From 0e71adefb77ee33a560982a54903c16279df69e0 Mon Sep 17 00:00:00 2001 From: Nethmi Rodrigo Date: Tue, 27 Aug 2024 20:50:19 +0530 Subject: [PATCH] (chore): Add mental assesment form --- .../Mental Health Assessment Form.json | 633 ++++++++++++++++++ 1 file changed, 633 insertions(+) create mode 100644 distro/configuration/ampathforms/Mental Health Assessment Form.json diff --git a/distro/configuration/ampathforms/Mental Health Assessment Form.json b/distro/configuration/ampathforms/Mental Health Assessment Form.json new file mode 100644 index 000000000..12c528ca9 --- /dev/null +++ b/distro/configuration/ampathforms/Mental Health Assessment Form.json @@ -0,0 +1,633 @@ +{ + "name": "Mental Health Assessment Form", + "version": "1", + "published": true, + "retired": false, + "pages": [ + { + "label": "PHQ-2", + "sections": [ + { + "label": "Introduction", + "isExpanded": "true", + "questions": [ + { + "type": "markdown", + "questionOptions": { + "rendering": "markdown" + }, + "id": "fooMarkdown", + "value": [ + "**This form is used :** for screening, diagnosing, monitoring and measuring the severity of depression." + ] + } + ] + }, + { + "label": "Patient Health Questionnaire-2 (PHQ-2)", + "isExpanded": "true", + "questions": [ + { + "label": "Screening Date", + "type": "obs", + "questionOptions": { + "rendering": "date", + "concept": "160753AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "conceptMappings": [ + { + "type": "CIEL", + "value": "160753" + }, + { + "type": "CIEL", + "value": "160753" + }, + { + "type": "SNOMED-CT", + "value": "439771001" + }, + { + "type": "SNOMED-CT", + "value": "439771001" + } + ] + }, + "behaviours": [ + { + "intent": "*", + "required": "true", + "unspecified": "true", + "hide": { + "hideWhenExpression": "false" + }, + "validators": [ + { + "type": "date", + "allowFutureDates": "false" + }, + { + "type": "js_expression", + "failsWhenExpression": "isDateBefore(myValue, '1980-01-01')" + } + ] + } + ], + "id": "phq9Date" + }, + { + "label": "1. Little interest or pleasure in doing things", + "type": "obs", + "questionOptions": { + "rendering": "radio", + "concept": "167006AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all", + "conceptMappings": [] + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days", + "conceptMappings": [] + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days", + "conceptMappings": [] + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day", + "conceptMappings": [] + } + ] + }, + "behaviours": [ + { + "intent": "*", + "required": "true", + "unspecified": "true", + "hide": { + "hideWhenExpression": "false" + } + } + ], + "id": "phq2_1" + }, + { + "label": "2. Feeling down, depressed or hopeless", + "type": "obs", + "questionOptions": { + "rendering": "radio", + "concept": "167007AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all", + "conceptMappings": [] + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days", + "conceptMappings": [] + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days", + "conceptMappings": [] + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day", + "conceptMappings": [] + } + ], + "conceptMappings": [ + { + "type": "CIEL", + "value": "167007" + }, + { + "type": "LOINC", + "value": "44255-8" + } + ] + }, + "behaviours": [ + { + "intent": "*", + "required": "true", + "unspecified": "true", + "hide": { + "hideWhenExpression": "false" + } + } + ], + "id": "phq2_2" + } + ] + } + ] + }, + { + "label": "PHQ-9", + "sections": [ + { + "label": "Further evaluation", + "isExpanded": "true", + "questions": [ + { + "label": "3. Trouble falling asleep, staying asleep, or sleeping too much", + "type": "obs", + "questionOptions": { + "rendering": "radio", + "concept": "167068AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "conceptMappings": [ + { + "type": "LOINC", + "value": "44259-0" + }, + { + "type": "CIEL", + "value": "167068" + } + ], + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all", + "conceptMappings": [] + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days", + "conceptMappings": [] + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days", + "conceptMappings": [] + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day", + "conceptMappings": [] + } + ] + }, + "behaviours": [ + { + "intent": "*", + "required": "true", + "unspecified": "true", + "hide": { + "hideWhenExpression": "false" + } + } + ], + "id": "phq9_3" + }, + { + "label": "4. Feeling tired or having little energy", + "type": "obs", + "questionOptions": { + "rendering": "radio", + "concept": "167069AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "conceptMappings": [ + { + "type": "LOINC", + "value": "44254-1" + }, + { + "type": "CIEL", + "value": "167069" + } + ], + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all", + "conceptMappings": [] + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days", + "conceptMappings": [] + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days", + "conceptMappings": [] + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day", + "conceptMappings": [] + } + ] + }, + "behaviours": [ + { + "intent": "*", + "required": "true", + "unspecified": "true", + "hide": { + "hideWhenExpression": "false" + } + } + ], + "id": "phq9_4" + }, + { + "label": "5. Poor appetite or overeating", + "type": "obs", + "questionOptions": { + "rendering": "radio", + "concept": "167070AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "conceptMappings": [ + { + "type": "CIEL", + "value": "167070" + }, + { + "type": "LOINC", + "value": "44251-7" + } + ], + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all", + "conceptMappings": [] + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days", + "conceptMappings": [] + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days", + "conceptMappings": [] + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day", + "conceptMappings": [] + } + ] + }, + "behaviours": [ + { + "intent": "*", + "required": "true", + "unspecified": "true", + "hide": { + "hideWhenExpression": "false" + } + } + ], + "id": "phq9_5" + }, + { + "label": "6. Feeling bad about yourself - or that you’re a failure or have let yourself or your family down", + "type": "obs", + "questionOptions": { + "rendering": "radio", + "concept": "167071AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "conceptMappings": [ + { + "type": "CIEL", + "value": "167071" + }, + { + "type": "LOINC", + "value": "44258-2" + } + ], + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all", + "conceptMappings": [] + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days", + "conceptMappings": [] + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days", + "conceptMappings": [] + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day", + "conceptMappings": [] + } + ] + }, + "behaviours": [ + { + "intent": "*", + "required": "true", + "unspecified": "true", + "hide": { + "hideWhenExpression": "false" + } + } + ], + "id": "phq9_6" + }, + { + "label": "7. Trouble concentrating on things, such as reading the newspaper or watching television", + "type": "obs", + "questionOptions": { + "rendering": "radio", + "concept": "167072AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "conceptMappings": [ + { + "type": "LOINC", + "value": "44252-5" + }, + { + "type": "CIEL", + "value": "167072" + } + ], + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all", + "conceptMappings": [] + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days", + "conceptMappings": [] + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days", + "conceptMappings": [] + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day", + "conceptMappings": [] + } + ] + }, + "behaviours": [ + { + "intent": "*", + "required": "true", + "unspecified": "true", + "hide": { + "hideWhenExpression": "false" + } + } + ], + "id": "phq9_7" + }, + { + "label": "8. Moving or speaking so slowly that other people could have noticed. Or, the opposite - being so fidgety or restless that you have been moving around a lot more than usual", + "type": "obs", + "questionOptions": { + "rendering": "radio", + "concept": "167073AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "conceptMappings": [ + { + "type": "CIEL", + "value": "167073" + }, + { + "type": "LOINC", + "value": "44253-3" + } + ], + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all", + "conceptMappings": [] + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days", + "conceptMappings": [] + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days", + "conceptMappings": [] + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day", + "conceptMappings": [] + } + ] + }, + "behaviours": [ + { + "intent": "*", + "required": "true", + "unspecified": "true", + "hide": { + "hideWhenExpression": "false" + } + } + ], + "id": "phq9_8" + }, + { + "label": "9. Thoughts that you would be better off dead or of hurting yourself in some way", + "type": "obs", + "questionOptions": { + "rendering": "radio", + "concept": "167074AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "conceptMappings": [ + { + "type": "CIEL", + "value": "167074" + }, + { + "type": "LOINC", + "value": "44260-8" + } + ], + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all", + "conceptMappings": [] + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days", + "conceptMappings": [] + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days", + "conceptMappings": [] + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day", + "conceptMappings": [] + } + ] + }, + "behaviours": [ + { + "intent": "*", + "required": "true", + "unspecified": "true", + "hide": { + "hideWhenExpression": "false" + } + } + ], + "id": "phq9_9" + } + ] + } + ], + "behaviours": [ + { + "intent": "*", + "hide": { + "hideWhenExpression": "phq2_1 === '160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA' && phq2_2 === '160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA'" + } + } + ] + }, + { + "label": "PHQ-9 score", + "sections": [ + { + "label": "Total scores", + "isExpanded": "true", + "questions": [ + { + "label": "PHQ-9 score obtained by adding score for each question", + "type": "obs", + "questionOptions": { + "rendering": "number", + "concept": "165137AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "max": "27", + "min": "0", + "showDate": "", + "conceptMappings": [ + { + "type": "SNOMED-CT", + "value": "720433000" + }, + { + "type": "CIEL", + "value": "165137" + } + ] + }, + "id": "phq9Score" + } + ] + } + ] + }, + { + "label": "Notes", + "sections": [ + { + "label": "Notes", + "isExpanded": "true", + "questions": [ + { + "label": "Mental Health Assessment Notes", + "type": "obs", + "questionOptions": { + "rendering": "textarea", + "concept": "165095AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rows": "", + "conceptMappings": [ + { + "type": "AMPATH", + "value": "1915" + }, + { + "type": "AMPATH", + "value": "1915" + }, + { + "type": "LOINC", + "value": "48767-8" + }, + { + "type": "CIEL", + "value": "160632" + } + ] + }, + "id": "phq9Notes" + } + ] + } + ] + } + ], + "availableIntents": [ + { + "intent": "*", + "display": "Mental Health Assessment Form" + } + ], + "processor": "EncounterFormProcessor", + "uuid": "2069bd57-d534-3de9-ae24-f1d4e4b2de83", + "referencedForms": [], + "encounterType": "36db5123-0ad5-41c0-9037-625b46e0ceef", + "encounter": "Mental Health Assessment" +} \ No newline at end of file