From 1593740a60f63fe45b4ccd378dada9b89dd0fab4 Mon Sep 17 00:00:00 2001 From: CynthiaKamau Date: Thu, 10 Aug 2023 13:57:20 +0300 Subject: [PATCH] KHP3-4003 Generalized anxiety disorder assessment form (#159) --- .../Generalized_Anxiety_Disorder.json | 282 ++++++++++++++++++ 1 file changed, 282 insertions(+) create mode 100644 configuration/ampathforms/Generalized_Anxiety_Disorder.json diff --git a/configuration/ampathforms/Generalized_Anxiety_Disorder.json b/configuration/ampathforms/Generalized_Anxiety_Disorder.json new file mode 100644 index 00000000..29d14257 --- /dev/null +++ b/configuration/ampathforms/Generalized_Anxiety_Disorder.json @@ -0,0 +1,282 @@ +{ + "name": "Generalized Anxiety Disorder Assessment", + "description": "Generalized Anxiety Disorder Assessment", + "version": "1.0", + "published": true, + "uuid": "524d078e-936a-4543-9ca6-7a8d9ed4db06", + "retired": false, + "encounter": "Generalized Anxiety Disorder Assessment", + "pages": [ + { + "label": "Generalized Anxiety Disorder Assessment", + "sections": [ + { + "label": "Visit Details", + "isExpanded": "true", + "questions": [ + { + "label": "Date:", + "type": "encounterDatetime", + "questionOptions": { + "rendering": "ui-select-extended" + }, + "id": "encDate", + "validators": [ + { + "type": "date", + "allowFutureDates": "false" + } + ] + }, + { + "label": "Provider:", + "type": "encounterProvider", + "questionOptions": { + "rendering": "ui-select-extended" + }, + "id": "encProvider " + }, + { + "label": "Location:", + "type": "encounterLocation", + "questionOptions": { + "rendering": "ui-select-extended" + }, + "id": "encLocation" + } + ] + }, + { + "label": "Over the last 2 weeks, how often have you been bothered by any of the following problems?", + "isExpanded": "true", + "questions": [ + { + "label": "Feeling nervous, anxious or on edge", + "type": "obs", + "id": "feelingNervousAnxious", + "questionOptions": { + "concept": "167003AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "radio", + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all" + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days " + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days" + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day" + } + ] + } + }, + { + "label": "Not being able to stop or control worrying", + "type": "obs", + "id": "stopOrControlWorrying", + "questionOptions": { + "concept": "167005AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "radio", + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all" + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days " + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days" + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day" + } + ] + } + }, + { + "label": "Worrying too much about different things", + "type": "obs", + "id": "worryingTooMuch", + "questionOptions": { + "concept": "166482AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "radio", + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all" + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days " + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days" + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day" + } + ] + } + }, + { + "label": "Trouble Relaxing", + "type": "obs", + "id": "troubleRelaxing", + "questionOptions": { + "concept": "167064AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "radio", + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all" + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days " + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days" + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day" + } + ] + } + }, + { + "label": "Being so restless that it is hard to sit still", + "type": "obs", + "id": "tooRestless", + "questionOptions": { + "concept": "167065AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "radio", + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all" + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days " + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days" + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day" + } + ] + } + }, + { + "label": "Feeling bad about yourself, or that you are a failure,or that you have let yourself or your family down", + "type": "obs", + "id": "feelingBadAboutYourself", + "questionOptions": { + "concept": "167066AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "radio", + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all" + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days " + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days" + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day" + } + ] + } + }, + { + "label": "Feeling afraid as if something awful might happen", + "type": "obs", + "id": "feelingAfraid", + "questionOptions": { + "concept": "167067AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "radio", + "answers": [ + { + "concept": "160215AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Not at all" + }, + { + "concept": "167000AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Several days " + }, + { + "concept": "167001AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "More than half the days" + }, + { + "concept": "167002AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Nearly every day" + } + ] + } + } + ] + }, + { + "label": "Anxiety Assessment Score", + "isExpanded": "true", + "questions": [ + { + "label": "GAD 7 Rating", + "type": "obs", + "id": "gad7", + "questionOptions": { + "concept": "167267AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "rendering": "radio", + "answers": [ + { + "concept": "159410AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Minimal Anxiety" + }, + { + "concept": "1498AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Mild Anxiety" + }, + { + "concept": "1499AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Moderate Anxiety" + }, + { + "concept": "1500AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA", + "label": "Severe Anxiety" + } + ] + } + } + ] + } + ], + "processor": "EncounterFormProcessor", + "referencedForms": [] + } + ] +}