Name | Value |
---|---|
INSTRUMENT | PHQ-15 |
LAST UPDATE | 2022-04-08 08:58:47 |
ENTRY CHECKSUM | 1061241056 |
ENTRY SPECIFICATION | {"name": "PHQ-15", {"id": "q5191", "type": "ChoiceQuestion", "required": false, "inline": true, {"id": "q5304", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "j. Shortness of breath", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, "text": "a. Stomach pain", {"id": "q5305", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "k. Pain or problems during sexual intercourse", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, "intro": "During the past 4 weeks, how much have you been bothered by any of the following {"id": "q5306", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "l. Constipation, loose bowels, or diarrhea", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, problems? ", {"id": "q5307", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "m. Nausea, gas, or indigestion", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, "columns": 3, {"id": "q5308", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "n. Feeling tired or having low energy", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, "choices":[ {"id": "q5400", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "o. Trouble sleeping", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}] {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, } {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, "copyright": "Copyright (c) Pfizer Inc. All rights reserved. Reproduced with permission.", {"id": "q5192", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "b. Back pain", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, "restartDays": 2, {"id": "q5297", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "c. Pain in your arms, legs, or joints (knees, hips, etc.)", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, "printTitle": "Patient Health Questionnaire 15-Item Somatic Symptom Severity Scale", {"id": "q5298", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "d. Menstrual cramps or other problems with your periods [Women only]", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, "content":[ {"id": "q5299", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "e. Headaches", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, {"id": "i599", "type": "IntroText", {"id": "q5300", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "f. Chest pain", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, "text": "During the past 4 weeks, how much have you been bothered by any of the following {"id": "q5301", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "g. Dizziness", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, problems? " {"id": "q5302", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "h. Fainting spells", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, }, {"id": "q5303", "type": "ChoiceQuestion", "required": false, "inline": true, "text": "i. Feeling your heart pound or race", "intro": "During the past 4 weeks, how much have you been bothered by any of the following problems? ", "columns": 3, "choices":[ {"id": "c2933", "text": "0. Not bothered at all", "quickKey": 0}, {"id": "c2934", "text": "1. Bothered a little", "quickKey": 1}, {"id": "c2935", "text": "2. Bothered a lot", "quickKey": 2} ]}, |