ID

1535

Beschreibung

Z6051 International Index of Erectile Function Questionnaire (IIEF) Laparoscopic-Assisted Resection or Open Resection in Treating Patients With Stage IIA, Stage IIIA, or Stage IIIB Rectal Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4AE9A885-FEFA-574B-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=4AE9A885-FEFA-574B-E044-0003BA3F9857

Stichworte

Versionen (3)
  1. 27.08.12 27.08.12 -
  2. 20.03.14 20.03.14 - Martin Dugas
  3. 09.01.15 09.01.15 - Martin Dugas
Hochgeladen am

27. August 2012

DOI

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Lizenz

Creative Commons BY-NC 3.0 Legacy
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Colorectal Cancer NCT00726622 Quality of Life - Z6051 International Index of Erectile Function Questionnaire (IIEF) - 2740994v1.0

Englisch

INSTRUCTIONS: These questions ask about your sexual feelings and responses during the past 4 weeks. Please answer the following questions as honestly and clearly as possible. Your responses will be kept completely confidential.

1 Formulare  
Header Module
Beschreibung

Header Module

Visit
Beschreibung

AmericanCollegeofSurgeonsOncologyGroupVisitPeriodAmericanCollegeofSurgeonsOncologyGroupVisitPeriodType

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C25616
UMLS 2011AA Property
C1948053
NCI Thesaurus ObjectClass
C19712
UMLS 2011AA ObjectClass
C1515944
NCI Thesaurus ObjectClass
C25716
UMLS 2011AA ObjectClass
C0545082
Patient ID (Pt. ID issued during registration unless pt. previously registered to an ACOSOG study.)
Beschreibung

PatientCoordinatingIdentifierNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25462
UMLS 2011AA Property
C0700114
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Initials
Beschreibung

PatientInitialsName

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
Institution Name
Beschreibung

InstitutionName

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus ValueDomain
C21541
UMLS 2011AA ValueDomain
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Institution No.
Beschreibung

InstitutionIdentifierNumber

Datentyp

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Date
Beschreibung

AssessmentPerformedDate

Datentyp

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25367
NCI Thesaurus ValueDomain
C25367
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
Unnamed 1
Beschreibung

Unnamed 1

Over the past 4 weeks, how often were you able to have an erection during sexual activity
Beschreibung

SexBehaviorQualityofLifeErectionOccurrenceAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C25740
UMLS 2011AA Property
C0030847
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, when you had erections with sexual stimulation, how often were your erections hard enough for penetration
Beschreibung

SexBehaviorQualityofLifeErectionSufficientPenetrationOccurrenceAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C25740
UMLS 2011AA Property
C0030847
NCI Thesaurus Property
C25612
UMLS 2011AA Property
C0205321
NCI Thesaurus Property
C63351
UMLS 2011AA Property
C0205410
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, when you attempted sexual intercourse, how often were you able to penetrate (enter) your partner
Beschreibung

SexBehaviorQualityofLifePenetrationOccurrenceAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C25612
UMLS 2011AA Property
C0205321
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, during sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner
Beschreibung

SexBehaviorQualityofLifeErectionPostPenetrationOccurrenceAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C38008
UMLS 2011AA Property
C0687676
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C25740
UMLS 2011AA Property
C0030847
NCI Thesaurus Property
C25612
UMLS 2011AA Property
C0205321
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, during sexual intercourse, how difficult was it to maintain your erection to complete intercourse
Beschreibung

SexBehaviorQualityofLifeErectionMaintenanceDifficultyAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C53297
UMLS 2011AA Property
C0024501
NCI Thesaurus Property
C62189
UMLS 2011AA Property
C1299586
NCI Thesaurus Property
C25740
UMLS 2011AA Property
C0030847
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, how many times did you attempt sexual intercourse
Beschreibung

SexBehaviorQualityofLifeSexualIntercourseOccurrenceAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C72881
UMLS 2011AA Property
C0009253
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, when you attempted sexual intercourse, how often was it satisfactory for you
Beschreibung

