{
  "resourceType": "StructureDefinition",
  "id": "zib-ChecklistPainBehaviour",
  "url": "http://nictiz.nl/fhir/StructureDefinition/zib-ChecklistPainBehaviour",
  "version": "1.0.2",
  "name": "Zib ChecklistPainBehaviour",
  "title": "HCIM ChecklistPainBehaviour",
  "status": "active",
  "publisher": "Nictiz",
  "contact": [
    {
      "name": "Nictiz",
      "telecom": [
        {
          "system": "url",
          "value": "https://www.nictiz.nl",
          "use": "work"
        }
      ]
    }
  ],
  "description": "An Observation resource as defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) ChecklistPainBehavior-v1.0(2017EN)\r\n\r\nThe CPB (Checklist Pain Behaviour) is a pain assessment tool, that is used to assess pain in children with a limited expressive repertoire or with a profound cognitive impairment, by observing their behaviour\r\nThe CPB has ten observations that need te be addressed. The final score indicates whether the observed child suffers pain and 'how much'. The score is often combined with a VAS score that is completed by the nurses on basis of clinical experience.",
  "purpose": "A pain assessment tool is an instrument for determining the intensity of pain and can be useful in order to determine the effectiveness of pain treatment interventions (pharmacological or non-pharmacological). For children with a limited expressive repertoire it is nevertheless difficult to differentiate between pain or distress/anxiety. This difference is relevant in determining the treatment. The score on a pain observation instrument remains a snapshot in time.",
  "copyright": "CC0",
  "fhirVersion": "3.0.2",
  "mapping": [
    {
      "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
      "uri": "https://zibs.nl/wiki/ChecklistPainBehavior-v1.0(2017EN)",
      "name": "HCIM ChecklistPainBehavior-v1.0(2017EN)"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://fhir.nl/fhir/StructureDefinition/nl-core-observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "short": "ChecklistPainBehaviour",
        "alias": [
          "ChecklistPijnGedrag"
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.1",
            "comment": "ChecklistPainBehaviour"
          }
        ]
      },
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Observation.code.coding:ChecklistPainBehaviourCode",
        "path": "Observation.code.coding",
        "sliceName": "ChecklistPainBehaviourCode",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.code.coding:ChecklistPainBehaviourCode.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.code.coding:ChecklistPainBehaviourCode.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "fixedCode": "108331000146104"
      },
      {
        "id": "Observation.code.coding:ChecklistPainBehaviourCode.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.code.coding.display",
        "defaultValueString": "Pain Behaviour Checklist"
      },
      {
        "id": "Observation.effective[x]:effectiveDateTime",
        "path": "Observation.effectiveDateTime",
        "sliceName": "effectiveDateTime",
        "short": "ScoreDateTime",
        "definition": "The date and time at which the CPB score was determined.",
        "alias": [
          "ScoreDatumTijd"
        ],
        "min": 1,
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.13",
            "comment": "ScoreDateTime"
          }
        ]
      },
      {
        "id": "Observation.value[x]:valueQuantity",
        "path": "Observation.value[x]",
        "sliceName": "valueQuantity",
        "short": "TotalScore",
        "definition": "The total score is the sum of all the individual scores. The total score has a range from 0 - 10.",
        "alias": [
          "TotaalScore"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "minValueQuantity": {
          "value": 0
        },
        "maxValueQuantity": {
          "value": 10
        },
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.2",
            "comment": "TotalScore"
          }
        ]
      },
      {
        "id": "Observation.comment",
        "path": "Observation.comment",
        "short": "Comment",
        "alias": [
          "Toelichting"
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.14",
            "comment": "Comment"
          }
        ]
      },
      {
        "id": "Observation.component",
        "path": "Observation.component",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "code"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:Face",
        "path": "Observation.component",
        "sliceName": "Face",
        "max": "1"
      },
      {
        "id": "Observation.component:Face.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "12.17.3"
            }
          ]
        }
      },
      {
        "id": "Observation.component:Face.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Face"
      },
      {
        "id": "Observation.component:Face.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "Face",
