Generated Narrative: Questionnaire DHOEpworthSleepinessScaleDiagnosticTesting

LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. DHOEpworthSleepinessScaleDiagnosticTestingCollects Epworth Sleepiness Scale responses and related diagnostic testing detailsQuestionnairehttps://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHOEpworthSleepinessScaleDiagnosticTesting#1.0.0
... headerEpworth Scale0..1group
.... header-leftDiagnostic Testing Department Ph: (03) 214 57750..1display
.... header-rightTom McKendrick Sleep Laboratory Dunedin Hospital Ph: (03) 470 97420..1display
... patient-infoPatient Information0..1group
.... patient-namePatient0..1string
.... nhi-numberNHI No0..1string
.... physicianPhysician0..1string
... treatmentPlease fill in the form below.0..1group
.... on-cpap-nivOn CPAP / NIV Treatment?0..1choice
.... current-pressure-settingCurrent Pressure Setting0..1string
.... dateDate0..1date
.... instructions-displayHow likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation. 0 = Would never doze 1 = Slight chance of dozing 2 = Moderate chance of dozing 3 = High chance of dozing0..1display
.... sitting-readingSitting and reading1..1choiceValue Set: sleep-scale
.... WatchingtvWatching TV1..1choiceValue Set: sleep-scale
.... sittinginactiveSitting, inactive in a public place (e.g., a theatre or meeting)1..1choiceValue Set: sleep-scale
.... passengercarbreakAs a passenger in a car for an hour without a break1..1choiceValue Set: sleep-scale
.... restintheafternoonLying down to rest in the afternoon when circumstances permit1..1choiceValue Set: sleep-scale
.... sittingandtalkingSitting and talking1..1choiceValue Set: sleep-scale
.... sittingquietlySitting quietly after a lunch without alcohol1..1choiceValue Set: sleep-scale
.... totalTotal0..1integer

doco Documentation for this format

Contained Resources

ValueSet #sleep-scale

This value set expansion contains 4 concepts.

CodeSystemDisplay
  00 -- Would never dose
  11 -- Slight chance of dozing
  22 -- Moderate chance of dozing
  33 -- High chance of dozing
 <status value="active"/> <subjectType value="Patient"/> <date value="2026-04-16T21:32:31+00:00"/> <publisher value="Te Whatu Ora"/> <contact> <name value="Te Whatu Ora"/> <telecom> <system value="url"/> <value value="https://www.tewhatuora.govt.nz/"/> </telecom> </contact> <contact> <name value="Te Whatu Ora Integration Team"/> <telecom> <system value="email"/> <value value="integration@tewhatuora.govt.nz"/> <use value="work"/> </telecom> </contact> <description value="Collects Epworth Sleepiness Scale responses and related diagnostic testing details"/> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166"/> <code value="NZ"/> <display value="New Zealand"/> </coding> </jurisdiction> <purpose value="Collects Epworth Sleepiness Scale responses and related diagnostic testing details to support assessment of daytime sleepiness."/> <item> <linkId value="header"/> <text value="Epworth Scale"/> <type value="group"/> <item> <linkId value="header-left"/> <text value="Diagnostic Testing Department Ph: (03) 214 5775"/> <type value="display"/> </item> <item> <linkId value="header-right"/> <text value="Tom McKendrick Sleep Laboratory Dunedin Hospital Ph: (03) 470 9742"/> <type value="display"/> </item> </item> <item> <linkId value="patient-info"/> <text value="Patient Information"/> <type value="group"/> <item> <linkId value="patient-name"/> <text value="Patient"/> <type value="string"/> </item> <item> <linkId value="nhi-number"/> <text value="NHI No"/> <type value="string"/> </item> <item> <linkId value="physician"/> <text value="Physician"/> <type value="string"/> </item> </item> <item> <linkId value="treatment"/> <text value="Please fill in the form below."/> <type value="group"/> <item> <linkId value="on-cpap-niv"/> <text value="On CPAP / NIV Treatment?"/> <type value="choice"/> </item> <item> <linkId value="current-pressure-setting"/> <text value="Current Pressure Setting"/> <type value="string"/> </item> <item> <linkId value="date"/> <text value="Date"/> <type value="date"/> </item> <item> <extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-displayCategory"> <valueCodeableConcept> <text value="instructions"/> </valueCodeableConcept> </extension> <linkId value="instructions-display"/> <text value="How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation. 0 = Would never doze 1 = Slight chance of dozing 2 = Moderate chance of dozing 3 = High chance of dozing"/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="drop-down"/> <display value="Drop down"/> </coding> </valueCodeableConcept> </extension> <linkId value="sitting-reading"/> <text value="Sitting and reading"/> <type value="choice"/> <required value="true"/> <answerValueSet value="#sleep-scale"/> </item> <item> <linkId value="Watchingtv"/> <text value="Watching TV"/> <type value="choice"/> <required value="true"/> <answerValueSet value="#sleep-scale"/> </item> <item> <linkId value="sittinginactive"/> <text value="Sitting, inactive in a public place (e.g., a theatre or meeting)"/> <type value="choice"/> <required value="true"/> <answerValueSet value="#sleep-scale"/> </item> <item> <linkId value="passengercarbreak"/> <text value="As a passenger in a car for an hour without a break"/> <type value="choice"/> <required value="true"/> <answerValueSet value="#sleep-scale"/> </item> <item> <linkId value="restintheafternoon"/> <text value="Lying down to rest in the afternoon when circumstances permit"/> <type value="choice"/> <required value="true"/> <answerValueSet value="#sleep-scale"/> </item> <item> <linkId value="sittingandtalking"/> <text value="Sitting and talking"/> <type value="choice"/> <required value="true"/> <answerValueSet value="#sleep-scale"/> </item> <item> <linkId value="sittingquietly"/> <text value="Sitting quietly after a lunch without alcohol"/> <type value="choice"/> <required value="true"/> <answerValueSet value="#sleep-scale"/> </item> <item> <linkId value="total"/> <text value="Total"/> <type value="integer"/> </item> </item> </Questionnaire>