SPECIFICATION |
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rs to the person you indicated above) responds to you when he or she knows you are in pain. On the scale listed \r\nbelow each question, indicate HOW OFTEN your significant other generally responds to you in that particular way WHEN YOU AR
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to your \"significant other.\" A significant other is a person with whom you feel closest. This includes anyone that you relate to on a regular or \r\ninfrequent basis. It is very important that you identify someone as your \"significant
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how your significant other (this refers to the person you indicated above) responds to you when he or she knows you are in pain. On the scale listed
other.\" ","max":0,"min":0,"questionDisplay":43191,"questionId":5201,"questionText":"Do you currently live with this person?","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":40},{"choice":[{"choiceId":2594,"choi
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we are interested in knowing how your significant other (this refers to the person you indicated above) responds to you when he or she knows you are in pain. On the scale listed \r\nbelow each question, indicate HOW OFTEN your significant
other generally responds to you in that particular way WHEN YOU ARE IN PAIN. ","max":6,"min":0,"questionDisplay":43249,"questionId":5229,"questionText":"Takes over my jobs or duties.","required":false,"responseTypeId":7,"responseTypeText"
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this refers to the person you indicated above) responds to you when he or she knows you are in pain. On the scale listed \r\nbelow each question, indicate HOW OFTEN your significant other generally responds to you in that particular way WH
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you indicated above) responds to you when he or she knows you are in pain. On the scale listed \r\nbelow each question, indicate HOW OFTEN your significant other generally responds to you in that particular way WHEN YOU ARE IN PAIN. ","m
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s you are in pain. On the scale listed \r\nbelow each question, indicate HOW OFTEN your significant other generally responds to you in that particular way WHEN YOU ARE IN PAIN. ","max":6,"min":0,"questionDisplay":43255,"questionId":5232,"
questionText":"Tries to get me to rest.","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":380},{"choice":[{"choiceId":217,
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to you when he or she knows you are in pain. On the scale listed \r\nbelow each question, indicate HOW OFTEN your significant other generally responds to you in that particular way WHEN YOU ARE IN PAIN. ","max":6,"min":0,"questionDisplay"
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he scale listed \r\nbelow each question, indicate HOW OFTEN your significant other generally responds to you in that particular way WHEN YOU ARE IN PAIN. ","max":6,"min":0,"questionDisplay":43259,"questionId":5234,"questionText":"Expresse
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n this section, we are interested in knowing how your significant other (this refers to the person you indicated above) responds to you when he or she knows you are in pain. On the scale listed \r\nbelow each question, indicate HOW OFTEN y
our significant other generally responds to you in that particular way WHEN YOU ARE IN PAIN. ","max":6,"min":0,"questionDisplay":43261,"questionId":5235,"questionText":"Gets me some pain medication.","required":false,"responseTypeId":7,"re
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scale to record your answer. Read each question carefully and then select \r\nthe number on the scale to indicate how that specific question applies to you. You can click on the number with the mouse or enter the number on the key board.
