ID

10165

Descripción

Copyright David Cella, Ph.D. Only academic use allowed, industry use requires a license. Terms of use and details see http://www.facit.org/

Link

http://www.facit.org/

Palabras clave

Versiones (1)
  1. 17/4/15 17/4/15 - Martin Dugas
Titular de derechos de autor

Copyright David Cella, Ph.D.

Subido en

17 de abril de 2015

DOI

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Licencia

Creative Commons BY-NC-ND 3.0
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FACT-G

Alemán Inglés

Functional Assessment of Cancer Therapy-General (Version 4)

1 formularios  
Below is a list of statements that other people with your illness have said are important. Please circle or mark one number per line to indicate your response as it applies to the past 7 days.
Descripción

Below is a list of statements that other people with your illness have said are important. Please circle or mark one number per line to indicate your response as it applies to the past 7 days.

Patient ID
Descripción

Patient ID

Tipo de datos

text

Alias
UMLS CUI-1
C2348585
Assessment date
Descripción

Assessment date

Tipo de datos

date

Alias
UMLS CUI-1
C2985720
PHYSICAL WELL-BEING
Descripción

PHYSICAL WELL-BEING

Alias
UMLS CUI-1
C0517226
I have a lack of energy
Descripción

lack of energy

Tipo de datos

integer

Alias
UMLS CUI-1
C3830237
I have nausea
Descripción

nausea

Tipo de datos

integer

Alias
UMLS CUI-1
C0027497
Because of my physical condition, I have trouble meeting the needs of my family
Descripción

trouble meeting family needs

Tipo de datos

integer

Alias
UMLS CUI-1
C3830235
I have pain
Descripción

pain

Tipo de datos

integer

Alias
UMLS CUI-1
C0030193
I am bothered by side effects of treatment
Descripción

bothered by side effects

Tipo de datos

integer

Alias
UMLS CUI-1
C2984047
I feel ill
Descripción

feel ill

Tipo de datos

integer

Alias
UMLS CUI-1
C0231218
I am forced to spend time in bed
Descripción

forced to spend time in bed

Tipo de datos

integer

SOCIAL/FAMILY WELL-BEING
Descripción

SOCIAL/FAMILY WELL-BEING

Alias
UMLS CUI-1
C3476515
I feel close to my friends
Descripción

feel close to friends

Tipo de datos

integer

Alias
UMLS CUI-1
C2984048
I get emotional support from my family
Descripción

emotional support from family

Tipo de datos

integer

Alias
UMLS CUI-1
C2984050
I get support from my friends
Descripción

support from friends

Tipo de datos

integer

Alias
UMLS CUI-1
C3161725
My family has accepted my illness
Descripción

Family accepted illness

Tipo de datos

integer

Alias
UMLS CUI-1
C2984053
I am satisfied with family communication about my illness
Descripción

satisfied with family

Tipo de datos

integer

Alias
UMLS CUI-1
C2364309
I feel close to my partner (or the person who is my main support)
Descripción

feel close to partner

Tipo de datos

integer

Alias
UMLS CUI-1
C2984059
Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section
Descripción

no answer to sexual activity

Tipo de datos

boolean

I am satisfied with my sex life
Descripción

Satisfied with sex life

Tipo de datos

integer

Alias
UMLS CUI-1
C2984060
EMOTIONAL WELL-BEING
Descripción

EMOTIONAL WELL-BEING

Alias
UMLS CUI-1
C2984554
I feel sad
Descripción

feel sad

Tipo de datos

integer

Alias
UMLS CUI-1
C2987511
I am satisfied with how I am coping with my illness
Descripción

satisfied with coping with illness

Tipo de datos

integer

Alias
UMLS CUI-1
C2984061
I am losing hope in the fight against my illness
Descripción

losing hope

Tipo de datos

integer

Alias
UMLS CUI-1
C2984056
I feel nervous
Descripción

Feel Nervous

Tipo de datos

integer

Alias
UMLS CUI-1
C3536990
I worry about dying
Descripción

worry about dying

Tipo de datos

integer

Alias
UMLS CUI-1
C2984076
I worry that my condition will get worse
Descripción

worry about worsening condition

Tipo de datos

integer

Alias
UMLS CUI-1
C2984075
FUNCTIONAL WELL-BEING
Descripción

FUNCTIONAL WELL-BEING

Alias
UMLS CUI-1
C2984555
I am able to work (include work at home)
Descripción

able to work

Tipo de datos

integer

Alias
UMLS CUI-1
C2984044
My work (include work at home) is fulfilling
Descripción

work fulfilling

Tipo de datos

integer

Alias
UMLS CUI-1
C2984074
I am able to enjoy life
Descripción

enjoy life

Tipo de datos

integer

Alias
UMLS CUI-1
C2984051
I have accepted my illness
Descripción

accepted illness

Tipo de datos

integer

Alias
UMLS CUI-1
C2984045
I am sleeping well
Descripción

sleep well

Tipo de datos

integer

Alias
UMLS CUI-1
C2984071
I am enjoying the things I usually do for fun
Descripción

enjoy things

Tipo de datos

integer

Alias
UMLS CUI-1
C2984052
I am content with the quality of my life right now
Descripción

content with quality of life

Tipo de datos

integer

Alias
UMLS CUI-1
C2984049
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Similar models

