BARTHEL INDEX (68)    MH TEST/SURVEY SPEC (601.712)

Name Value
INSTRUMENT BARTHEL INDEX
LAST UPDATE 2022-04-08 09:03:35
ENTRY CHECKSUM 202152581
ENTRY SPECIFICATION
{"name": "BARTHEL INDEX", 
 patient's self-report, from a separate party who is familiar with the patient's
     {"id": "c3026", "text": "0. Immobile", "quickKey": 0}, 
     {"id": "c3027", "text": "1. Wheelchair independent, including corners, etc.", "quickKey": 1}, 
     {"id": "c3028", "text": "2. Walks with help of one person (verbal or physical)", "quickKey": 2}, 
     {"id": "c3029", "text": "3. Independent (but may use any aid, e.g., cane)", "quickKey": 3}
   ]}, 
   {"id": "q5680", "type": "ChoiceQuestion", "required": false, "inline": false, 
    "text": "8. Dressing:", 
    "intro": "Choose the scoring point for the statement that most closely corresponds to the
 patient's current level of ability for each of the following 10 items. Record
 actual, not potential, functioning.   Information can be obtained from the
 abilities (such as a relative), or from observation.  "
 patient's self-report, from a separate party who is familiar with the patient's
 abilities (such as a relative), or from observation.  ", 
    "columns": 1, 
    "choices":[
     {"id": "c3016", "text": "0. Dependent", "quickKey": 0}, 
     {"id": "c3030", "text": "1. Needs help, but can do about half unaided", "quickKey": 1}, 
     {"id": "c3031", "text": "2. Independent (including buttons, zippers, laces, etc.)", "quickKey": 2}
   ]}, 
   {"id": "q5681", "type": "ChoiceQuestion", "required": false, "inline": false, 
    "text": "9. Stairs:", 
    }, 
    "intro": "Choose the scoring point for the statement that most closely corresponds to the
 patient's current level of ability for each of the following 10 items. Record
 actual, not potential, functioning.   Information can be obtained from the
 patient's self-report, from a separate party who is familiar with the patient's
 abilities (such as a relative), or from observation.  ", 
    "columns": 1, 
    "choices":[
     {"id": "c3019", "text": "0. Unable", "quickKey": 0}, 
     {"id": "c3032", "text": "1. Needs help (verbal, physical, carrying aid)", "quickKey": 1}, 
     {"id": "c3033", "text": "2. Independent, up and down", "quickKey": 2}
   {"id": "q5673", "type": "ChoiceQuestion", "required": false, "inline": false, 
   ]}, 
   {"id": "q5682", "type": "ChoiceQuestion", "required": false, "inline": false, 
    "text": "10. Bathing:", 
    "intro": "Choose the scoring point for the statement that most closely corresponds to the
 patient's current level of ability for each of the following 10 items. Record
 actual, not potential, functioning.   Information can be obtained from the
 patient's self-report, from a separate party who is familiar with the patient's
 abilities (such as a relative), or from observation.  ", 
    "columns": 1, 
    "choices":[
    "text": "1. Bowels (preceding week):", 
     {"id": "c3016", "text": "0. Dependent", "quickKey": 0}, 
     {"id": "c3034", "text": "1. Independent (can perform all the steps)", "quickKey": 1}
   ]}]
}
    "intro": "Choose the scoring point for the statement that most closely corresponds to the
 patient's current level of ability for each of the following 10 items. Record
 actual, not potential, functioning.   Information can be obtained from the
 patient's self-report, from a separate party who is familiar with the patient's
 abilities (such as a relative), or from observation.  ", 
 "copyright": "Copyright (c) 1965, Maryland State Medical Journal", 
    "columns": 1, 
    "choices":[
     {"id": "c3008", "text": "0. Incontinent (or needs to be given enema)", "quickKey": 0}, 
     {"id": "c3009", "text": "1. Occasional accident (once per week)", "quickKey": 1}, 
     {"id": "c3010", "text": "2. Continent", "quickKey": 2}
   ]}, 
   {"id": "q5674", "type": "ChoiceQuestion", "required": false, "inline": false, 
    "text": "2. Bladder (preceding week):", 
    "intro": "Choose the scoring point for the statement that most closely corresponds to the
 patient's current level of ability for each of the following 10 items. Record
 "restartDays": 2, 
 actual, not potential, functioning.   Information can be obtained from the
 patient's self-report, from a separate party who is familiar with the patient's
 abilities (such as a relative), or from observation.  ", 
    "columns": 1, 
    "choices":[