nificant other (this refers to the person you indicated above) responds to you when he or she knows you are in pain. On the scale listed \r\nbelow each question, indicate HOW OFTEN your significant other generally responds to you in that p
articular way WHEN YOU ARE IN PAIN. ","max":6,"min":0,"questionDisplay":43263,"questionId":5236,"questionText":"Encourages me to work on a hobby.","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":420},{"choice"
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"In this section, we are interested in knowing how your significant other (this refers to the person you indicated above) responds to you when he or she knows you are in pain. On the scale listed \r\nbelow each question, indicate HOW OFTEN
your significant other generally responds to you in that particular way WHEN YOU ARE IN PAIN. ","max":6,"min":0,"questionDisplay":43265,"questionId":5237,"questionText":"Gets me something to eat or drink.","required":false,"responseTypeId
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our significant other (this refers to the person you indicated above) responds to you when he or she knows you are in pain. On the scale listed \r\nbelow each question, indicate HOW OFTEN your significant other generally responds to you in
that particular way WHEN YOU ARE IN PAIN. ","max":6,"min":0,"questionDisplay":43267,"questionId":5238,"questionText":"Turns on the TV to take my mind off my pain.","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequen
","max":6,"min":0,"questionDisplay":43195,"questionId":5202,"questionText":"Rate the level of your pain at the present moment.","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":70},{"choice":[{"choiceId":2596,"c
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EN you do each of these activities by selecting a number on the scale below each activity. Please complete ALL 18 questions. ","max":6,"min":0,"questionDisplay":43273,"questionId":5240,"questionText":"Mow the lawn.","required":false,"respo
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. Please indicate HOW OFTEN you do each of these activities by selecting a number on the scale below each activity. Please complete ALL 18 questions. ","max":6,"min":0,"questionDisplay":43275,"questionId":5241,"questionText":"Go out to eat
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below each activity. Please complete ALL 18 questions. ","max":6,"min":0,"questionDisplay":43279,"questionId":5243,"questionText":"Go grocery shopping.","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":510},{"
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"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do each of these activities by selecting a number on the scale below each activity. Please complete ALL 18 questions. ","max":6,"min":0,"questionDisplay":43287,"qu
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ill be asked to describe your pain and how it affects your life. Under each question is a scale to record your answer. Read each question carefully and then select \r\nthe number on the scale to indicate how that specific question applies
oDisplay":43270,"introId":588,"introText":"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do each of these activities by selecting a number on the scale below each activity. Please complete ALL 18 questions. ","
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to you. You can click on the number with the mouse or enter the number on the key board. ","max":6,"min":0,"questionDisplay":43197,"questionId":5203,"questionText":"In general, how much does your pain problem interfere with your day to day
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".|.|West Haven-Yale Multidimensional Pain Inventory||Date Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Location.>||Veteran: <.Patient_Name_Last_First.>|SSN: <.Patient_SSN.>|DOB: \r\n<.Patient_Date_Of_Birth.> (<.Patient
_Age.>)|Gender: <.Patient_Gender.>| |WHYMPI Scales||Part I| Interference <-Interference->| Support <-Support->| Pain Severity \r\n <-Pain Severity->| Life-Con
\r\ntrol <-Life-Control->| Affective Distress <-Affective Distress->||Part II| Negative Responses <-Negative Responses->| Solicitous Responses \r\n <-Solicitous Respon
ses->| Distracting Responses <-Distracting Responses->|\r\n|Part III| Household Chores <-Household Chores->| Outdoor Work <-Outdoor Work->| Activities Away from Home <-Ac
tivities Away from Home->| Social Activities \r\n<-Social Activities->| General Activity <-General Activity->||Questions and Answers||1.\r\nPlease indicate who your significant other is:| <*Answer_5
199*>|Significant\r\n other:| <*Answer_5200*>|2. Do you currently live with this person?| <*Answer_5201*>|A1. Rate the level of your pain at the present moment.| <*Answer_5202*>|A2. In general, how much does your \r\npain problem i
the following 20 questions, you will be asked to describe your pain and how it affects your life. Under each question is a scale to record your answer. Read each question carefully and then select \r\nthe number on the scale to indicate ho
