ID

13609

Description

Source: http://www.medizinisch-berufliche-orientierung.de/bausteine/diagnostische_instrumente/#simbo German Federal Pension Insurance Department of Rehabilitation Coordination and Development of Medical and Vocational Rehabilitation Hohenzollerndamm 47 D-10704 Berlin ( +49(0)30 865-81591 (phone) 7 +49(0)30 865-82122 (fax) mailto: dr.marco.streibelt@drv-bund.de

Link

http://www.medizinisch-berufliche-orientierung.de/bausteine/diagnostische_instrumente/#simbo

Keywords

Versions (4)
  1. 2/17/16 2/17/16 -
  2. 2/19/16 2/19/16 - Julian Varghese
  3. 2/19/16 2/19/16 - Julian Varghese
  4. 2/24/16 2/24/16 -
Uploaded on

February 19, 2016

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Screening instrument to evaluate the need for medical-vocational rehabilitation (SIMBO-C)

English

SIMBO-C Questionnaire

1 forms  
  1. StudyEvent: ODM
    1. SIMBO-C Questionnaire
SIMBO-C Questionnaire
Description

SIMBO-C Questionnaire

Please enter your social security number
Description

Social security number

Data type

integer

Alias
UMLS CUI [1]
C1301821
Age
Description

Age

Data type

integer

Measurement units
  • years
Alias
UMLS CUI [1]
C0001779
years
Gender
Description

Gender

Data type

integer

Alias
UMLS CUI [1]
C0079399
What is your current employment situation?
Description

Employment situation

Data type

text

Alias
UMLS CUI [1]
C3261398
Did your physician declare you currently unfit for work?
Description

Unfit for work

Data type

boolean

Alias
UMLS CUI [1]
C0425098
Have you been declared unfit for work within the last 12 month?
Description

Unfit to work

Data type

boolean

Alias
UMLS CUI [1]
C0425098
If you have been declared unfit to work within the last 12 month, how long was that in total?
Description

Unfit to work

Data type

text

Alias
UMLS CUI [1]
C0425098
How severe would you rate your impairment at work through your health issues?
Description

0 being no impairment at all, 10 being completely impaired

Data type

text

Alias
UMLS CUI [1]
C3842836
How would you see your occupational future? I think I
Description

Vocational assessment

Data type

text

Alias
UMLS CUI [1]
C0204115
What do you expect from your medical-vocational rehabilitation? I hope that finally somebody will have time for me
Description

Expectations

Data type

text

Alias
UMLS CUI [1]
C0679138
What do you expect from your medical-vocational rehabilitation? I hope that I will find relief of strain through psychological counseling
Description

Expectations

Data type

text

Alias
UMLS CUI [1]
C0679138
What do you expect from your medical-vocational rehabilitation? I hope that the rehabilitation will help to settle or to improve my occupational situation
Description

Expectations

Data type

text

Alias
UMLS CUI [1]
C0679138
Back to the top of the page

Similar models

SIMBO-C Questionnaire

1 forms
  1. StudyEvent: ODM
    1. SIMBO-C Questionnaire
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
SIMBO-C Questionnaire
Social security number
Item
Please enter your social security number
integer
C1301821 (UMLS CUI [1])
Age
Item
Age
integer
C0001779 (UMLS CUI [1])
Item
Gender
integer
C0079399 (UMLS CUI [1])
Gender
Code List
Gender
CL Item
male (1)
CL Item
female (2)
Item
What is your current employment situation?
text
C3261398 (UMLS CUI [1])
Employment situation
Code List
What is your current employment situation?
CL Item
fulltime employment (1)
CL Item
halftime employment (2)
CL Item
part time employment (3)
CL Item
homemaker (4)
CL Item
unemployed (5)
CL Item
on disability pension (6)
CL Item
retiree (7)
CL Item
not working due to other reasons (8)
Unfit for work
Item
Did your physician declare you currently unfit for work?
boolean
C0425098 (UMLS CUI [1])
Unfit to work
Item
Have you been declared unfit for work within the last 12 month?
boolean
C0425098 (UMLS CUI [1])
Item
If you have been declared unfit to work within the last 12 month, how long was that in total?
text
C0425098 (UMLS CUI [1])
Unfit to work
Code List
If you have been declared unfit to work within the last 12 month, how long was that in total?
CL Item
less than a week (1)
CL Item
1-6 weeks (2)
CL Item
7-12 weeks (3)
CL Item
13-26 weeks (4)
CL Item
longer than 26 weeks (5)
Item
How severe would you rate your impairment at work through your health issues?
text
C3842836 (UMLS CUI [1])
Impairment at work
Code List
How severe would you rate your impairment at work through your health issues?
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
CL Item
6 (6)
CL Item
7 (7)
CL Item
8 (8)
CL Item
9 (9)
CL Item
10 (10)
Item
How would you see your occupational future? I think I
text
C0204115 (UMLS CUI [1])
Vocational assessment
Code List
How would you see your occupational future? I think I
CL Item
can work in my profession in the future (1)
CL Item
cannot work in my profession in the future (2)
CL Item
will search for another employment (3)
CL Item
will be unable to work at all (4)
CL Item
will apply for a pension/will receive a pension (5)
CL Item
will be unemployed (6)
CL Item
will be declared unfit for work (7)
CL Item
don´t know it yet (8)
Item
What do you expect from your medical-vocational rehabilitation? I hope that finally somebody will have time for me
text
C0679138 (UMLS CUI [1])
Expectations
Code List
What do you expect from your medical-vocational rehabilitation? I hope that finally somebody will have time for me
CL Item
not at all (1)
CL Item
a little (2)
CL Item
moderately (3)
CL Item
pretty much (4)
CL Item
very much (5)
Item
What do you expect from your medical-vocational rehabilitation? I hope that I will find relief of strain through psychological counseling
text
C0679138 (UMLS CUI [1])
Expectations
Code List
What do you expect from your medical-vocational rehabilitation? I hope that I will find relief of strain through psychological counseling
CL Item
not at all (1)
CL Item
a little (2)
CL Item
moderately (3)
CL Item
pretty much (4)
CL Item
very much (5)
Item
What do you expect from your medical-vocational rehabilitation? I hope that the rehabilitation will help to settle or to improve my occupational situation
text
C0679138 (UMLS CUI [1])
Expectations
Code List
What do you expect from your medical-vocational rehabilitation? I hope that the rehabilitation will help to settle or to improve my occupational situation
CL Item
not at all (1)
CL Item
a little (2)
CL Item
moderately (3)
CL Item
pretty much (4)
CL Item
very much (5)
Back to the top of the page 

Contact

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial