{
  "description": "Back pain prevention questionnaire",
  "_filename": "back-pain-prevention-en.questionnaire.json",
  "package_name": "smart4health.eu.core",
  "subjectType": [ "Patient" ],
  "date": "2022-03-10",
  "publisher": "D4L data4life gGmbH",
  "name": "Smart4Health_back_pain_prevention_questionnaire",
  "item": [ {
    "text": "When is this questionnaire being administered?",
    "type": "choice",
    "linkId": "questionnaire_timing",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-quetionnaire-timing"
  }, {
    "text": "How often do you suffer from back pain?",
    "type": "choice",
    "linkId": "back_pain_frequency",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-back-pain-frequency"
  }, {
    "text": "How long has this pain been occurring?",
    "type": "choice",
    "linkId": "back_pain_duration",
    "required": true,
    "enableWhen": [ {
      "operator": "!=",
      "question": "back_pain_frequency",
      "answerCoding": {
        "code": "nev",
        "system": "http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency"
      }
    } ],
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-back-pain-duration"
  }, {
    "text": "In which body part does the pain appear?",
    "type": "choice",
    "linkId": "back_pain_location",
    "repeats": true,
    "required": true,
    "enableWhen": [ {
      "operator": "!=",
      "question": "back_pain_frequency",
      "answerCoding": {
        "code": "nev",
        "system": "http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency"
      }
    } ],
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-back-pain-location"
  }, {
    "text": "What are the consequences of your back pain and how does it impact your life situation?",
    "type": "choice",
    "linkId": "back_pain_impact",
    "repeats": true,
    "required": true,
    "enableWhen": [ {
      "operator": "!=",
      "question": "back_pain_frequency",
      "answerCoding": {
        "code": "nev",
        "system": "http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency"
      }
    } ],
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-pain-impact"
  }, {
    "text": "To what extent do you think you can influence your state of health?",
    "type": "choice",
    "linkId": "influence_on_health",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-influence-degree"
  }, {
    "text": "How do you assess your state of health?",
    "type": "choice",
    "linkId": "state_of_health",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-health-state"
  }, {
    "text": "How often are you physically active in your free time?",
    "type": "choice",
    "linkId": "physical_activity_freq",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-activity-frequency"
  }, {
    "text": "What are the reasons you work out?",
    "type": "choice",
    "linkId": "workout_reason",
    "repeats": true,
    "required": true,
    "enableWhen": [ {
      "operator": "!=",
      "question": "physical_activity_freq",
      "answerCoding": {
        "code": "nev",
        "system": "http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency"
      }
    } ],
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-activity-reason"
  }, {
    "text": "What hinders you from taking part in sports activities?",
    "type": "choice",
    "linkId": "workout_hindrance",
    "repeats": true,
    "required": true,
    "enableWhen": [ {
      "operator": "=",
      "question": "physical_activity_freq",
      "answerCoding": {
        "code": "nev",
        "system": "http://fhir.smart4health.eu/CodeSystem/s4h-event-frequency"
      }
    } ],
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-activity-hindrance"
  }, {
    "text": "Physical burden at your workplace: Unilateral/tense posture",
    "type": "choice",
    "linkId": "physical_burden_tense_posture",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-burden-frequency"
  }, {
    "text": "Physical burden at your workplace: Primarily in standing position",
    "type": "choice",
    "linkId": "physical_burden_standing",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-burden-frequency"
  }, {
    "text": "Physical burden at your workplace: Primarily in sitting position",
    "type": "choice",
    "linkId": "physical_burden_sitting",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-burden-frequency"
  }, {
    "text": "Physical burden at your workplace: Upper body leans forward",
    "type": "choice",
    "linkId": "physical_burden_leaning",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-burden-frequency"
  }, {
    "text": "Physical burden at your workplace: Heavy lifting",
    "type": "choice",
    "linkId": "physical_burden_lifting",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-physical-burden-frequency"
  }, {
    "text": "Do you think ergonomic advice can reduce your physical stress at your workplace?",
    "type": "choice",
    "linkId": "ergonomic_advice_impact",
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-perceived-likelihood"
  }, {
    "text": "What are your goals in participating in the training?",
    "type": "choice",
    "linkId": "training_goals",
    "repeats": true,
    "required": true,
    "answerValueSet": "http://fhir.smart4health.eu/ValueSet/s4h-back-pain-prevention-goal"
  } ],
  "type": null,
  "experimental": null,
  "resourceType": "Questionnaire",
  "title": "Back pain prevention questionnaire",
  "package_version": "0.5.0",
  "status": "draft",
  "language": "en",
  "id": "26ba775a-597b-40ea-a1a5-c1a0289617ba",
  "kind": null,
  "url": "http://fhir.smart4health.eu/Questionnaire/back-pain-prevention",
  "version": "1.0.0",
  "contact": [ {
    "name": "ITTM Solutions",
    "telecom": [ {
      "value": "https://www.ittm-solutions.com/",
      "system": "url"
    } ]
  }, {
    "name": "D4L data4life gGmbH",
    "telecom": [ {
      "value": "https://www.data4life.care",
      "system": "url"
    } ]
  } ]
}