nterfere with your day to day activities?| <*Answer_5203*>|Are you retired from work for reasons other than your pain problem?| <*Answer_5204*>|A3. Since the time you developed a \r\npain problem, how much has your pain changed your a
bility to work?| <*Answer_5205*>|A4. How much has your pain changed the amount of satisfaction or enjoyment you get from participating in social \r\nand recreational activities?| <*Answer_5206*>|A5. How supportive or helpful is your s
pouse (significant other) to you in relation to your pain?| <*Answer_5207*>|A6. Rate your overall mood \r\nduring the PAST WEEK.| <*Answer_5208*>|A7. On the average, how severe has your pain been during the LAST WEEK?| <*Answer_520
9*>|A8. How much has your pain changed your ability to participate in \r\nrecreational and other social activities?| <*Answer_5210*>|A9. How much has your pain changed the amount of satisfaction you get from family-related activities?|
<*Answer_5211*>|A10. How \r\nworried is your spouse (significant other) about you in reaction to your pain problem?| <*Answer_5212*>|A11. During the PAST WEEK, how much control do you feel that you have had over your life?| \r\n <*An
swer_5213*>|A12. How much SUFFERING do you experience because of your pain?| <*Answer_5214*>|A13. How much has your pain changed your marriage and other family relationships?| \r\n<*Answer_5215*>|Are you currently working?| <*Answe
r_5216*>|A14. How much has your pain changed the amount of satisfaction or enjoyment you get from work?| <*Answer_5217*>|A15. How attentive is \r\nyour spouse (significant other) to your pain problem?| <*Answer_5218*>|A16. During the
PAST WEEK, how much do you feel that you've been able to deal with your problems?| <*Answer_5219*>|A17. \r\nHow much has your pain changed your ability to do household chores?| <*Answer_5220*>|A18. During the PAST WEEK, how irritable
have you been?| <*Answer_5221*>|A19. How much has your pain changed \r\nyour friendships with people other than your family?| <*Answer_5222*>|A20. During the PAST WEEK, how tense or anxious have you been?| <*Answer_5223*>|B1. Ignor
es me.| <*Answer_5225*>|B2. \r\nAsks me what he\/she can do to help.| <*Answer_5226*>|B3. Reads to me.| <*Answer_5227*>|B4. Expresses irritation at me.| <*Answer_5228*>|B5. Takes over my jobs or duties.| \r\n<*Answer_5229*>|B
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6. Talks to me about something else to take my mind off the pain.| <*Answer_5230*>|B7. Expresses frustration with me.| <*Answer_5231*>|B8. Tries to get me to rest.| \r\n<*Answer_5232*>|B9. Tries to involve me in some activity.|
<*Answer_5233*>|B10. Expresses anger with me.| <*Answer_5234*>|B11. Gets me some pain medication.| <*Answer_5235*>|B12. Encourages \r\nme to work on a hobby.| <*Answer_5236*>|B13. Gets me something to eat or drink.| <*Answer_523
7*>|B14. Turns on the TV to take my mind off my pain.| <*Answer_5238*>|C1. Washes dishes.|
\r\n<*Answer_5239*>|C2. Mow the lawn.| <*Answer_5240*>|C3. Go out to eat.| <*Answer_5241*>|C4. Play cards or other games.| <*Answer_5242*>|C5. Go grocery shopping.| <*Answer_5243*>|C6. Work \r\nin the garden.| <*Answer_5244*>
|C7. Go to a movie.| <*Answer_5245*>|C8. Visit a friend.| <*Answer_5246*>|C9. Help with the house cleaning.| <*Answer_5247*>|C10. Work on a car.| \r\n<*Answer_5248*>|C11. Take a ride in a car.| <*Answer_5249*>|C12. Visit rela
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5*>|C18. Work on a needed house repair.| <*Answer_5256*>|||Information \r\ncontained in this note is based on a self-report assessment and is not sufficient to use alone for diagnostic purposes. Assessment results should be verified for
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t\": \"A10. How worried is your spouse (significant other) about you in reaction to your\r\n pain problem?\", \r\n \"intro\": \"In the following 20 questions, you will be asked to describe your pain and how it\r\n affects your life. Unde
r each question is a scale to record your answer. Read\r\n each question carefully and then select the number on the scale to indicate how
\r\n that specific question applies to you. You can click on the number with the\r\n mouse or enter the number on the key board. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Not at all worried\", \" Extremely worried\"]}, \r\n
{\"id\": \"q5213\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"A11. During the PAST WEEK, how much control do you feel that you have had over\r\n your life?\", \r\n \"intro\": \"In the following 20 question
s, you will be asked to describe your pain and how it\r\n affects your life. Under each question is a scale to record your answer. Read\r\n each question carefully and then select the number on the scale to indicate how\r\n that specific q
\r\nthe number on the scale to indicate how that specific question applies to you. You can click on the number with the mouse or enter the number on the key board. ","max":6,"min":0,"questionDisplay":43215,"questionId":5212,"questionText"
uestion applies to you. You can click on the number with the\r\n mouse or enter the number on the key board. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Not at all in control\", \" Extremely in control\"]}, \r\n {\"id\": \"
