YS*5.01*234 PEG (287)    MH INSTRUMENT EXCHANGE (601.95)

Name Value
NAME YS*5.01*234 PEG
DATE CREATED 2023-08-02 14:27:01
SOURCE LEE@CAMP MASTER
SPECIFICATION
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ment, and General Activity (PEG)\r\n|  \r\n|   Date Given: <.Date_Given.>\r\n|   Clinician: <.Staff_Ordered_By.>\r\n|   Location:  <.Location.>\r\n|  
\r\n|   Veteran:  <.Patient_Name_Last_First.>\r\n|   SSN: <.Patient_SSN.>\r\n|   DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)\r\n|   Gender: <.Patient_Gender.>\r\n|  \r\n|   PEG Average Score = <-AVERAGE->\r\n|  \r\n|  \r\n|Questions an
d Answers:\r\n|  \r\n|   1.  What number best describes your pain on average in the past week?\r\n|       <*Answer_9089*>\r\n|   2.  What number best describes how, during the past week, pain has\r\n|       interfered with your enjoyment of
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 life?\r\n|       <*Answer_9090*>\r\n|   3.  What number best describes how, during the past week, pain has\r\n|       interfered with your general activity?\r\n|       <*Answer_9091*>\r\n|  \r\n|Information contained in this note is based 
on a self-report assessment \r\n|and is not sufficient to use alone for diagnostic purposes. Assessment \r\n|results should be verified for accuracy and used in conjunction with \r\n|other diagnostic activities."},"scaleGroup":[{"grid1":0,"
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r\n    \"text\": \"2. What number best describes how, during the past week, pain has interfered with your enjoyment of life?\",\r\n    \"intro\": \"Answer the following questions on a scale from 0 to 10.\", \r\n    \"min\": 0, \"max\": 10, 
\r\n    \"legend\":[\"Does not|  interfere\", \"Unable to carry on|  any activities\"]}, \r\n   {\"id\": \"q9091\", \"type\": \"SliderQuestion\", \"required\": false, \r\n    \"text\": \"3. What number best describes how, during the past we
ek, pain has interfered with your general activity?\",\r\n    \"intro\": \"Answer the following questions on a scale from 0 to 10.\", \r\n    \"min\": 0, \"max\": 10, \r\n    \"legend\":[\"Does not|  interfere\", \"Completely|  interferes\"
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iceId":5673,"choiceText":"Does not interfere","ien":109359,"legacyValue":0,"sequence":1},{"choiceId":5674,"choiceText":"Unable to carry on any activities","ien":109360,"legacyValue":10,"sequence":2}],"choiceDisplay":81373,"choiceIdentifier"
:"N","choiceIdentifierIen":42383,"choiceTypeId":15138,"designator":"2.","hint":null,"id":9155,"instrument":315,"introDisplay":81371,"introId":2526,"introText":"Answer the following questions on a scale from 0 to 10.","max":10,"min":0,"quest
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choice":[{"choiceId":5675,"choiceText":"Does not interfere","ien":109361,"legacyValue":0,"sequence":1},{"choiceId":5676,"choiceText":"Completely interferes","ien":109362,"legacyValue":10,"sequence":2}],"choiceDisplay":81373,"choiceIdentifie
r":"N","choiceIdentifierIen":42384,"choiceTypeId":15139,"designator":"3.","hint":null,"id":9156,"instrument":315,"introDisplay":81371,"introId":2526,"introText":"Answer the following questions on a scale from 0 to 10.","max":10,"min":0,"que
stionDisplay":81372,"questionId":9091,"questionText":"What number best describes how, during the past week, pain has interfered with your general activity?","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":30}],
DESCRIPTION
New PEG instrument.
INSTALL HISTORY
  • INSTALL DATE:   2023-11-28 09:44:30
    INSTALLED BY:   File: 200, IEN: 1099
  • INSTALL DATE:   2023-11-28 09:48:17
    INSTALLED BY:   File: 200, IEN: 1099
  • INSTALL DATE:   2023-12-27 11:57:17
    INSTALLED BY:   USER,EIGHTYNINE