SexBehaviorQualityofLifeSexualIntercourseSatisfactionOccurrenceAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C62185
UMLS 2011AA Property
C0242428
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C72881
UMLS 2011AA Property
C0009253
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, how much did you enjoy sexual intercourse
Beschreibung

SexBehaviorQualityofLifeSexualIntercourseSatisfactionAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C62185
UMLS 2011AA Property
C0242428
NCI Thesaurus Property
C72881
UMLS 2011AA Property
C0009253
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you ejaculate
Beschreibung

SexBehaviorQualityofLifeSexualIntercourseEjaculationOccurrenceAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C72881
UMLS 2011AA Property
C0009253
NCI Thesaurus Property
C16531
UMLS 2011AA Property
C0013746
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you have the feeling of orgasm or climax
Beschreibung

SexBehaviorQualityofLifeOrgasmOccurrenceAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C73521
UMLS 2011AA Property
C0029260
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, how often did you feel sexual desire
Beschreibung

SexBehaviorQualityofLifeLibidoAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C37986
UMLS 2011AA Property
C0023618
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, how would you rate your level of sexual desire
Beschreibung

SexBehaviorQualityofLifeLibidoOccurrenceAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
NCI Thesaurus Property
C37986
UMLS 2011AA Property
C0023618
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, how satisfied have you been with your overall sexual life
Beschreibung

SexBehaviorQualityofLifeOverallSatisfactionAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25605
UMLS 2011AA Property
C1561607
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C62185
UMLS 2011AA Property
C0242428
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner
Beschreibung

SexBehaviorQualityofLifeSatisfactionAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C62185
UMLS 2011AA Property
C0242428
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
Over the past 4 weeks, how do you rate your confidence that you could have and keep an erection
Beschreibung

SexBehaviorQualityofLifeErectionConfidenceAssessmentScale

Datentyp

text

Alias
NCI Thesaurus ObjectClass
C17047
UMLS 2011AA ObjectClass
C0518214
NCI Thesaurus ObjectClass
C17127
UMLS 2011AA ObjectClass
C0036864
NCI Thesaurus Property
C25367
NCI Thesaurus Property
C43367
UMLS 2011AA Property
C1704726
NCI Thesaurus Property
C25740
UMLS 2011AA Property
C0030847
NCI Thesaurus ValueDomain
C25664
UMLS 2011AA ValueDomain
C0349674
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Ähnliche Modelle

INSTRUCTIONS: These questions ask about your sexual feelings and responses during the past 4 weeks. Please answer the following questions as honestly and clearly as possible. Your responses will be kept completely confidential.

