• canyoufeelthat > chronic-9 - CANIS

  • chronic-9 - CANIS

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    chronic-9

      A B C D
    1 MAJOR CATEGORY MINOR CATEGORY SPECIFIC CATEGORY            STATUS QUESTION
    2        
    3  Diagnosis General Personal How good is your health?
    4 Diagnosis General Personal Is your health getting better or worse?
    5 Diagnosis General Personal What is your primary disease?
    6 Diagnosis General Personal How long have you had this disease?
    7 Diagnosis General Personal How severe is your disease?
    8 Diagnosis General Personal Do you think your condition will improve?
    9 Diagnosis General Personal Do you think you will die from this disease?
    10 Diagnosis General Personal Do you have another major disease?
    11 Diagnosis General Personal Do you think your condition will improve with this disease?
    12 Diagnosis General Personal What is your typical energy level?
    13 Diagnosis General Physician Do you feel comfortable with your current doctor?
    14 Diagnosis General Physician Does your doctor give you enough information?
    15 Diagnosis General Physician Can you understand what your doctor tells you?
    16 Diagnosis General Physician Have you switched doctors within the past year?
    17 Diagnosis Disease Heart Do you have shortness of breath?
    18 Diagnosis Disease Heart Do your ankles swell up?
    19 Diagnosis Disease Heart Do you have chest pains?
    20 Diagnosis Disease Arthritis Can you pick up a pencil without pain (hands) ?
    21 Diagnosis Disease Arthritis Can you reach shelves above your head without pain (arms) ?
    22 Diagnosis Disease Arthritis Can you walk around the room without pain (legs) ?
    23 Diagnosis Disease Arthritis Can you walk up a flight of stairs without pain (legs) ?
    24        
    25  Treatment Drugs   What classes of drugs do you take?
    26 Treatment Drugs   How often does taking the drugs increase your mobility?
    27 Treatment Drugs   How often does taking the drugs decrease your pain?
    28 Treatment Drugs   Do you have side-effects from medication (depression, nausea)?
    29 Treatment Drugs   Do you limit your intake of drugs due to side-effects?
    30 Treatment Drugs   Can you function in everyday life without prescription drugs?
    31 Treatment Surgery   Have you had outpatient (walk-in) treatment within the past year?
    32 Treatment Surgery   Have you had surgery within the past year?
    33 Treatment Surgery   Are you satisfied with the results of the surgery?
    34 Treatment Diet   Do you eat well-balanced foods?
    35 Treatment Diet   How much do you eat?
    36 Treatment Diet   How often do you eat?
    37 Treatment Diet   How often do you drink alcohol?
    38 Treatment Diet   How high is your consumption of salt?
    39 Treatment Diet   How high is your consumption of fat?
    40 Treatment Diet   How much do you drink?
    41 Treatment Diet   Are you constipated (incomplete urine or bowel movements)?
    42 Treatment Exercise   How often do you exercise (for at least half an hour)?
    43 Treatment Exercise   How often are you tired without exercising?
    44 Treatment Exercise   Does it hurt when you exercise?
    45 Treatment Exercise   How often does stretching help?
    46 Treatment Exercise   How often does heat help?  (e.g. heating pad)
    47 Treatment Exercise   How often does cold help?  (e.g. ice pack)
    48 Treatment Exercise   How often does relaxation help?  (e.g. meditation)
    49 Treatment Exercise   How often does massage of hurting area help?
    50 Treatment Exercise   How much do you sleep a night?
    51 Treatment Exercise   Do you get enough sleep (to not be tired)?
    52 Treatment Alternative   How often does acupuncture help (ease your pain)?
    53 Treatment Alternative   How often does chiropractor help (ease your pain)?
    54        
    55  Pain General   How often are you in pain?
    56 Pain General   How intense is your pain?
    57 Pain General   How often does the pain affect your everyday life?
    58 Pain General   Where is the pain the worst?
    59 Pain General   What character does the pain have?  (fire,ice,cut,stab,pull,push)
    60 Pain General   Did the pain interfere with your work?
    61 Pain General   Did the pain interfere with your mood?
    62 Pain General   Does the pain interfere with your sleep?
    63 Pain General   Does the pain interfere with your eating?
    64 Pain General   Is the pain worse when you move or walk?
    65 Pain General   Are you unable to do what you wish because of pain?
    66 Pain General   Are you unable to do what you wish due to physical incapability?
    67 Pain Specific   Does it hurt to walk?
    68 Pain Specific   Does it hurt to bend down at the waist?
