ID

17851

Descripción

Hospital Routine Documentation Form at the University Hospital Muenster. Original Form name: KIORTH CPChild MS. German description: CPChild Ein Index zur gesundheitsbezogenen Lebensqualität bei Menschen mit Behinderung

Palabras clave

  1. 5/10/16 5/10/16 -
  2. 6/10/16 6/10/16 - Julian Varghese
  3. 5/12/16 5/12/16 -
  4. 13/4/21 13/4/21 - Dr. rer. medic Philipp Neuhaus
  5. 17/11/21 17/11/21 -
Subido en

5 de octubre de 2016

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 3.0

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KIORTH CPChild MS University Hospital Muenster (UKM)

KIORTH CPChild MS University Hospital Muenster (UKM)

Allgemeines
Descripción

Allgemeines

Name des Kindes
Descripción

Name of child

Tipo de datos

text

Name der Eltern oder Pflegeperson, die den Bogen ausfüllt
Descripción

Name of parents or caregiver

Tipo de datos

text

Date
Descripción

Datum

Tipo de datos

date

Teil 1: Körperpflege / Aktivitäten des täglichen Lebens
Descripción

Teil 1: Körperpflege / Aktivitäten des täglichen Lebens

1 Essen/Trinken oder gefüttert werden (wie im Alltag gemacht wird z.B. über den Mund oder über Sonde oder beides): Schwierigkeit
Descripción

Wie schwierig war Folgendes in den letzten 2 Wochen

Tipo de datos

integer

1 Essen/Trinken oder gefüttert werden (wie im Alltag gemacht wird z.B. über den Mund oder über Sonde oder beides): Grad der Hilfestellung
Descripción