q5214\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"A12. How much SUFFERING do you experience because of your pain?\", \r\n \"intro\": \"In the following 20 questions, you will be asked to describe your pain a
nd how it\r\n affects your life. Under each question is a scale to record your answer. Read\r\n each question carefully and then select the number on the scale to indicate how\r\n that specific question applies to you. You can click on the
number with the\r\n mouse or enter the number on the key board. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"No suffering\", \" Extreme suffering\"]}, \r\n {\"id\": \"q5215\", \"type\": \"SliderQuestion\", \"required\": fal
se, \r\n \"text\": \"A13. How much has your pain changed your marriage and other family relationships?\", \r\n \"intro\": \"In the following 20 questions, you will be asked to describe your pain and how it\r\n affects your life. Under
each question is a scale to record your answer. Read\r\n each question carefully and then select the number on the scale to indicate how\r\n that specific question applies to you. You can click on the number with the\r\n mouse or enter th
e number on the key board. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"No change\", \" Extreme change\"]}, \r\n {\"id\": \"q5216\", \"type\": \"ChoiceQuestion\", \"required\": false, \"inline\": true, \r\n \"text\": \" A
re you currently working?\", \r\n \"intro\": \"In the following 20 questions, you will be asked to describe your pain and how it\r\n affects your life. Under each question is a scale to record your answer. Read\r\n each question carefull
y and then select the number on the scale to indicate how\r\n that specific question applies to you. You can click on the number with the\r\n mouse or enter the number on the key board. \", \r\n \"columns\": 2, \r\n \"choices\":[\r\
n {\"id\": \"c241\", \"text\": \"1. Yes\", \"quickKey\": 1}, \r\n {\"id\": \"c237\", \"text\": \"2. No\", \"quickKey\": 2}\r\n ]}, \r\n {\"id\": \"q5217\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"A
:"How worried is your spouse (significant other) about you in reaction to your pain problem?","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":170},{"choice":[{"choiceId":2605,"choiceText":"Not at all in control
14. How much has your pain changed the amount of satisfaction or enjoyment you\r\n get from work?\", \r\n \"intro\": \"In the following 20 questions, you will be asked to describe your pain and how it\r\n affects your life. Under each qu
estion is a scale to record your answer. Read\r\n each question carefully and then select the number on the scale to indicate how\r\n that specific question applies to you. You can click on the number with the\r\n mouse or enter the number
on the key board. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"No change\", \" Extreme change\"]}, \r\n {\"id\": \"q5218\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"A15. How attentive is your s
pouse (significant other) to your pain problem?\", \r\n \"intro\": \"In the following 20 questions, you will be asked to describe your pain and how it
\r\n affects your life. Under each question is a scale to record your answer. Read\r\n each question carefully and then select the number on the scale to indicate how\r\n that specific question applies to you. You can click on the number w
ith the\r\n mouse or enter the number on the key board. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Not at all attentive\", \" Extremely attentive\"]}, \r\n {\"id\": \"q5219\", \"type\": \"SliderQuestion\", \"required\": fa
lse, \r\n \"text\": \"A16. During the PAST WEEK, how much do you feel that you've been able to deal\r\n with your problems?\", \r\n \"intro\": \"In the following 20 questions, you will be asked to describe your pain and how it\r\n aff
ects your life. Under each question is a scale to record your answer. Read\r\n each question carefully and then select the number on the scale to indicate how\r\n that specific question applies to you. You can click on the number with the\
r\n mouse or enter the number on the key board. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Not at all\", \" Extremely well\"]}, \r\n {\"id\": \"q5220\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\":
\"A17. How much has your pain changed your ability to do household chores?\", \r\n \"intro\": \"In the following 20 questions, you will be asked to describe your pain and how it\r\n affects your life. Under each question is a scale to re
,"questionId":5199,"questionText":"Please indicate who your significant other is:","required":false,"responseTypeId":1,"responseTypeText":"MCHOICE","sequence":20},{"choiceDisplay":43190,"choiceTypeId":null,"designator":null,"hint":null,"id"
","ien":51060,"legacyValue":0,"sequence":1},{"choiceId":2606,"choiceText":" Extremely in control","ien":51061,"legacyValue":1,"sequence":2}],"choiceDisplay":43218,"choiceIdentifier":"N","choiceIdentifierIen":16376,"choiceTypeId":24883,"desi
cord your answer. Read\r\n each question carefully and then select the number on the scale to indicate how\r\n that specific question applies to you. You can click on the number with the\r\n mouse or enter the number on the key board. \",
