extension> <linkId value="back_pain_level_before" /> <code> <system value="http://loinc.org" /> <code value="72514-3" /> </code> <text value="Lower back pain level before training" /> <type value="choice" /> <required value="true" /> <answerValueSet value="http://loinc.org/vs/LL2335-9" /> <item> <linkId value="back_pain_level_before.explanation" /> <text value="In the following, please provide your pain level (Visual Analog Scale for Pain - VAS Pain). Please select how you experience your pain (under your usual medication dose) from the given scale (0-10). The VAS pain level describes the scale between '0' ('no pain') and '10' ('worst imaginable pain')." /> <type value="display" /> <enableBehavior value="any" /> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://fhir.smart4health.eu/CodeSystem/questionnaire-ui-codes" /> <code value="wellbeingscalewithlabels" /> </coding> </valueCodeableConcept> </extension> <linkId value="well_being" /> <text value="Well being" /> <type value="choice" /> <required value="true" /> <answerValueSet value="http://loinc.org/vs/LL2335-9" /> <item> <linkId value="well_being.explanation" /> <text value="0: All well, 10: All bad" /> <type value="display" /> </item> </item> <item> <linkId value="well-being_summary" /> <text value="Summary of your health, general well-being and activities in the last days/weeks" /> <type value="choice" /> <required value="true" /> <answerValueSet value="http://fhir.smart4health.eu/ValueSet/s4h-pre-training-well-being-summary" /> </item> <item> <linkId value="extraordinary_circumstances" /> <text value="Extraordinary circumstances" /> <type value="choice" /> <enableWhen> <question value="well-being_summary" /> <operator value="=" /> <answerCoding> <system value="http://fhir.smart4health.eu/CodeSystem/s4h-pre-training-well-being-summary" /> <code value="extraordinary" /> </answerCoding> </enableWhen> <required value="true" /> <repeats value="true" /> <answerValueSet value="http://fhir.smart4health.eu/ValueSet/s4h-backpain-extraordinary-circumstances" /> </item> </Questionnaire>