Generated Narrative: Questionnaire DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire Structure LinkID Text Cardinality Type Description & Constraints DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire A Respiratory Physiology Paediatric OSAS Screening Questionnaire. Questionnaire https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire#1.0 #xD; patientformcomplete Please ensure patient details are completed here 0..1 display #xD; surname_11 Surname 1..1 string #xD; fullname_12 Full Name 1..1 string #xD; nhinumber_13 NHI number 1..1 string #xD; dob_14 DOB 1..1 date #xD; sex_15 Sex 1..1 choice Options: 2 options #xD; caregivername Caregiver Name 1..1 string #xD; date_31 Date 1..1 date #xD; answeronbehalf Please answer on behalf of your child for the past month. 0..1 display #xD; options_31 Does your child have any of the following: 0..1 display #xD; runnynose A constant blocked or runny nose? 1..1 choice Options: 3 options #xD; chestinfections Recurrent chest infections/pneumonia? 1..1 choice Options: 3 options #xD; airwaynrrowing An airway narrowing or abnormality? 1..1 choice Options: 3 options #xD; syndromemajor A syndrome or other major health problem? 1..1 choice Options: 3 options #xD; type_01 Type 1..1 string #xD; tonsils Does your child have large tonsils? 1..1 choice Options: 3 options #xD; tonsilsremoved Has your child had their adenoids or tonsils removed? 1..1 choice Options: 3 options #xD; whilesleeping While sleeping, does your child 0..1 display #xD; snore_22 snore more than half the time? 1..1 choice Options: 3 options #xD; alwayssnore always snore? 1..1 choice Options: 3 options #xD; snoreloundly snore loudly? 1..1 choice Options: 3 options #xD; troublebreathing have trouble breathing, or struggle to breathe? 1..1 choice Options: 3 options #xD; loudbreathing have "heavy" or loud breathing? 1..1 choice Options: 3 options #xD; stopbreathingnight Have you ever seen your child stop breathing during the night? 1..1 choice Options: 3 options #xD; followingoptions Does your child has the following 0..1 display #xD; breathethroughmouth tend to breathe through the mouth during the day? 1..1 choice Options: 3 options #xD; wetthebed occasionally wet the bed? 1..1 choice Options: 3 options #xD; unrefreshedmorning wake up feeling unrefreshed in the morning? 1..1 choice Options: 3 options #xD; sleepinessduringday have a problem with sleepiness during the day? 1..1 choice Options: 3 options #xD; sleepyatnight Has a teacher commented that your child appears sleepy during the day? 1..1 choice Options: 3 options #xD; hardtowakeup Is it hard to wake your child up in the morning? 1..1 choice Options: 3 options #xD; headachesinthemorning Does your child wake up with headaches in the morning? 1..1 choice Options: 3 options #xD; stopgrowing Did your child stop growing at a normal rate at any time since birth? 1..1 choice Options: 3 options #xD; childoverweight Is your child overweight? 1..1 choice Options: 3 options #xD; childoftenhas My child often . 0..1 display #xD; listenissues does not seem to listen when spoken to directly. 1..1 choice Options: 3 options #xD; difficultyinorganizing has difficulty organizing task and activities. 1..1 choice Options: 3 options #xD; stimulieasily is easily distracted by extraneous stimuli. 1..1 choice Options: 3 options #xD; squirmsseat fidgets with hands or feet or squirms in seat. 1..1 choice Options: 3 options #xD; drivenbyamotor is 'on the go' or often acts as if 'driven by a motor'. 1..1 choice Options: 3 options #xD; intrudesother interrupts or intrudes on others (e.g. butts into conversations or games). 1..1 choice Options: 3 options #xD; Documentation for this format Options Sets Answer options for sex_15 null#male ("Male") null#female ("Female") Answer options for runnynose null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for chestinfections null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for airwaynrrowing null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for syndromemajor null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for tonsils null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for tonsilsremoved null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for snore_22 null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for alwayssnore null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for snoreloundly null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for troublebreathing null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for loudbreathing null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for stopbreathingnight null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for breathethroughmouth null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for wetthebed null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for unrefreshedmorning null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for sleepinessduringday null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for sleepyatnight null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for hardtowakeup null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for headachesinthemorning null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for stopgrowing null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for childoverweight null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for listenissues null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for difficultyinorganizing null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for stimulieasily null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for squirmsseat null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for drivenbyamotor null#yes ("Yes") null#no ("No") null#unknown ("Unknown") Answer options for intrudesother null#yes ("Yes") null#no ("No") null#unknown ("Unknown")
Respiratory Physiology Paediatric OSAS Screening Questionnaire
A Respiratory Physiology Paediatric OSAS Screening Questionnaire.
Please ensure patient details are completed here
Please answer on behalf of your child for the past month.
Does your child have any of the following:
A syndrome or other major health problem?
Has your child had their adenoids or tonsils removed?
have trouble breathing, or struggle to breathe?
Have you ever seen your child stop breathing during the night?
tend to breathe through the mouth during the day?
wake up feeling unrefreshed in the morning?
have a problem with sleepiness during the day?
Has a teacher commented that your child appears sleepy during the day?
Is it hard to wake your child up in the morning?
Does your child wake up with headaches in the morning?
Did your child stop growing at a normal rate at any time since birth?
does not seem to listen when spoken to directly.
has difficulty organizing task and activities.
is easily distracted by extraneous stimuli.
fidgets with hands or feet or squirms in seat.
is 'on the go' or often acts as if 'driven by a motor'.
interrupts or intrudes on others (e.g. butts into conversations or games).