Name | Value |
---|---|
INSTRUMENT | BBHI-2 |
LAST UPDATE | 2022-04-08 09:18:08 |
ENTRY CHECKSUM | 201812392 |
ENTRY SPECIFICATION | {"name": "BBHI-2", REQUIRED)", {"id": "c4092", "text": " 8"}, {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} ]}, {"id": "q8230", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "4. Arms or hands?", "intro": "This survey will help your caregiver better understand how you feel. There are no right or wrong answers. This survey usually takes about 10 minutes to complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of "columns": 1, pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain Worst Pain You<br /> Could Imagine", "columns": 11, "choices":[ {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, "choices":[ {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} ]}, {"id": "q8231", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "5. Chest?", "intro": "This survey will help your caregiver better understand how you feel. There are no {"id": "c4125", "text": "1. Head/Headache", "quickKey": 1}, right or wrong answers. This survey usually takes about 10 minutes to complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain Worst Pain You<br /> Could Imagine", "columns": 11, "choices":[ {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4126", "text": "2. Neck", "quickKey": 2}, {"id": "c4086", "text": " 2"}, {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} ]}, {"id": "c4127", "text": "3. Upper Body", "quickKey": 3}, {"id": "q8232", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "6. Abdomen or stomach?", "intro": "This survey will help your caregiver better understand how you feel. There are no right or wrong answers. This survey usually takes about 10 minutes to complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain Worst Pain You<br /> Could Imagine", "columns": 11, {"id": "c4128", "text": "4. Back/Lower Body", "quickKey": 4}, "choices":[ {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, {"id": "c4129", "text": "5. Legs/Feet", "quickKey": 5} {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} ]}, {"id": "q8233", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "7. Middle back?", "intro": "This survey will help your caregiver better understand how you feel. There are no right or wrong answers. This survey usually takes about 10 minutes to complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain ]}, Worst Pain You<br /> Could Imagine", "columns": 11, "choices":[ {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, {"id": "c4089", "text": " 5"}, {"id": "i2383", "type": "IntroText", {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} ]}, {"id": "q8234", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "8. Lower back?", "intro": "This survey will help your caregiver better understand how you feel. There are no right or wrong answers. This survey usually takes about 10 minutes to "copyright": "Copyright 2002 NCS Pearson, Inc. All rights reserved. Pearson, the PSI Design, "text": "This survey will help your caregiver better understand how you feel. There are no complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain Worst Pain You<br /> Could Imagine", "columns": 11, "choices":[ {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, right or wrong answers. This survey usually takes about 10 minutes to {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} ]}, {"id": "q8235", "type": "ChoiceQuestion", "required": false, "inline": true, complete.<br /><br /> This part contains questions concerning your level of pain "text": "9. Genital area?", "intro": "This survey will help your caregiver better understand how you feel. There are no right or wrong answers. This survey usually takes about 10 minutes to complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain Worst Pain You<br /> Could Imagine", "columns": 11, "choices":[ during the past month.<br /> <br /> Use the following to describe your level of {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, {"id": "c4093", "text": " 9"}, pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain {"id": "c4094", "text": " 10"} ]}, {"id": "q8236", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "10. Legs or feet?", "intro": "This survey will help your caregiver better understand how you feel. There are no right or wrong answers. This survey usually takes about 10 minutes to complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain Worst Pain You<br /> & Could Imagine", "columns": 11, "choices":[ {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, nbsp; &nb {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} ]}, {"id": "q8237", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "11. Taking into account all parts of your body that hurt, what was your overall highest level of pain during the past month?", "intro": "This survey will help your caregiver better understand how you feel. There are no right or wrong answers. This survey usually takes about 10 minutes to sp; complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain Worst Pain You<br /> Could Imagine", "columns": 11, "choices":[ {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, Worst Pain You<br /> {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} ]}, {"id": "q8238", "type": "ChoiceQuestion", "required": false, "inline": true, &n "text": "12. Taking into account all parts of your body that hurt, what was your overall lowest level of pain during the past month?", "intro": "This survey will help your caregiver better understand how you feel. There are no right or wrong answers. This survey usually takes about 10 minutes to complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain Worst Pain You<br /> Could Imagine", "columns": 11, PsychCorp, and BBHI are trademarks in the US and/or other countries, of Pearson bsp; &nbs "choices":[ {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, p; {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} ]}, {"id": "q8239", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "13. Taking into account all parts of your body that hurt, what is your overall level of pain right now?", "intro": "This survey will help your caregiver better understand how you feel. There are no right or wrong answers. This survey usually takes about 10 minutes to complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain Worst Pain You<br /> Could Imagine", "columns": 11, "choices":[ {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, Could Imagine" {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} ]}, {"id": "q8240", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "14. Taking into account all parts of your body that hurt, what level of pain could you tolerate and still work and get on with your life?", }, "intro": "This survey will help your caregiver better understand how you feel. There are no right or wrong answers. This survey usually takes about 10 minutes to complete.<br /><br /> This part contains questions concerning your level of pain during the past month.