Clinical response questionnaire at baseline - JSON Representation

Smart Bear Implementation Guide - Local Development build (v3.4.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
: Clinical response questionnaire at baseline - JSON Representation

Draft as of 2024-09-17
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{
  "resourceType" : "Questionnaire",
  "id" : "IADLQuestionnaire",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire IADLQuestionnaire</b></p><a name=\"IADLQuestionnaire\"> </a><a name=\"hcIADLQuestionnaire\"> </a><a name=\"IADLQuestionnaire-en-US\"> </a><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> IADLQuestionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Clinical response IADL questionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">https://smart-bear.eu/fhir/Questionnaire/IADLQuestionnaire#3.4.1</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.0\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 0</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ability to Use Telephone</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.0\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Shopping</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.1\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 2</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Food Preparation</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.2\">4 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.3\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 3</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Housekeeping</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.3\">5 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.4\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 4</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Laundry</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.4\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.5\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 5</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Mode of Transportation</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.5\">5 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.6\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 6</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Responsibility for own medications</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.6\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.7\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 7</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Ability to Handle Finances</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.7\">3 options</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.globalScore\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> globalScore</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">null</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.ptScore\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> ptScore</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">null</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name=\"opt-item.0\"> </a><p><b>Answer options for 0 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLTelephone#3 (&quot;Operates telephone on own initiative; looks up and dials numbers&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLTelephone#2 (&quot;Dials a few well-known numbers&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLTelephone#1 (&quot;Answers telephone, but does not dial&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLTelephone#0 (&quot;Does not use telephone at all&quot;)</li></ul><a name=\"opt-item.1\"> </a><p><b>Answer options for 1 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLShopping#3 (&quot;Takes care of all shopping needs independent&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLShopping#2 (&quot;Shops independently for small purchases&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLShopping#1 (&quot;Needs to be accompanied on any shopping trip&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLShopping#0 (&quot;Completely unable to shop&quot;)</li></ul><a name=\"opt-item.2\"> </a><p><b>Answer options for 2 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLMeals#3 (&quot;Plans, prepares, and serves adequate meals independently&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLMeals#2 (&quot;Prepares adequate meals if supplied with ingredients&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLMeals#1 (&quot;Heats and serves prepared meals or prepares meals but does not maintain adequate diet&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLMeals#0 (&quot;Needs to have meals prepared and served&quot;)</li></ul><a name=\"opt-item.3\"> </a><p><b>Answer options for 3 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLHouseKeeping#4 (&quot;Maintains house alone with occasion assistance (heavy work)&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLHouseKeeping#3 (&quot;Performs light daily tasks such as dishwashing, bed making&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLHouseKeeping#2 (&quot;Performs light daily tasks, but cannot maintain acceptable level of cleanliness&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLHouseKeeping#1 (&quot;Needs help with all home maintenance tasks&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLHouseKeeping#0 (&quot;Does not participate in any housekeeping tasks&quot;)</li></ul><a name=\"opt-item.4\"> </a><p><b>Answer options for 4 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLLaundry#2 (&quot;Does personal laundry completely.&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLLaundry#1 (&quot;Launders small items, rinses socks, stockings, etc&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLLaundry#0 (&quot;All laundry must be done by others&quot;)</li></ul><a name=\"opt-item.5\"> </a><p><b>Answer options for 5 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLTransportation#4 (&quot;Travels independently on public transportation or drives own car&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLTransportation#3 (&quot;Arranges own travel via taxi, but does not otherwise use public transportation&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLTransportation#2 (&quot;Travels on public transportation when assisted or accompanied by another&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLTransportation#1 (&quot;Travel limited to taxi or automobile with assistance of another&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLTransportation#0 (&quot;Does not travel at all&quot;)</li></ul><a name=\"opt-item.6\"> </a><p><b>Answer options for 6 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLMedications#2 (&quot;Is responsible for taking medication in correct dosages at correct time&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLMedications#1 (&quot;Takes responsibility if medication is prepared in advance in separate dosages&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLMedications#0 (&quot;Is not capable of dispensing own medication&quot;)</li></ul><a name=\"opt-item.7\"> </a><p><b>Answer options for 7 </b></p><ul><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLMoney#2 (&quot;Manages financial matters independently (budgets, writes checks, pays rent and bills, goes to bank); collects and keeps track of income&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLMoney#1 (&quot;Manages day-to-day purchases, but needs help with banking, major purchases, etc&quot;)</li><li style=\"font-size: 11px\">https://smart-bear.eu/fhir/CodeSystem/IADLMoney#0 (&quot;Incapable of handling money&quot;)</li></ul></div>"
