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Informations:
Erreur:
ID
11305
Description
Items used as routine documentation by the university hospital muenster. Derived from original form "DAST Aufnahme PSYCH MS", converted to ODM format.
Mots-clés
Versions (2)
- 28.06.15 28.06.15 -
- 28.06.15 28.06.15 -
Téléchargé le
28. Juni 2015
DOI
Pour une demande vous connecter.
Licence
Creative Commons BY-NC 3.0 Legacy
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DAST Basic Documentation_Admission
DAST Basic Documentation_Admission
- StudyEvent: ODM
Similar models
DAST Basic Documentation_Admission
- StudyEvent: ODM
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Patient's name
Item
Name of the patient:
text
C1299487 (UMLS CUI-1)
Date of birth
Item
Date of birth:
date
C0421451 (UMLS CUI-1)
Date of admission
Item
Date of admission:
date
C0011008 (UMLS CUI-1)
C0019994 (UMLS CUI-2)
C0809949 (UMLS CUI-3)
C0019994 (UMLS CUI-2)
C0809949 (UMLS CUI-3)
Document date
Item
Document date:
date
C1978797 (UMLS CUI-1)
CL Item
Male (1)
CL Item
Female (2)
Age
Item
Age in years:
integer
C0001779 (UMLS CUI-1)
CL Item
Married (1)
CL Item
Single (2)
CL Item
Widowed (3)
CL Item
Separated/ Divorced (4)
CL Item
Fixed partnership (5)
Number of children
Item
How many children do you have?
integer
C2229974 (UMLS CUI-1)
Number of people in household
Item
How many people live in your house? Please enter as follow: Number of children, number of adults and total number of people living in your house.
text
Birth country
Item
Name of the country you were born in:
text
C1300001 (UMLS CUI-1)
Number of years in Germany
Item
If you were not born in Germany, for how long are you living in Germany?
text
C0439234 (UMLS CUI-1)
C0017480 (UMLS CUI-2)
C0017480 (UMLS CUI-2)
Birth country of parents
Item
Birth country of your parents, please mention the birth country for both of your parents:
text
C1300001 (UMLS CUI-1)
C0030551 (UMLS CUI-2)
C0030551 (UMLS CUI-2)
Item
What is your highest school-leaving qualification?
text
C1522410 (UMLS CUI-1)
C0036375 (UMLS CUI-2)
C1711333 (UMLS CUI-3)
C0036375 (UMLS CUI-2)
C1711333 (UMLS CUI-3)
CL Item
Without graduation (1)
CL Item
Primary school (2)
CL Item
Secondary school (3)
CL Item
University (4)
CL Item
University of applied science (5)
CL Item
Others (6)
Number of years in school
Item
How many years did you go to school?
integer
C0237753 (UMLS CUI-1)
C0439234 (UMLS CUI-2)
C0036375 (UMLS CUI-3)
C0439234 (UMLS CUI-2)
C0036375 (UMLS CUI-3)
Highest vocational qualification
Item
What is your highest vocational qualification?
text
C0042933 (UMLS CUI-1)
CL Item
Unemployed (1)
CL Item
Employed (2)
CL Item
Self-employed (3)
CL Item
Free-lancer (4)
CL Item
Craftsman (5)
CL Item
Skilled worker (6)
CL Item
Employee (7)
Psychiatric disorders in first-degree relatives
Item
Do you have any first-degree relative who suffers from psychiatric disorder? If yes, please mention the person's relation to you and the type of psychiatric disorder he has.
text
C0004936 (UMLS CUI-1)
C1517194 (UMLS CUI-2)
C1517194 (UMLS CUI-2)
None
Item
None
boolean
C0549184 (UMLS CUI-1)
Antidepressive therapy
Item
Did you undergo antidepressive therapy? If yes please mention the drug generic, dose and therapy duration:
text
C0003289 (UMLS CUI-1)
C0087111 (UMLS CUI-2)
C0087111 (UMLS CUI-2)
Electroconvulsive therapy
Item
Did you undergo electroconvulsive therapy, ECT? If yes, please state the number of single stimulations you recieved.