<br /> <br /> Use the following to describe your level of pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain Worst Pain You<br /> Could Imagine", "columns": 11, "choices":[ {"id": "c3927", "text": " 0"}, {"id": "q8227", "type": "ChoiceQuestion", "required": false, "inline": true, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, {"id": "c4092", "text": " 8"}, {"id": "c4093", "text": " 9"}, {"id": "c4094", "text": " 10"} "text": "1. Head (headache pain)?", ]}, {"id": "i2384", "type": "IntroText", "text": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month." }, {"id": "q8241", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "15. Feeling exhausted but being unable to sleep?", "intro": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month.", "columns": 1, "intro": "This survey will help your caregiver better understand how you feel. There are no "choices":[ {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} ]}, {"id": "q8242", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "16. Irritability?", "intro": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month.", right or wrong answers. This survey usually takes about 10 minutes to "columns": 1, "choices":[ {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} ]}, {"id": "q8243", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "17. Shakiness or jitters?", "intro": "This part contains a list of symptoms that people sometimes have. For each complete.<br /><br /> This part contains questions concerning your level of pain symptom, decide how much of a problem it has been for you in the past month.", "columns": 1, "choices":[ {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} ]}, {"id": "q8244", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "18. Being unable to relax?", Education, Inc., or its affiliates.", during the past month.<br /> <br /> Use the following to describe your level of "intro": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month.", "columns": 1, "choices":[ {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} ]}, {"id": "q8245", "type": "ChoiceQuestion", "required": false, "inline": false, pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain "text": "19. Feeling that nothing seems real?", "intro": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month.", "columns": 1, "choices":[ {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} ]}, Worst Pain You<br /> {"id": "q8246", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "20. Lump in throat/difficulty swallowing?", "intro": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month.", "columns": 1, "choices":[ {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} Could Imagine", ]}, {"id": "q8247", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "21. Pounding or racing heart when not exerting yourself?", "intro": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month.", "columns": 1, "choices":[ {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, "columns": 11, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} ]}, {"id": "q8248", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "22. Hearing voices that other people don't hear?", "intro": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month.", "columns": 1, "choices":[ {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, "choices":[ {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} ]}, {"id": "q8249", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "23. Feeling bloated or gassy?", "intro": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month.", "columns": 1, "choices":[ {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3927", "text": " 0"}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} ]}, {"id": "q8250", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "24. Lack of interest in sex?", "intro": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month.", "columns": 1, "choices":[ {"id": "c3928", "text": " 1"}, {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} ]}, {"id": "q8251", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "25. Difficulty concentrating?", "intro": "This part contains a list of symptoms that people sometimes have. For each symptom, decide how much of a problem it has been for you in the past month.", "columns": 1, {"id": "c4086", "text": " 2"}, "choices":[ {"id": "c3929", "text": "1. No Problem if the symptom has not been a concern for you", "quickKey": 1}, {"id": "c3930", "text": "2. Small Problem if the symptom has caused you occasional or mild concern", "quickKey": 2}, {"id": "c3931", "text": "3. Moderate Problem if the symptom has caused you periodic or significant concern", "quickKey": 3}, {"id": "c3932", "text": "4. Big Problem if the symptom has caused you frequent or great concern", "quickKey": 4} ]}, {"id": "i2385", "type": "IntroText", "text": "This part consists of a number of statements. Read each statement and decide how it applies to you." }, {"id": "c4087", "text": " 3"}, {"id": "q8252", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "26. I am satisfied with the medical care I am receiving.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} "restartDays": 2, {"id": "c4088", "text": " 4"}, ]}, {"id": "q8253", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "27. I am barely able to keep up with my work.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c4089", "text": " 5"}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8254", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "28. I worry about becoming dependent on prescription medication.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c4090", "text": " 6"}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8255", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "29. I walk and move very carefully so I won't cause myself pain.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c4091", "text": " 7"}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8256", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "30. Things have been terrible at home lately.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c4092", "text": " 8"}, {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8257", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "31. I've had no problems with sleeping.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, {"id": "c4093", "text": " 9"}, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8258", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "32. I am not disabled.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", {"id": "c4094", "text": " 10"} "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8259", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "33. I have never abused alcohol or drugs.", "intro": "This part consists of a number of statements. Read each statement and decide how ]}, it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8260", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "34. I can't work.", {"id": "q8228", "type": "ChoiceQuestion", "required": false, "inline": true, "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8261", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "2. Jaw or face?", "text": "35. Somebody owes me for all of my pain and suffering.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, "printTitle": "Brief Battery for Health Improvement 2 (BBHI-2)", "intro": "This survey will help your caregiver better understand how you feel. There are no {"id": "q8262", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "36. Pain would not stop me from doing my favorite things.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} right or wrong answers. This survey usually takes about 10 minutes to ]}, {"id": "q8263", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "37. I am very angry with one or more of my doctors.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, complete.