  },
  "url" : "https://smart-bear.eu/fhir/Questionnaire/IADLQuestionnaire",
  "version" : "3.4.1",
  "name" : "IADLQuestionnaire",
  "title" : "Clinical response questionnaire at baseline",
  "status" : "draft",
  "date" : "2024-09-17T08:57:54+02:00",
  "description" : "Clinical response IADL questionnaire",
  "item" : [
    {
      "linkId" : "0",
      "text" : "Ability to Use Telephone",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLTelephone",
            "code" : "3",
            "display" : "Operates telephone on own initiative; looks up and dials numbers"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLTelephone",
            "code" : "2",
            "display" : "Dials a few well-known numbers"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLTelephone",
            "code" : "1",
            "display" : "Answers telephone, but does not dial"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLTelephone",
            "code" : "0",
            "display" : "Does not use telephone at all"
          },
          "initialSelected" : true
        }
      ]
    },
    {
      "linkId" : "1",
      "text" : "Shopping",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLShopping",
            "code" : "3",
            "display" : "Takes care of all shopping needs independent"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLShopping",
            "code" : "2",
            "display" : "Shops independently for small purchases"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLShopping",
            "code" : "1",
            "display" : "Needs to be accompanied on any shopping trip"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLShopping",
            "code" : "0",
            "display" : "Completely unable to shop"
          },
          "initialSelected" : true
        }
      ]
    },
    {
      "linkId" : "2",
      "text" : "Food Preparation",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLMeals",
            "code" : "3",
            "display" : "Plans, prepares, and serves adequate meals independently"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLMeals",
            "code" : "2",
            "display" : "Prepares adequate meals if supplied with ingredients"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLMeals",
            "code" : "1",
            "display" : "Heats and serves prepared meals or prepares meals but does not maintain adequate diet"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLMeals",
            "code" : "0",
            "display" : "Needs to have meals prepared and served"
          },
          "initialSelected" : true
        }
      ]
    },
    {
      "linkId" : "3",
      "text" : "Housekeeping",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLHouseKeeping",
            "code" : "4",
            "display" : "Maintains house alone with occasion assistance (heavy work)"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLHouseKeeping",
            "code" : "3",
            "display" : "Performs light daily tasks such as dishwashing, bed making"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLHouseKeeping",
            "code" : "2",
            "display" : "Performs light daily tasks, but cannot maintain acceptable level of cleanliness"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLHouseKeeping",
            "code" : "1",
            "display" : "Needs help with all home maintenance tasks"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLHouseKeeping",
            "code" : "0",
            "display" : "Does not participate in any housekeeping tasks"
          },
          "initialSelected" : true
        }
      ]
    },
    {
      "linkId" : "4",
      "text" : "Laundry",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLLaundry",
            "code" : "2",
            "display" : "Does personal laundry completely."
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLLaundry",
            "code" : "1",
            "display" : "Launders small items, rinses socks, stockings, etc"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLLaundry",
            "code" : "0",
            "display" : "All laundry must be done by others"
          },
          "initialSelected" : true
        }
      ]
    },
    {
      "linkId" : "5",
      "text" : "Mode of Transportation",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLTransportation",
            "code" : "4",
            "display" : "Travels independently on public transportation or drives own car"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLTransportation",
            "code" : "3",
            "display" : "Arranges own travel via taxi, but does not otherwise use public transportation"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLTransportation",
            "code" : "2",
            "display" : "Travels on public transportation when assisted or accompanied by another"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLTransportation",
            "code" : "1",
            "display" : "Travel limited to taxi or automobile with assistance of another"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLTransportation",
            "code" : "0",
            "display" : "Does not travel at all"
          },
          "initialSelected" : true
        }
      ]
    },
    {
      "linkId" : "6",
      "text" : "Responsibility for own medications",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLMedications",
            "code" : "2",
            "display" : "Is responsible for taking medication in correct dosages at correct time"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLMedications",
            "code" : "1",
            "display" : "Takes responsibility if medication is prepared in advance in separate dosages"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLMedications",
            "code" : "0",
            "display" : "Is not capable of dispensing own medication"
          },
          "initialSelected" : true
        }
      ]
    },
    {
      "linkId" : "7",
      "text" : "Ability to Handle Finances",
      "type" : "choice",
      "required" : true,
      "answerOption" : [
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLMoney",
            "code" : "2",
            "display" : "Manages financial matters independently (budgets, writes checks, pays rent and bills, goes to bank); collects and keeps track of income"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLMoney",
            "code" : "1",
            "display" : "Manages day-to-day purchases, but needs help with banking, major purchases, etc"
          }
        },
        {
          "valueCoding" : {
            "system" : "https://smart-bear.eu/fhir/CodeSystem/IADLMoney",
            "code" : "0",
            "display" : "Incapable of handling money"
          },
          "initialSelected" : true
        }
      ]
    },
    {
      "linkId" : "globalScore",
      "type" : "integer",
      "required" : true
    },
    {
      "linkId" : "ptScore",
      "type" : "integer",
      "required" : true
    }
  ]
}