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Header Module
Item
Visit
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C19712 (NCI Thesaurus ObjectClass)
C1515944 (UMLS 2011AA ObjectClass)
C25716 (NCI Thesaurus ObjectClass)
C0545082 (UMLS 2011AA ObjectClass)
CL.1
Code List
Visit
CL Item
Pre-operative (Pre-Op)
CL Item
4-6 Weeks Post-surgery (4-6 weeks post-surgery)
CL Item
Month 3 (Month 3)
CL Item
Month 12 (Month 12)
PatientCoordinatingIdentifierNumber
Item
Patient ID (Pt. ID issued during registration unless pt. previously registered to an ACOSOG study.)
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientInitialsName
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
InstitutionName
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C21541 (NCI Thesaurus ValueDomain)
C0018704 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
InstitutionIdentifierNumber
Item
Institution No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
AssessmentPerformedDate
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ObjectClass)
C25367 (NCI Thesaurus ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
Item Group
Unnamed 1
Item
Over the past 4 weeks, how often were you able to have an erection during sexual activity
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C25740 (NCI Thesaurus Property)
C0030847 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.2
Code List
Over the past 4 weeks, how often were you able to have an erection during sexual activity
CL Item
A Few Times (A few times)
CL Item
Almost Always/ Always (almost always/ always)
CL Item
Almost Never/ Never (almost never/ never)
CL Item
Most Times (Most times)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, when you had erections with sexual stimulation, how often were your erections hard enough for penetration
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C25740 (NCI Thesaurus Property)
C0030847 (UMLS 2011AA Property)
C25612 (NCI Thesaurus Property)
C0205321 (UMLS 2011AA Property)
C63351 (NCI Thesaurus Property)
C0205410 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.3
Code List
Over the past 4 weeks, when you had erections with sexual stimulation, how often were your erections hard enough for penetration
CL Item
A Few Times (A few times)
CL Item
Almost Always/ Always (almost always/ always)
CL Item
Almost Never/ Never (almost never/ never)
CL Item
Most Times (Most times)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, when you attempted sexual intercourse, how often were you able to penetrate (enter) your partner
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C25612 (NCI Thesaurus Property)
C0205321 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.4
Code List
Over the past 4 weeks, when you attempted sexual intercourse, how often were you able to penetrate (enter) your partner
CL Item
A Few Times (A few times)
CL Item
Almost Always/ Always (almost always/ always)
CL Item
Almost Never/ Never (almost never/ never)
CL Item
Most Times (Most times)
CL Item
No Sexual Activity (No sexual activity)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, during sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C38008 (NCI Thesaurus Property)
C0687676 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C25740 (NCI Thesaurus Property)
C0030847 (UMLS 2011AA Property)
C25612 (NCI Thesaurus Property)
C0205321 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.5
Code List
Over the past 4 weeks, during sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner
CL Item
A Few Times (A few times)
CL Item
Almost Always/ Always (almost always/ always)
CL Item
Almost Never/ Never (almost never/ never)
CL Item
Did Not Attempt Intercourse (Did not attempt intercourse)
CL Item
Most Times (Most times)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, during sexual intercourse, how difficult was it to maintain your erection to complete intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C53297 (NCI Thesaurus Property)
C0024501 (UMLS 2011AA Property)
C62189 (NCI Thesaurus Property)
C1299586 (UMLS 2011AA Property)
C25740 (NCI Thesaurus Property)
C0030847 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.6
Code List
Over the past 4 weeks, during sexual intercourse, how difficult was it to maintain your erection to complete intercourse
CL Item
Did Not Attempt Intercourse (Did not attempt intercourse)
CL Item
Difficult (Difficult)
CL Item
Not Difficult (Not difficult)
CL Item
Slightly Difficult (Slightly difficult)
CL Item
Very Difficult (Very difficult)
CL Item
Extremely Difficult (Extremely difficult)
Item
Over the past 4 weeks, how many times did you attempt sexual intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C72881 (NCI Thesaurus Property)
C0009253 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.7
Code List
Over the past 4 weeks, how many times did you attempt sexual intercourse
CL Item
Five To Six Attempts (Five to six attempts)
CL Item
More Than Eleven Attempts (More than eleven attempts)
CL Item
No Attempt (No attempt)
CL Item
One To Two Attempts (One to two attempts)
CL Item
Seven To Ten Attempts (Seven to ten attempts)
CL Item
Three To Four Attempts (Three to four attempts)
Item
Over the past 4 weeks, when you attempted sexual intercourse, how often was it satisfactory for you
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property)
C0242428 (UMLS 2011AA Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C72881 (NCI Thesaurus Property)