        "definition": "Tense face; one or more muscles in the face are tensed.",
        "alias": [
          "Gezicht"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.3",
            "comment": "Face"
          }
        ]
      },
      {
        "id": "Observation.component:Face.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "minValueDecimal": 0,
        "maxValueDecimal": 1
      },
      {
        "id": "Observation.component:Mouth",
        "path": "Observation.component",
        "sliceName": "Mouth",
        "max": "1"
      },
      {
        "id": "Observation.component:Mouth.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "12.17.4"
            }
          ]
        }
      },
      {
        "id": "Observation.component:Mouth.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Mouth"
      },
      {
        "id": "Observation.component:Mouth.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "Mouth",
        "definition": "Deeper naso-labial furrow; the line between the nose and mouth (naso-labial furrow) is deeper and aside.",
        "alias": [
          "Mond"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.4",
            "comment": "Mouth"
          }
        ]
      },
      {
        "id": "Observation.component:Mouth.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "minValueDecimal": 0,
        "maxValueDecimal": 1
      },
      {
        "id": "Observation.component:Grimace",
        "path": "Observation.component",
        "sliceName": "Grimace",
        "max": "1"
      },
      {
        "id": "Observation.component:Grimace.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "12.17.5"
            }
          ]
        }
      },
      {
        "id": "Observation.component:Grimace.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Grimace"
      },
      {
        "id": "Observation.component:Grimace.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "Grimace",
        "definition": "Grimace; the co-occurrence of: furrowed eyebrows; eyes that are composed or pinched; a deeper line between the nose and mouth; opened mouth.",
        "alias": [
          "Grimas"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.5",
            "comment": "Grimace"
          }
        ]
      },
      {
        "id": "Observation.component:Grimace.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "minValueDecimal": 0,
        "maxValueDecimal": 1
      },
      {
        "id": "Observation.component:LookingSad",
        "path": "Observation.component",
        "sliceName": "LookingSad",
        "max": "1"
      },
      {
        "id": "Observation.component:LookingSad.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "12.17.6"
            }
          ]
        }
      },
      {
        "id": "Observation.component:LookingSad.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Looking sad"
      },
      {
        "id": "Observation.component:LookingSad.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "LookingSad",
        "definition": "Looking sad, almost in tears: eyebrows which have been pulled up laterally on the inner sides; wrinkles in the forehead, especially over the nose; eyes are squeezed; mouth drawn down possibly combined with a pout.",
        "alias": [
          "VerdrietigeBlik"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.6",
            "comment": "LookingSad"
          }
        ]
      },
      {
        "id": "Observation.component:LookingSad.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "minValueDecimal": 0,
        "maxValueDecimal": 1
      },
      {
        "id": "Observation.component:Eyes",
        "path": "Observation.component",
        "sliceName": "Eyes",
        "max": "1"
      },
      {
        "id": "Observation.component:Eyes.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "12.17.7"
            }
          ]
        }
      },
      {
        "id": "Observation.component:Eyes.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Eyes"
      },
      {
        "id": "Observation.component:Eyes.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "Eyes",
        "definition": "Eyes squeezed. Note: Do NOT score as present when the child is blinking or when the eyes are still closed without blinking.",
        "alias": [
          "Ogen"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.7",
            "comment": "Eyes"
          }
        ]
      },
      {
        "id": "Observation.component:Eyes.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "minValueDecimal": 0,
        "maxValueDecimal": 1
      },
      {
        "id": "Observation.component:Panic",
        "path": "Observation.component",
        "sliceName": "Panic",
        "max": "1"
      },
      {
        "id": "Observation.component:Panic.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "12.17.8"
            }
          ]
        }
      },
      {
        "id": "Observation.component:Panic.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Panic"
      },
      {
