| ENTRY SPECIFICATION |
{"name": "POQ",
possible pain, how would you rate your pain on the AVERAGE during the LAST WEEK?",
"min": 0, "max": 10,
"legend":["no pain at all", " worse possible pain"]},
{"id": "q5140", "type": "SliderQuestion", "required": false,
"text": "3. Does your pain interfere with your ability to walk?",
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]},
{"id": "q5141", "type": "SliderQuestion", "required": false,
"text": "4. Does your pain interfere with your ability to carry/handle everyday objects
such as a bag of groceries or books?",
"restartDays": 2,
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]},
{"id": "q5142", "type": "SliderQuestion", "required": false,
"text": "5. Does your pain interfere with your ability to climb stairs?",
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]},
{"id": "q5143", "type": "SliderQuestion", "required": false,
"text": "6. Does your pain require you to use a cane, walker, wheelchair or other devices?",
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]},
"printTitle": "Pain Outcomes Questionnaire",
{"id": "q5144", "type": "SliderQuestion", "required": false,
"text": "7. Does your pain interfere with your ability to bathe yourself?",
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]},
{"id": "q5145", "type": "SliderQuestion", "required": false,
"text": "8. Does your pain interfere with your ability to dress yourself?",
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]},
{"id": "q5146", "type": "SliderQuestion", "required": false,
"text": "9. Does your pain interfere with your ability to use the bathroom?",
"content":[
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]},
{"id": "q5147", "type": "SliderQuestion", "required": false,
"text": "10. Does your pain interfere with your ability to manage your personal grooming
(for example, combing your hair, brushing your teeth, etc.)?",
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]},
{"id": "q5148", "type": "SliderQuestion", "required": false,
"text": "11. Does your pain affect your self-esteem or self-worth?",
"min": 0, "max": 10,
{"id": "q5138", "type": "DateQuestion", "required": false, "inline": true,
"legend":["Not at all", "All the time"]},
{"id": "q5149", "type": "SliderQuestion", "required": false,
"text": "12. How would you rate your physical activity?",
"min": 0, "max": 10,
"legend":["significant limitation in basic activities", " can perform vigorous activities without limitation"]},
{"id": "q5150", "type": "SliderQuestion", "required": false,
"text": "13. How would you rate your overall energy?",
"min": 0, "max": 10,
"legend":["totally worn out", " most energy ever"]},
{"id": "q5151", "type": "SliderQuestion", "required": false,
"text": "1. Today's date:",
"text": "14. How would you rate your strength and endurance TODAY?",
"min": 0, "max": 10,
"legend":["very poor strength and endurance", "very high strength and endurance"]},
{"id": "q5152", "type": "SliderQuestion", "required": false,
"text": "15. How would you rate your feelings of depression TODAY?",
"min": 0, "max": 10,
"legend":["not depressed at all", "extremely depressed"]},
{"id": "q5153", "type": "SliderQuestion", "required": false,
"text": "16. How would you rate your feelings of anxiety TODAY?",
"min": 0, "max": 10,
"controlWidth": 120, "daysBack": 30, "daysAhead": 0},
"legend":["not anxious at all", " extremely anxious"]},
{"id": "q5154", "type": "SliderQuestion", "required": false,
"text": "17. How much do you worry about re-injuring yourself if you are more active?",
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]},
{"id": "q5155", "type": "SliderQuestion", "required": false,
"text": "18. How safe do you think it is for you to exercise?",
"min": 0, "max": 10,
"legend":["not safe at all", " extremely safe"]},
{"id": "q5156", "type": "SliderQuestion", "required": false,
{"id": "q5139", "type": "SliderQuestion", "required": false,
"text": "19. Do you have problems concentrating on things TODAY?",
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]},
{"id": "q5157", "type": "SliderQuestion", "required": false,
"text": "20. How often do you feel tense?",
"min": 0, "max": 10,
"legend":["Not at all", "All the time"]}],
"rules":[
{"question": "q4295", "operator": "EQ", "value": "c1572",
"conjunction": "and", "question2": "q4296", "operator2": "EQ", "value2": 1000,
"text": "2. On a scale of 0 to 10, with 0 being no pain at all and 10 being the worst
"skips":["q4299"]},
{"question": "q4295", "operator": "NE", "value": "c1572",
"conjunction": "and", "question2": "q4296", "operator2": "NE", "value2": 1000,
"skips":["q4299"]}]
}
|