Functional Assessment of Cancer Therapy-General (Version 4)

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Below is a list of statements that other people with your illness have said are important. Please circle or mark one number per line to indicate your response as it applies to the past 7 days.
Patient ID
Item
Patient ID
text
C2348585 (UMLS CUI-1)
Date
Item
Assessment date
date
C2985720 (UMLS CUI-1)
Item Group
PHYSICAL WELL-BEING
C0517226 (UMLS CUI-1)
Item
I have a lack of energy
integer
C3830237 (UMLS CUI-1)
Lack of energy
Code List
I have a lack of energy
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I have nausea
integer
C0027497 (UMLS CUI-1)
Lack of energy
Code List
I have nausea
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
Because of my physical condition, I have trouble meeting the needs of my family
integer
C3830235 (UMLS CUI-1)
Lack of energy
Code List
Because of my physical condition, I have trouble meeting the needs of my family
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I have pain
integer
C0030193 (UMLS CUI-1)
Lack of energy
Code List
I have pain
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I am bothered by side effects of treatment
integer
C2984047 (UMLS CUI-1)
Lack of energy
Code List
I am bothered by side effects of treatment
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I feel ill
integer
C0231218 (UMLS CUI-1)
Lack of energy
Code List
I feel ill
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I am forced to spend time in bed
integer
Lack of energy
Code List
I am forced to spend time in bed
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item Group
SOCIAL/FAMILY WELL-BEING
C3476515 (UMLS CUI-1)
Item
I feel close to my friends
integer
C2984048 (UMLS CUI-1)
Lack of energy
Code List
I feel close to my friends
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I get emotional support from my family
integer
C2984050 (UMLS CUI-1)
Lack of energy
Code List
I get emotional support from my family
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I get support from my friends
integer
C3161725 (UMLS CUI-1)
Lack of energy
Code List
I get support from my friends
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
My family has accepted my illness
integer
C2984053 (UMLS CUI-1)
Lack of energy
Code List
My family has accepted my illness
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I am satisfied with family communication about my illness
integer
C2364309 (UMLS CUI-1)
Lack of energy
Code List
I am satisfied with family communication about my illness
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I feel close to my partner (or the person who is my main support)
integer
C2984059 (UMLS CUI-1)
Lack of energy
Code List
I feel close to my partner (or the person who is my main support)
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Q1
Item
Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section
boolean
Item
I am satisfied with my sex life
integer
C2984060 (UMLS CUI-1)
Lack of energy
Code List
I am satisfied with my sex life
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item Group
EMOTIONAL WELL-BEING
C2984554 (UMLS CUI-1)
Item
I feel sad
integer
C2987511 (UMLS CUI-1)
Lack of energy
Code List
I feel sad
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I am satisfied with how I am coping with my illness
integer
C2984061 (UMLS CUI-1)
Lack of energy
Code List
I am satisfied with how I am coping with my illness
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I am losing hope in the fight against my illness
integer
C2984056 (UMLS CUI-1)
Lack of energy
Code List
I am losing hope in the fight against my illness
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I feel nervous
integer
C3536990 (UMLS CUI-1)
Lack of energy
Code List
I feel nervous
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I worry about dying
integer
C2984076 (UMLS CUI-1)
Lack of energy
Code List
I worry about dying
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I worry that my condition will get worse
integer
C2984075 (UMLS CUI-1)
Lack of energy
Code List
I worry that my condition will get worse
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item Group
FUNCTIONAL WELL-BEING
C2984555 (UMLS CUI-1)
Item
I am able to work (include work at home)
integer
C2984044 (UMLS CUI-1)
Lack of energy
Code List
I am able to work (include work at home)
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
My work (include work at home) is fulfilling
integer
C2984074 (UMLS CUI-1)
Lack of energy
Code List
My work (include work at home) is fulfilling
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I am able to enjoy life
integer
C2984051 (UMLS CUI-1)
Lack of energy
Code List
I am able to enjoy life
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I have accepted my illness
integer
C2984045 (UMLS CUI-1)
Lack of energy
Code List
I have accepted my illness
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I am sleeping well
integer
C2984071 (UMLS CUI-1)
Lack of energy
Code List
I am sleeping well
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I am enjoying the things I usually do for fun
integer
C2984052 (UMLS CUI-1)
Lack of energy
Code List
I am enjoying the things I usually do for fun
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
Item
I am content with the quality of my life right now
integer
C2984049 (UMLS CUI-1)
Lack of energy
Code List
I am content with the quality of my life right now
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
A little bit (1)
C2984078 (UMLS CUI-1)
CL Item
Somewhat (2)
C2984079 (UMLS CUI-1)
CL Item
Quite a bit (3)
C2984080 (UMLS CUI-1)
CL Item
Very much (4)
C2984081 (UMLS CUI-1)
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