        "id": "Observation.component:Panic.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "Panic",
        "definition": "Panics, panic attack: an extreme form of anxiety which manifests itself in random restless body movements or violent resistance. This may be associated with an anxious look characterized by large widely opened eyes and eyebrows which are on the inner side raised up.",
        "alias": [
          "Paniek"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.8",
            "comment": "Panic"
          }
        ]
      },
      {
        "id": "Observation.component:Panic.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "minValueDecimal": 0,
        "maxValueDecimal": 1
      },
      {
        "id": "Observation.component:Moaning",
        "path": "Observation.component",
        "sliceName": "Moaning",
        "max": "1"
      },
      {
        "id": "Observation.component:Moaning.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "12.17.9"
            }
          ]
        }
      },
      {
        "id": "Observation.component:Moaning.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Moaning"
      },
      {
        "id": "Observation.component:Moaning.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "Moaning",
        "definition": "Moaning, groaning; monotonous sound on plaintive tone",
        "alias": [
          "Kreunen"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.9",
            "comment": "Moaning"
          }
        ]
      },
      {
        "id": "Observation.component:Moaning.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "minValueDecimal": 0,
        "maxValueDecimal": 1
      },
      {
        "id": "Observation.component:Cry",
        "path": "Observation.component",
        "sliceName": "Cry",
        "max": "1"
      },
      {
        "id": "Observation.component:Cry.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "12.17.10"
            }
          ]
        }
      },
      {
        "id": "Observation.component:Cry.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Cry"
      },
      {
        "id": "Observation.component:Cry.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "Cry",
        "definition": "Cries softly; crying is accompanied by a shocking breath.",
        "alias": [
          "Huilen"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.10",
            "comment": "Cry"
          }
        ]
      },
      {
        "id": "Observation.component:Cry.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "minValueDecimal": 0,
        "maxValueDecimal": 1
      },
      {
        "id": "Observation.component:SoundsOfRestlessness",
        "path": "Observation.component",
        "sliceName": "SoundsOfRestlessness",
        "max": "1"
      },
      {
        "id": "Observation.component:SoundsOfRestlessness.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "12.17.11"
            }
          ]
        }
      },
      {
        "id": "Observation.component:SoundsOfRestlessness.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Sounds of restlessness"
      },
      {
        "id": "Observation.component:SoundsOfRestlessness.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "SoundsOfRestlessness",
        "definition": "Penetrating sounds of restlessness: sudden or longer lasting intense cries or verbal expressions of pain, such as \"au\" or 'you hurt me'",
        "alias": [
          "OnrustigeGeluiden"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.11",
            "comment": "SoundsOfRestlessness"
          }
        ]
      },
      {
        "id": "Observation.component:SoundsOfRestlessness.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "minValueDecimal": 0,
        "maxValueDecimal": 1
      },
      {
        "id": "Observation.component:Tears",
        "path": "Observation.component",
        "sliceName": "Tears",
        "max": "1"
      },
      {
        "id": "Observation.component:Tears.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0",
              "code": "12.17.12"
            }
          ]
        }
      },
      {
        "id": "Observation.component:Tears.code.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.component.code.coding.display",
        "defaultValueString": "Tears"
      },
      {
        "id": "Observation.component:Tears.value[x]:valueQuantity",
        "path": "Observation.component.valueQuantity",
        "sliceName": "valueQuantity",
        "short": "Tears",
        "definition": "Tears: child produces tears in at least one eye, so more than just watery eyes.",
        "alias": [
          "Tranen"
        ],
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-checklistpainbehavior-v1.0-2017EN",
            "map": "NL-CM:12.17.12",
            "comment": "Tears"
          }
        ]
      },
      {
        "id": "Observation.component:Tears.value[x]:valueQuantity.value",
        "path": "Observation.component.valueQuantity.value",
        "minValueDecimal": 0,
        "maxValueDecimal": 1
      }
    ]
  }
}