    69 Pain Specific   Does it hurt to dress?
    70 Pain Specific   Does it hurt to carry things (like groceries)?
    71 Pain Specific   Does it hurt to reach over your head?
    72 Pain Specific   Does it hurt to vacuum (push things)?
    73 Pain Specific   Does it hurt to make your meals?
    74        
    75  Psychological (Mind) Well-Being   Do you feel happy with your life?
    76 Psychological (Mind) Well-Being   Is your family supportive of your health?
    77 Psychological (Mind) Well-Being   Are your friends supportive of your health?
    78 Psychological (Mind) Well-Being   Does your health limit your life?
    79 Psychological (Mind) Well-Being   Are you willing to suffer more pain to do more?
    80 Psychological (Mind) Well-Being   Can you lead a full life with your current health?
    81 Psychological (Mind) Well-Being   Have you ever not been able to lead a full life?
    82 Psychological (Mind) Well-Being   When you feel bad, do you get upset?
    83 Psychological (Mind) Well-Being   When you feel bad, do you focus on fixing the problem?
    84 Psychological (Mind) Well-Being   Can you prevent your health problems?
    85 Psychological (Mind) Well-Being   Do emotional problems prevent you from leading a full life?
    86 Psychological (Mind) Well-Being   Do you worry too much?
    87 Psychological (Mind) Well-Being   Can you deal adequately with all your problems?
    88 Psychological (Mind) Well-Being   Do you enjoy playing with children?
    89 Psychological (Mind) Well-Being   Do you feel attractive?
    90 Psychological (Mind) Well-Being   Are you forgetful?
    91 Psychological (Mind) Well-Being   Does your memory interfere with your daily activities?
    92 Psychological (Mind) Well-Being   Do your looks limit your life?
    93 Psychological (Mind) Well-Being   Do you have enough children of your own?
    94 Psychological (Mind) Healthcare   Do you have access to healthcare when you need it?
    95 Psychological (Mind) Healthcare   Is the healthcare available adequate for your needs?
    96 Psychological (Mind) Healthcare   Can you get enough information to understand your health?
    97 Psychological (Mind) Healthcare   When health problems occur, do you make a definite plan of action?
    98 Psychological (Mind) Healthcare   When health problems occur, do you let some things slide?
    99 Psychological (Mind) Healthcare   When health problems occur, do you try to distract yourself?
    100 Psychological (Mind) Spirituality   Are you deeply religious?
    101 Psychological (Mind) Spirituality   Do you go to church every week?
    102 Psychological (Mind) Spirituality   Do you feel spiritual comfort on an everyday basis?
    103 Psychological (Mind) Spirituality   Are you deeply spiritual?
    104 Psychological (Mind) Spirituality   Are you worried about things you cannot control?
    105        
    106  Physiological (Body)     What is your blood pressure?
    107 Physiological (Body)     What is your weight?
    108 Physiological (Body)     How long do you sleep on the average?
    109 Physiological (Body)     How often do you feel too tired to function properly?
    110 Physiological (Body)     How often do you have difficulty focusing your attention?
    111        
    112  Genetics (Nature)     What is your age?
    113 Genetics (Nature)     What is your sex?
    114 Genetics (Nature)     What is your race?
    115 Genetics (Nature)     Did your parents have your primary disease?
    116 Genetics (Nature)     Did your parents die of your primary disease?
    117 Genetics (Nature)     Did your parents have your other major disease?
    118 Genetics (Nature)     Do any of your siblings have your primary disease?
    119        
    120  Environment (Nurture) Surroundings   Is your house quiet enough to sleep in?
    121 Environment (Nurture) Surroundings   Is your local air safe to breathe?
    122 Environment (Nurture) Surroundings   Is your local water safe to drink?
    123 Environment (Nurture) Surroundings   Do you have enough friends?
    124 Environment (Nurture) Social   Can you talk to someone when you feel blue?
    125 Environment (Nurture) Social   Do you have enough social interactions?
    126 Environment (Nurture) Social   Does time hang heavy on you in an average day?
    127 Environment (Nurture) Social   Do you need help with everyday life (cooking, cleaning)?
    128 Environment (Nurture) Social   Do you get everyday help to a satisfactory degree?
    129 Environment (Nurture) Social   Do you have social services to check in on you?
    130 Environment (Nurture) Social   Do you feel safe in everyday life?
    131 Environment (Nurture) Social   Do you have enough money for everyday needs?
    132        
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