text
C0013806 (UMLS CUI-1)
Sleep deprivation
Item
Did you undergo a therapy for sleep deprivation?
boolean
C0037316 (UMLS CUI-1)
Light therapy
Item
Did you undergo light therapy?
boolean
C0031765 (UMLS CUI-1)
Psychotherapy
Item
Did you receive any individual psychotherapy session?
boolean
C0033968 (UMLS CUI-1)
Psychotherapy
Item
Did you receive any group psychotherapy session?
boolean
Others
Item
Others:
text
C0205394 (UMLS CUI-1)
Main diagnosis
Item
Main diagnosis according to DSM-IV
text
C0332137 (UMLS CUI-1)
Secondary diagnosis
Item
Secondary diagnoses according to DSM-IV:
text
C0332138 (UMLS CUI-1)
Body height
Item
Body height (in centimetres):
float
C0005890 (UMLS CUI-1)
Weight
Item
Weight (in kilograms):
float
C0005910 (UMLS CUI-1)
Electrocardiogram
Item
Electrocardiogram, QTC- Interval (in seconds):
float
C1623258 (UMLS CUI-1)
Depressive episode
Item
When did you have your first depressive episode?
text
C0349217 (UMLS CUI-1)
Depressive episode
Item
Number of previous depressive episodes:
integer
C0349217 (UMLS CUI-1)
stationary psychiatric hospitalization
Item
Number of previous stationary psychiatric hospitalizations:
integer
Item
Clinical global impression (Severity of illness), please evaluate only for the period of last week.
text
Code List
Clinical global impression (Severity of illness), please evaluate only for the period of last week.
CL Item
0 Can not be assessed. (1)
CL Item
1 Patient is not ill. (2)
CL Item
2 Patient is a borderline case of psychiatric illness. (3)
CL Item
3 Patient is only slightly ill. (4)
CL Item
4 Patient is moderately ill. (5)
CL Item
5 Patient is clearly ill. (6)
CL Item
6 Patient is seriously ill. (7)
Item
Please select the score range based on the Global Assessment of Functioning (GAF) Scale. The evaluation of the GAF scale should relate to the period of last week before admission:
text
C0561904 (UMLS CUI-1)
Code List
Please select the score range based on the Global Assessment of Functioning (GAF) Scale. The evaluation of the GAF scale should relate to the period of last week before admission:
CL Item
100-91 Superior functioning in all areas. (1)
CL Item
90-81 Good functioning in all areas. (2)
CL Item
80-71 No more than slight impairment. (3)
CL Item
70-61 Some difficulty. (4)
CL Item
60-51 Moderate difficulty. (5)
CL Item
50-41 Serious impairment. (6)
CL Item
40-31 Major impairment in several areas. (7)
CL Item
30-21 Inability to function in almost all areas. (8)
CL Item
20-11 Some danger of hurting self or others. (9)
CL Item
10-1 Permanent risk or persistent inability. (10)
CL Item
Inadequate information. (0)
Score
Item
Patient's actual score:
float
C0030705 (UMLS CUI-1)
C0018684 (UMLS CUI-2)
C0449820 (UMLS CUI-3)
C0018684 (UMLS CUI-2)
C0449820 (UMLS CUI-3)
CL Item
Not specified (1)
CL Item
Is available (2)
CL Item
Patient is severely ill. (3)
CL Item
Denied (4)
CL Item
Others (5)
CL Item
Not specified (1)
CL Item
Is available (2)
CL Item
Patient is severely ill. (3)
CL Item
Denied (4)
CL Item
Others (5)
CL Item
Not specified (1)
CL Item
Is available (2)
CL Item
Patient is severely ill. (3)
CL Item
Denied (4)
CL Item
Others (5)
Others
Item
Others:
text
C0205394 (UMLS CUI-1)