POQ (51)    MH TEST/SURVEY SPEC (601.712)

Name Value
INSTRUMENT POQ
LAST UPDATE 2022-04-08 08:56:37
ENTRY CHECKSUM 1072980573
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"]}]
}