<QuestionnaireResponse xmlns="http://hl7.org/fhir">
  <id value="s4h-back-pain-prevention-with-pain-response-example" />
  <language value="en" />
  <identifier>
    <system value="urn:ietf:rfc:3986" />
    <value value="urn:uuid:d4879af2-9925-4224-b972-3cbf3fff2124" />
  </identifier>
  <questionnaire value="http://fhir.smart4health.eu/Questionnaire/back-pain-prevention|1.0.0" />
  <status value="completed" />
  <subject>
    <display value="Marie Lux-Brennard" />
  </subject>
  <authored value="2020-05-04T14:15:00-05:00" />
  <item>
    <linkId value="questionnaire_timing" />
    <text value="When is this questionnaire being administered?" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-questionnaire-timing" />
        <code value="pre" />
        <display value="Before session begin" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="back_pain_frequency" />
    <text value="How often do you suffer from back pain?" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency" />
        <code value="freq1wk" />
        <display value="Frequently (at least once a week)" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="back_pain_duration" />
    <text value="How long has this pain been occurring?" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-event-duration" />
        <code value="ov3mon" />
        <display value="More than 3 months" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="back_pain_location" />
    <text value="In which body part does the pain appear?" />
    <answer>
      <valueCoding>
        <system value="http://snomed.info/sct" />
        <code value="122495006" />
        <display value="Thoracic spine (TS)" />
      </valueCoding>
    </answer>
    <answer>
      <valueCoding>
        <system value="http://snomed.info/sct" />
        <code value="122496007" />
        <display value="Lumbar spine (LS)" />
      </valueCoding>
    </answer>
  </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?" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-pain-impact" />
        <code value="leisure" />
        <display value="Limitations during leisure time" />
      </valueCoding>
    </answer>
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-pain-impact" />
        <code value="absence" />
        <display value="Periods of absence at work" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="influence_on_health" />
    <text value="To what extent do you think you can influence your state of health?" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-influence-degree" />
        <code value="str" />
        <display value="Strongly" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="state_of_health" />
    <text value="How do you assess your state of health?" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-health-state" />
        <code value="goo" />
        <display value="Good" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="physical_activity_freq" />
    <text value="How often are you physically active in your free time?" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency" />
        <code value="1xwk" />
        <display value="1x per week" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="workout_reason" />
    <text value="What are the reasons you work out?" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-activity-reason" />
        <code value="fun" />
        <display value="Fun" />
      </valueCoding>
    </answer>
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-activity-reason" />
        <code value="hea" />
        <display value="Health promotion" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="physical_burden_tense_posture" />
    <text value="Physical burden at your workplace: Unilateral/tense posture" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency" />
        <code value="freq" />
        <display value="Frequently" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="physical_burden_standing" />
    <text value="Physical burden at your workplace: Primarily in standing position" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency" />
        <code value="occ" />
        <display value="Occasionally" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="physical_burden_sitting" />
    <text value="Physical burden at your workplace: Primarily in sitting position" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency" />
        <code value="vfreq" />
        <display value="Very frequently" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="physical_burden_leaning" />
    <text value="Physical burden at your workplace: Upper body leans forward" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency" />
        <code value="occ" />
        <display value="Occasionally" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="physical_burden_lifting" />
    <text value="Physical burden at your workplace: Heavy lifting" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency" />
        <code value="nev" />
        <display value="Never" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="ergonomic_advice_impact" />
    <text value="Do you think ergonomic advice can reduce your physical stress at your workplace?" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-perceived-likelihood" />
        <code value="img" />
        <display value="Yes, I could imagine it" />
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="training_goals" />
    <text value="What are your goals in participating in the training?" />
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-back-pain-prevention-goal" />
        <code value="pmd" />
        <display value="Prevention of muscular and skeletal disorders" />
      </valueCoding>
    </answer>
    <answer>
      <valueCoding>
        <system value="http://fhir.smart4health.eu/CodeSystem/s4h-back-pain-prevention-goal" />
        <code value="sth" />
        <display value="Stabilize health" />
      </valueCoding>
    </answer>
  </item>
</QuestionnaireResponse>