\r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"No change\", \" Extreme change\"]}, \r\n {\"id\": \"q5221\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"A18. During the PAST WEEK, how irritable have you b
een?\", \r\n \"intro\": \"In the following 20 questions, you will be asked to describe your pain and how it\r\n affects your life. Under each question is a scale to record your answer. Read\r\n each question carefully and then select th
e number on the scale to indicate how\r\n that specific question applies to you. You can click on the number with the\r\n mouse or enter the number on the key board. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Not at all irri
table\", \" Extremely irritable\"]}, \r\n {\"id\": \"q5222\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"A19. How much has your pain changed your friendships with people other than your\r\n family?\", \r\n \
"intro\": \"In the following 20 questions, you will be asked to describe your pain and how it\r\n affects your life. Under each question is a scale to record your answer. Read\r\n each question carefully and then select the number on the s
cale to indicate how\r\n that specific question applies to you. You can click on the number with the\r\n mouse or enter the number on the key board. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"No change\", \" Extreme change\"
]}, \r\n {\"id\": \"q5223\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"A20. During the PAST WEEK, how tense or anxious have you been?\", \r\n \"intro\": \"In the following 20 questions, you will be asked to
describe your pain and how it\r\n affects your life. Under each question is a scale to record your answer. Read\r\n each question carefully and then select the number on the scale to indicate how\r\n that specific question applies to you.
You can click on the number with the\r\n mouse or enter the number on the key board. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Not at all tense or anxious\", \" Extremely tense or anxious\"]}, \r\n {\"id\": \"i587\", \"t
gnator":"A11.","hint":null,"id":5404,"instrument":161,"introDisplay":43194,"introId":586,"introText":"In the following 20 questions, you will be asked to describe your pain and how it affects your life. Under each question is a scale to rec
ype\": \"IntroText\", \r\n \"text\": \"B.<br \/>In this section, we are interested in knowing how your significant other
\r\n (this refers to the person you indicated above) responds to you when he or she\r\n knows you are in pain. On the scale listed below each question, indicate HOW\r\n OFTEN your significant other generally responds to you in that particu
lar way\r\n WHEN YOU ARE IN PAIN. \"\r\n }, \r\n {\"id\": \"q5225\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B1. Ignores me.\", \r\n \"intro\": \"In this section, we are interested in knowing how your
significant other (this\r\n refers to the person you indicated above) responds to you when he or she knows\r\n you are in pain. On the scale listed below each question, indicate HOW OFTEN\r\n your significant other generally responds to y
ou in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5226\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B2.
Asks me what he\/she can do to help.\", \r\n \"intro\": \"In this section, we are interested in knowing how your significant other (this\r\n refers to the person you indicated above) responds to you when he or she knows\r\n you are in p
ain. On the scale listed below each question, indicate HOW OFTEN\r\n your significant other generally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" V
ery often\"]}, \r\n {\"id\": \"q5227\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B3. Reads to me.\", \r\n \"intro\": \"In this section, we are interested in knowing how your significant other (this\r\n ref
ers to the person you indicated above) responds to you when he or she knows\r\n you are in pain. On the scale listed below each question, indicate HOW OFTEN\r\n your significant other generally responds to you in that particular way WHEN Y
OU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5228\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B4. Expresses irritation at me.\",
ord your answer. Read each question carefully and then select \r\nthe number on the scale to indicate how that specific question applies to you. You can click on the number with the mouse or enter the number on the key board. ","max":6,"m
\r\n \"intro\": \"In this section, we are interested in knowing how your significant other (this\r\n refers to the person you indicated above) responds to you when he or she knows\r\n you are in pain. On the scale listed below each ques
tion, indicate HOW OFTEN\r\n your significant other generally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5229\",
\"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B5. Takes over my jobs or duties.\", \r\n \"intro\": \"In this section, we are interested in knowing how your significant other (this\r\n refers to the person you in
dicated above) responds to you when he or she knows\r\n you are in pain. On the scale listed below each question, indicate HOW OFTEN\r\n your significant other generally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \",