     {"id": "c3011", "text": "0. Incontinent, or catheterized and unable to manage", "quickKey": 0}, 
     {"id": "c3012", "text": "1. Occasional accident (maximum, once per 24 hours)", "quickKey": 1}, 
     {"id": "c3013", "text": "2. Continent (for over 7 days)", "quickKey": 2}
   ]}, 
   {"id": "q5675", "type": "ChoiceQuestion", "required": false, "inline": false, 
 "printTitle": "Barthel Index of Activities of Daily Living",
    "text": "3. Grooming (preceding 24 - 48 hours):", 
    "intro": "Choose the scoring point for the statement that most closely corresponds to the
 patient's current level of ability for each of the following 10 items. Record
 actual, not potential, functioning.   Information can be obtained from the
 patient's self-report, from a separate party who is familiar with the patient's
 abilities (such as a relative), or from observation.  ", 
    "columns": 1, 
    "choices":[
     {"id": "c3014", "text": "0. Needs help with personal care", "quickKey": 0}, 
     {"id": "c3015", "text": "1. Independent face/hair/teeth/shaving (implements provided)", "quickKey": 1}
 "content":[
   ]}, 
   {"id": "q5676", "type": "ChoiceQuestion", "required": false, "inline": false, 
    "text": "4. Toilet use:", 
    "intro": "Choose the scoring point for the statement that most closely corresponds to the
 patient's current level of ability for each of the following 10 items. Record
 actual, not potential, functioning.   Information can be obtained from the
 patient's self-report, from a separate party who is familiar with the patient's
 abilities (such as a relative), or from observation.  ", 
    "columns": 1, 
    "choices":[
   {"id": "i1047", "type": "IntroText", 
     {"id": "c3016", "text": "0. Dependent", "quickKey": 0}, 
     {"id": "c3156", "text": "1. Needs some help, but can do some things alone", "quickKey": 1}, 
     {"id": "c3018", "text": "2. Independent (on and off, dressing, wiping)", "quickKey": 2}
   ]}, 
   {"id": "q5677", "type": "ChoiceQuestion", "required": false, "inline": false, 
    "text": "5. Feeding:", 
    "intro": "Choose the scoring point for the statement that most closely corresponds to the
 patient's current level of ability for each of the following 10 items. Record
 actual, not potential, functioning.   Information can be obtained from the
 patient's self-report, from a separate party who is familiar with the patient's
    "text": "Choose the scoring point for the statement that most closely corresponds to the
 abilities (such as a relative), or from observation.  ", 
    "columns": 1, 
    "choices":[
     {"id": "c3019", "text": "0. Unable", "quickKey": 0}, 
     {"id": "c3020", "text": "1. Needs help cutting, spreading butter, etc.", "quickKey": 1}, 
     {"id": "c3021", "text": "2. Independent (food provided within reach)", "quickKey": 2}
   ]}, 
   {"id": "q5678", "type": "ChoiceQuestion", "required": false, "inline": false, 
    "text": "6. Transfer:", 
    "intro": "Choose the scoring point for the statement that most closely corresponds to the
 patient's current level of ability for each of the following 10 items. Record
 patient's current level of ability for each of the following 10 items. Record
 actual, not potential, functioning.   Information can be obtained from the
 patient's self-report, from a separate party who is familiar with the patient's
 abilities (such as a relative), or from observation.  ", 
    "columns": 1, 
    "choices":[
     {"id": "c3022", "text": "0. Unable, no sitting balance", "quickKey": 0}, 
     {"id": "c3023", "text": "1. Major help (one or two people, physical), can sit", "quickKey": 1}, 
     {"id": "c3024", "text": "2. Minor help (verbal or physical)", "quickKey": 2}, 
     {"id": "c3025", "text": "3. Independent", "quickKey": 3}
 actual, not potential, functioning.   Information can be obtained from the
   ]}, 
   {"id": "q5679", "type": "ChoiceQuestion", "required": false, "inline": false, 
    "text": "7. Mobility:", 
    "intro": "Choose the scoring point for the statement that most closely corresponds to the
 patient's current level of ability for each of the following 10 items. Record
 actual, not potential, functioning.   Information can be obtained from the
 patient's self-report, from a separate party who is familiar with the patient's
 abilities (such as a relative), or from observation.  ", 
    "columns": 1, 
    "choices":[