C0009253 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.8
Code List
Over the past 4 weeks, when you attempted sexual intercourse, how often was it satisfactory for you
CL Item
A Few Times (A few times)
CL Item
Almost Always/ Always (almost always/ always)
CL Item
Almost Never/ Never (almost never/ never)
CL Item
Did Not Attempt Intercourse (Did not attempt intercourse)
CL Item
Most Times (Most times)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, how much did you enjoy sexual intercourse
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property)
C0242428 (UMLS 2011AA Property)
C72881 (NCI Thesaurus Property)
C0009253 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.9
Code List
Over the past 4 weeks, how much did you enjoy sexual intercourse
CL Item
Fairly Enjoyable (Fairly enjoyable)
CL Item
Highly Enjoyable (Highly enjoyable)
CL Item
No Enjoyment (No enjoyment)
CL Item
No Intercourse (No intercourse)
CL Item
Not Very Enjoyable (Not very enjoyable)
CL Item
Very Highly Enjoyable (Very highly enjoyable)
Item
Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you ejaculate
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C72881 (NCI Thesaurus Property)
C0009253 (UMLS 2011AA Property)
C16531 (NCI Thesaurus Property)
C0013746 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.10
Code List
Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you ejaculate
CL Item
A Few Times (A few times)
CL Item
Almost Always/ Always (almost always/ always)
CL Item
Almost Never/ Never (almost never/ never)
CL Item
Did Not Attempt Intercourse (Did not attempt intercourse)
CL Item
Most Times (Most times)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you have the feeling of orgasm or climax
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C73521 (NCI Thesaurus Property)
C0029260 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.11
Code List
Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you have the feeling of orgasm or climax
CL Item
A Few Times (A few times)
CL Item
Almost Always/ Always (almost always/ always)
CL Item
Almost Never/ Never (almost never/ never)
CL Item
Most Times (Most times)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, how often did you feel sexual desire
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C37986 (NCI Thesaurus Property)
C0023618 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.12
Code List
Over the past 4 weeks, how often did you feel sexual desire
CL Item
A Few Times (A few times)
CL Item
Almost Always/ Always (almost always/ always)
CL Item
Almost Never/ Never (almost never/ never)
CL Item
Most Times (Most times)
CL Item
Sometimes (Sometimes)
Item
Over the past 4 weeks, how would you rate your level of sexual desire
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
C37986 (NCI Thesaurus Property)
C0023618 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.13
Code List
Over the past 4 weeks, how would you rate your level of sexual desire
CL Item
High (High)
C25227 (NCI Thesaurus)
C0205250 (UMLS 2011AA)
CL Item
Low (Low)
C54722 (NCI Thesaurus)
C0205251 (UMLS 2011AA)
CL Item
Moderation (Moderate)
C61376 (NCI Thesaurus)
C1881878 (UMLS 2011AA)
CL Item
Very High (Very high)
CL Item
Very Low Or None At All (Very low or none at all)
Item
Over the past 4 weeks, how satisfied have you been with your overall sexual life
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25605 (NCI Thesaurus Property)
C1561607 (UMLS 2011AA Property)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property)
C0242428 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.14
Code List
Over the past 4 weeks, how satisfied have you been with your overall sexual life
CL Item
About Equally Satisfied And Dissatisfied (About equally satisfied and dissatisfied)
CL Item
Moderately Dissatisfied (Moderately dissatisfied)
CL Item
Moderately Satisfied (Moderately satisfied)
CL Item
Very Dissatisfied (Very dissatisfied)
CL Item
Very Satisfied (Very satisfied)
Item
Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C62185 (NCI Thesaurus Property)
C0242428 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.15
Code List
Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner
CL Item
About Equally Satisfied And Dissatisfied (About equally satisfied and dissatisfied)
CL Item
Moderately Dissatisfied (Moderately dissatisfied)
CL Item
Moderately Satisfied (Moderately satisfied)
CL Item
Very Dissatisfied (Very dissatisfied)
CL Item
Very Satisfied (Very satisfied)
Item
Over the past 4 weeks, how do you rate your confidence that you could have and keep an erection
text
C17047 (NCI Thesaurus ObjectClass)
C0518214 (UMLS 2011AA ObjectClass)
C17127 (NCI Thesaurus ObjectClass)
C0036864 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus Property)
C43367 (NCI Thesaurus Property)
C1704726 (UMLS 2011AA Property)
C25740 (NCI Thesaurus Property)
C0030847 (UMLS 2011AA Property)
C25664 (NCI Thesaurus ValueDomain)
C0349674 (UMLS 2011AA ValueDomain)
CL.16
Code List
Over the past 4 weeks, how do you rate your confidence that you could have and keep an erection
CL Item
Very Low (Very low)
CL Item
High (High)
C25227 (NCI Thesaurus)
C0205250 (UMLS 2011AA)
CL Item
Low (Low)
C54722 (NCI Thesaurus)
C0205251 (UMLS 2011AA)
CL Item
Moderation (Moderate)
C61376 (NCI Thesaurus)
C1881878 (UMLS 2011AA)
CL Item
Very High (Very high)
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