\r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5230\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B6. Talks to me about something else to take my mind off th
e pain.\", \r\n \"intro\": \"In this section, we are interested in knowing how your significant other (this\r\n refers to the person you indicated above) responds to you when he or she knows\r\n you are in pain. On the scale listed belo
w each question, indicate HOW OFTEN\r\n your significant other generally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\":
\"q5231\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B7. Expresses frustration with me.\",
\r\n \"intro\": \"In this section, we are interested in knowing how your significant other (this\r\n refers to the person you indicated above) responds to you when he or she knows\r\n you are in pain. On the scale listed below each ques
tion, indicate HOW OFTEN\r\n your significant other generally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5232\",
in":0,"questionDisplay":43217,"questionId":5213,"questionText":"During the PAST WEEK, how much control do you feel that you have had over your life?","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":180},{"choic
\"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B8. Tries to get me to rest.\", \r\n \"intro\": \"In this section, we are interested in knowing how your significant other (this\r\n refers to the person you indicat
ed above) responds to you when he or she knows\r\n you are in pain. On the scale listed below each question, indicate HOW OFTEN\r\n your significant other generally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n
\"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5233\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B9. Tries to involve me in some activity.\", \r\n \"intro\":
\"In this section, we are interested in knowing how your significant other (this\r\n refers to the person you indicated above) responds to you when he or she knows\r\n you are in pain. On the scale listed below each question, indicate HOW
OFTEN\r\n your significant other generally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5234\", \"type\": \"Slider
Question\", \"required\": false, \r\n \"text\": \"B10. Expresses anger with me.\", \r\n \"intro\": \"In this section, we are interested in knowing how your significant other (this\r\n refers to the person you indicated above) responds
to you when he or she knows\r\n you are in pain. On the scale listed below each question, indicate HOW OFTEN\r\n your significant other generally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"
max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5235\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B11. Gets me some pain medication.\", \r\n \"intro\": \"In this section, we are
interested in knowing how your significant other (this\r\n refers to the person you indicated above) responds to you when he or she knows\r\n you are in pain. On the scale listed below each question, indicate HOW OFTEN\r\n your significan
t other generally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5236\", \"type\": \"SliderQuestion\", \"required\":
e":[{"choiceId":2607,"choiceText":"No suffering","ien":51062,"legacyValue":0,"sequence":1},{"choiceId":2619,"choiceText":" Extreme suffering","ien":51063,"legacyValue":1,"sequence":2}],"choiceDisplay":43220,"choiceIdentifier":"N","choiceIde
false, \r\n \"text\": \"B12. Encourages me to work on a hobby.\", \r\n \"intro\": \"In this section, we are interested in knowing how your significant other (this\r\n refers to the person you indicated above) responds to you when he
or she knows\r\n you are in pain. On the scale listed below each question, indicate HOW OFTEN\r\n your significant other generally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n
\"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5237\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B13. Gets me something to eat or drink.\", \r\n \"intro\": \"In this section, we are interested
in knowing how your significant other (this\r\n refers to the person you indicated above) responds to you when he or she knows\r\n you are in pain. On the scale listed below each question, indicate HOW OFTEN\r\n your significant other gen
erally responds to you in that particular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]},
\r\n {\"id\": \"q5238\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"B14. Turns on the TV to take my mind off my pain.\", \r\n \"intro\": \"In this section, we are interested in knowing how your significant o
ther (this\r\n refers to the person you indicated above) responds to you when he or she knows\r\n you are in pain. On the scale listed below each question, indicate HOW OFTEN\r\n your significant other generally responds to you in that par
ticular way WHEN YOU\r\n ARE IN PAIN. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"i588\", \"type\": \"IntroText\", \r\n \"text\": \"C.<br \/>Listed below are 18 common daily ac
tivities. Please indicate HOW OFTEN\r\n you do each of these activities by selecting a number on the scale below each\r\n activity. Please complete ALL 18 questions. \"\r\n }, \r\n {\"id\": \"q5239\", \"type\": \"SliderQuestion\", \"r
equired\": false, \r\n \"text\": \"C1. Washes dishes.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activi
ntifierIen":16377,"choiceTypeId":24884,"designator":"A12.","hint":null,"id":5405,"instrument":161,"introDisplay":43194,"introId":586,"introText":"In the following 20 questions, you will be asked to describe your pain and how it affects your
ty.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5240\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C2. Mow the l
awn.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n
\"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5241\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C3. Go out to eat.\", \r\n \"intro\": \"Listed below are 18 co
mmon daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Ne
ver\", \" Very often\"]}, \r\n {\"id\": \"q5242\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C4. Play cards or other games.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate
HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\
": \"q5243\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C5. Go grocery shopping.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities
by selecting a number on the scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5244\", \"type\": \"SliderQuestion\", \
"required\": false, \r\n \"text\": \"C6. Work in the garden.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each
activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5245\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C7. Go
life. Under each question is a scale to record your answer. Read each question carefully and then select \r\nthe number on the scale to indicate how that specific question applies to you. You can click on the number with the mouse or ente
to a movie.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activity.\r\n Please complete ALL 18 questions. \
", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]},
\r\n {\"id\": \"q5246\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C8. Visit a friend.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these ac
tivities by selecting a number on the scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5247\", \"type\": \"SliderQuest
ion\", \"required\": false, \r\n \"text\": \"C9. Help with the house cleaning.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on th
e scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5248\", \"type\": \"SliderQuestion\", \"required\": false, \r\n
\"text\": \"C10. Work on a car.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activity.\r\n Please complete A
LL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5249\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C11. Take a ride in a car.\", \r\n
\"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \
"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5250\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C12. Visit relatives.\", \r\n \"intro\": \"Listed below are 18 common daily ac
r the number on the key board. ","max":6,"min":0,"questionDisplay":43219,"questionId":5214,"questionText":"How much SUFFERING do you experience because of your pain?","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequ
tivities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Ver
y often\"]}, \r\n {\"id\": \"q5251\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C13. Prepare a meal.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n ea
ch of these activities by selecting a number on the scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5252\", \"type\":
\"SliderQuestion\", \"required\": false, \r\n \"text\": \"C14. Wash the car.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the
scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5253\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \
"text\": \"C15. Take a trip.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activity.\r\n Please complete ALL
18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5254\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C16. Go to a park or beach.\", \r\n \"
intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activity.\r\n Please complete ALL 18 questions. \", \r\n \"min\": 0, \"m
ax\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5255\", \"type\": \"SliderQuestion\", \"required\": false,
\r\n \"text\": \"C17. Do a load of laundry.\", \r\n \"intro\": \"Listed below are 18 common daily activities. Please indicate HOW OFTEN you do\r\n each of these activities by selecting a number on the scale below each activity.\r\n Pl
ence":190},{"choice":[{"choiceId":2598,"choiceText":"No change","ien":51064,"legacyValue":0,"sequence":1},{"choiceId":2615,"choiceText":" Extreme change","ien":
ease complete ALL 18 questions. \", \r\n \"min\": 0, \"max\": 6, \r\n \"legend\":[\"Never\", \" Very often\"]}, \r\n {\"id\": \"q5256\", \"type\": \"SliderQuestion\", \"required\": false, \r\n \"text\": \"C18. Work on a needed h