<br /><br /> This part contains questions concerning your level of pain {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8264", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "38. My physical problems really don't bother me that much.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, during the past month.<br /> <br /> Use the following to describe your level of {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8265", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "39. I protect my health by staying at home.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8266", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "40. My pain never changes.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ Worst Pain You<br /> {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8267", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "41. I feel well enough to work.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, Could Imagine", "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8268", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "42. I'm afraid that my poor health will ruin my most important relationships.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 11, "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8269", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "43. There are many jobs that I am capable of doing.", "intro": "This part consists of a number of statements. Read each statement and decide how "choices":[ it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8270", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "44. My life is full and satisfying.", {"id": "c3927", "text": " 0"}, "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8271", "type": "ChoiceQuestion", "required": false, "inline": false, "content":[ {"id": "c3928", "text": " 1"}, "text": "45. I am afraid of pushing myself too hard.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "c4086", "text": " 2"}, {"id": "q8272", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "46. With my kind of problems, there's little hope of getting better.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} {"id": "c4087", "text": " 3"}, ]}, {"id": "q8273", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "47. This has been one of the worst times of my life.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c4088", "text": " 4"}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8274", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "48. I get so restless at times that I can't stand still.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c4089", "text": " 5"}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8275", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "49. My life used to be much better than it is now.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c4090", "text": " 6"}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8276", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "50. I am allergic to the glass found in jars.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c4091", "text": " 7"}, {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8277", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "51. I am afraid that my physical problems might kill me.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, {"id": "c4092", "text": " 8"}, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8278", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "52. Lately, I have been thinking about suicide a lot.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", {"id": "c4093", "text": " 9"}, "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8279", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "53. I am content with my life.", "intro": "This part consists of a number of statements. Read each statement and decide how {"id": "c4094", "text": " 10"} it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8280", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "54. I fear being struck down by an attack of some illness.", {"id": "q8402", "type": "ChoiceQuestion", "required": true, "inline": false, ]}, "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8281", "type": "ChoiceQuestion", "required": false, "inline": false, {"id": "q8229", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "55. My life seems like one defeat after another.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, "text": "3. Neck or shoulders?", {"id": "q8282", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "56. My health problems really aren't that serious.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} "intro": "This survey will help your caregiver better understand how you feel. There are no ]}, {"id": "q8283", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "57. When I think about my physical problems, I get depressed.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, right or wrong answers. This survey usually takes about 10 minutes to {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8284", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "58. My life shouldn't be this hard.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, complete.<br /><br /> This part contains questions concerning your level of pain {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8285", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "59. I often get depressed; it's like I fall in a hole and can't get out.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, during the past month.<br /> <br /> Use the following to describe your level of {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8286", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "60. I have many severe problems that come and go.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, "choices":[ pain:<br /> <br /> 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10<br /> No Pain {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8287", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "61. There are many things I won't do for fear of hurting myself.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", "columns": 1, Worst Pain You<br /> "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8288", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "62. Recently my life has been a nightmare.", "intro": "This part consists of a number of statements. Read each statement and decide how it applies to you.", Could Imagine", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}, {"id": "q8289", "type": "ChoiceQuestion", "required": false, "inline": false, "text": "63. I'm often afraid that something bad will happen to me.", "intro": "This part consists of a number of statements. Read each statement and decide how "text": "0. Please select the primary area where you have pain: (this question is "columns": 11, it applies to you.", "columns": 1, "choices":[ {"id": "c3933", "text": "1. Strongly Disagree if the statement is not at all true", "quickKey": 1}, {"id": "c3934", "text": "2. Disagree if the statement is mostly not true", "quickKey": 2}, {"id": "c3935", "text": "3. Agree if the statement is mostly true", "quickKey": 3}, {"id": "c3936", "text": "4. Strongly Agree if the statement is very true", "quickKey": 4} ]}] } "choices":[ {"id": "c3927", "text": " 0"}, {"id": "c3928", "text": " 1"}, {"id": "c4086", "text": " 2"}, {"id": "c4087", "text": " 3"}, {"id": "c4088", "text": " 4"}, {"id": "c4089", "text": " 5"}, {"id": "c4090", "text": " 6"}, {"id": "c4091", "text": " 7"}, |