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fic question applies to you. You can click on the number with the mouse or enter the number on the key board. ","max":6,"min":0,"questionDisplay":43225,"questionId":5217,"questionText":"How much has your pain changed the amount of satisfac
u relate to on a regular or \r\ninfrequent basis. It is very important that you identify someone as your \"significant other.\" ","max":0,"min":0,"questionDisplay":43189,"questionId":5200,"questionText":"Significant other:","required":fal
tion or enjoyment you get from work?","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":220},{"choice":[{"choiceId":2608,"choiceText":"Not at all attentive","ien":51070,"legacyValue":0,"sequence":1},{"choiceId":2
609,"choiceText":" Extremely attentive","ien":51071,"legacyValue":1,"sequence":2}],"choiceDisplay":43228,"choiceIdentifier":"N","choiceIdentifierIen":16381,"choiceTypeId":24888,"designator":"A15.","hint":null,"id":5409,"instrument":161,"int
roDisplay":43194,"introId":586,"introText":"In the following 20 questions, you will be asked to describe your pain and how it affects your life. Under each question is a scale to record your answer. Read each question carefully and then sel
ect \r\nthe number on the scale to indicate how that specific question applies to you. You can click on the number with the mouse or enter the number on the key board. ","max":6,"min":0,"questionDisplay":43227,"questionId":5218,"questionT
ext":"How attentive is your spouse (significant other) to your pain problem?","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":230},{"choice":[{"choiceId":212,"choiceText":"Not at all","ien":51072,"legacyValue":
1,"sequence":1},{"choiceId":2621,"choiceText":" Extremely well","ien":51073,"legacyValue":1,"sequence":2}],"choiceDisplay":43230,"choiceIdentifier":"N",
"choiceIdentifierIen":16382,"choiceTypeId":24889,"designator":"A16.","hint":null,"id":5410,"instrument":161,"introDisplay":43194,"introId":586,"introText":"In the following 20 questions, you will be asked to describe your pain and how it af
fects your life. Under each question is a scale to record your answer. Read each question carefully and then select \r\nthe number on the scale to indicate how that specific question applies to you. You can click on the number with the mou
se or enter the number on the key board. ","max":6,"min":0,"questionDisplay":43229,"questionId":5219,"questionText":"During the PAST WEEK, how much do you feel that you've been able to deal with your problems?","required":false,"responseTy
peId":7,"responseTypeText":"TRACK BAR","sequence":240},{"choice":[{"choiceId":2598,"choiceText":"No change","ien":51074,"legacyValue":0,"sequence":1},{"choiceId":2615,"choiceText":" Extreme change","ien":51075,"legacyValue":1,"sequence":2}]
se,"responseTypeId":3,"responseTypeText":"STRING","sequence":30},{"choice":[{"choiceId":241,"choiceText":"Yes","ien":51036,"legacyValue":"Y","sequence":1},{"choiceId":237,"choiceText":"No","ien":51037,"legacyValue":"N","sequence":2}],"choic
,"choiceDisplay":43232,"choiceIdentifier":"N","choiceIdentifierIen":16383,"choiceTypeId":24890,"designator":"A17.","hint":null,"id":5411,"instrument":161,"introDisplay":43194,"introId":586,"introText":"In the following 20 questions, you wil
l be asked to describe your pain and how it affects your life. Under each question is a scale to record your answer. Read each question carefully and then select \r\nthe number on the scale to indicate how that specific question applies to
you. You can click on the number with the mouse or enter the number on the key board. ","max":6,"min":0,"questionDisplay":43231,"questionId":5220,"questionText":"How much has your pain changed your ability to do household chores?","requir
ed":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":250},{"choice":[{"choiceId":2610,"choiceText":"Not at all irritable","ien":51076,"legacyValue":0,"sequence":1},{"choiceId":2611,"choiceText":" Extremely irritable","ien"
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n the following 20 questions, you will be asked to describe your pain and how it affects your life. Under each question is a scale to record your answer. Read each question carefully and then select \r\nthe number on the scale to indicate
how that specific question applies to you. You can click on the number with the mouse or enter the number on the key board. ","max":6,"min":0,"questionDisplay":43233,"questionId":5221,"questionText":"During the PAST WEEK, how irritable hav
e you been?","required":false,"responseTypeId":7,"responseTypeText":"TRACK BAR","sequence":260},{"choice":[{"choiceId":2598,"choiceText":"No change","ien":51078,"legacyValue":0,"sequence":1},{"choiceId":2615,"choiceText":" Extreme change","
ien":51079,"legacyValue":1,"sequence":2}],"choiceDisplay":43236,"choiceIdentifier":"N","choiceIdentifierIen":16385,"choiceTypeId":24892,"designator":"A19.","hint":null,"id":5413,"instrument":161,"introDisplay":43194,"introId":586,"introText
":"In the following 20 questions, you will be asked to describe your pain and how it affects your life. Under each question is a scale to record your answer. Read each question carefully and then select \r\nthe number on the scale to indic
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