Wie schwierig war Folgendes in den letzten 2 Wochen

Tipo de datos

integer

2 Mundhygiene (Zähne putzen): Schwierigkeit
Descripción

Wie schwierig war Folgendes in den letzten 2 Wochen

Tipo de datos

integer

2 Mundhygiene (Zähne putzen): Grad der Hilfestellung
Descripción

Wie schwierig war Folgendes in den letzten 2 Wochen

Tipo de datos

integer

3 Waschen/Baden: Schwierigkeit
Descripción

Wie schwierig war Folgendes in den letzten 2 Wochen

Tipo de datos

integer

3 Waschen/Baden: Schwierigkeit
Descripción

Wie schwierig war Folgendes in den letzten 2 Wochen

Tipo de datos

integer

4. toileting activities: difficulty
Descripción

4. toileting activities: difficulty

Tipo de datos

integer

4. toileting activities: level of assistance
Descripción

4. toileting activities: level of assistance

Tipo de datos

integer

5. changing diapers/underwear: difficulty
Descripción

5. changing diapers/underwear: difficulty

Tipo de datos

integer

5. changing diapers/underwear: level of assistance
Descripción

5. changing diapers/underwear: level of assistance

Tipo de datos

integer

6. putting on/taking off upper body clothing: difficulty
Descripción

6. putting on/taking off upper body clothing: difficulty

Tipo de datos

integer

6. putting on/taking off upper body clothing: level of assistance
Descripción

6. putting on/taking off upper body clothing: level of assistance

Tipo de datos

integer

7. putting on/taking off lower body clothing: difficulty
Descripción

7. putting on/taking off lower body clothing: difficulty

Tipo de datos

integer

7. putting on/taking off lower body clothing: level of assistance
Descripción

7. putting on/taking off lower body clothing: level of assistance

Tipo de datos

integer

8. putting on/wearing footwear: difficulty
Descripción

8. putting on/wearing footwear: difficulty

Tipo de datos

integer

8. putting on/wearing footwear: level of assistance
Descripción

8. putting on/wearing footwear: level of assistance

Tipo de datos

integer

9. hair care: difficulty
Descripción

9. hair care: difficulty

Tipo de datos

integer

9. hair care: level of assistance
Descripción

9. hair care: level of assistance

Tipo de datos

integer

1A. other personal care activity
Descripción

1A. other personal care activity

Tipo de datos

text

1A. other personal care activity: difficulty
Descripción

1A. other personal care activity: difficulty

Tipo de datos

integer

1A. other personal care activity: level of assistance
Descripción

1A. other personal care activity: level of assistance

Tipo de datos

integer

1B. other personal care activity
Descripción

1B. other personal care activity

Tipo de datos

text

1B. other personal care activity: difficulty
Descripción

1B. other personal care activity: difficulty

Tipo de datos

integer

1B. other personal care activity: level of assistance
Descripción

1B. other personal care activity: level of assistance

Tipo de datos

integer

Part 1: difficulty score
Descripción

Part 1: difficulty score

Tipo de datos

text

Part 1: level of assistance score
Descripción

Part 1: level of assistance score

Tipo de datos

text

Part 1: total score
Descripción

Part 1: total score

Tipo de datos

text

2. Positioning, Transferring & Mobility
Descripción

2. Positioning, Transferring & Mobility

10. getting in and out of bed: difficulty
Descripción

10. getting in and out of bed: difficulty

Tipo de datos

integer

10. getting in and out of bed: level of assistance
Descripción

10. getting in and out of bed: level of assistance

Tipo de datos

integer

11. transferring into /out of a wheelchair/chair: difficulty
Descripción

11. transferring into /out of a wheelchair/chair: difficulty

Tipo de datos

integer

11. transferring into /out of a wheelchair/chair: level of assistance
Descripción

11. transferring into /out of a wheelchair/chair: level of assistance

Tipo de datos

integer

12. sitting in a wheelchair/chair: difficulty
Descripción

12. sitting in a wheelchair/chair: difficulty

Tipo de datos

integer

12. sitting in a wheelchair/chair: level of assistance
Descripción

12. sitting in a wheelchair/chair: level of assistance

Tipo de datos

integer

13. standing for exercise/transfers: difficulty
Descripción

13. standing for exercise/transfers: difficulty

Tipo de datos

integer

13. standing for exercise/transfers: level of assistance
Descripción

13. standing for exercise/transfers: level of assistance

Tipo de datos

integer

14. moving about in the home: difficulty
Descripción

14. moving about in the home: difficulty

Tipo de datos

integer

14. moving about in the home: level of assistance
Descripción

14. moving about in the home: level of assistance

Tipo de datos

integer

15. moving about outdoors: difficulty
Descripción

15. moving about outdoors: difficulty

Tipo de datos

integer

15. moving about outdoors: level of assistance
Descripción

15. moving about outdoors: level of assistance

Tipo de datos

integer

16. getting in and out of a motor vehicle: difficulty
Descripción

16. getting in and out of a motor vehicle: difficulty

Tipo de datos

integer

16. getting in and out of a motor vehicle: level of assistance
Descripción

16. getting in and out of a motor vehicle: level of assistance

Tipo de datos

integer

17. visiting public places: difficulty
Descripción

17. visiting public places: difficulty

Tipo de datos

integer

17. visiting public places: level of assistance
Descripción

17. visiting public places: level of assistance

Tipo de datos

integer

2A. other activity
Descripción

2A. other activity

Tipo de datos

text

2A. other activity: difficulty
Descripción

2A. other activity: difficulty

Tipo de datos

integer

2A. other activity: level of assistance
Descripción

2A. other activity: level of assistance

Tipo de datos

integer

2B. other activity
Descripción

2B. other activity

Tipo de datos

text

2B. other activity: difficulty
Descripción

2B. other activity: difficulty

Tipo de datos

integer

2B. other activity: level of assistance
Descripción

2B. other activity: level of assistance

Tipo de datos

integer

Part 2: difficulty score
Descripción

Part 2: difficulty score

Tipo de datos

text

Part 2: level of assistance score
Descripción

Part 2: level of assistance score

Tipo de datos

text

Part 2: total score
Descripción

Part 2: total score

Tipo de datos

text

3. Comfort & Emotions
Descripción

3. Comfort & Emotions

18. while eating/drinking or being fed: frequency
Descripción

18. while eating/drinking or being fed: frequency

Tipo de datos

integer

18. while eating/drinking or being fed: intensity
Descripción

18. while eating/drinking or being fed: intensity

Tipo de datos

integer

19. during toileting: frequency
Descripción

19. during toileting: frequency

Tipo de datos

integer

19. during toileting: intensity
Descripción

19. during toileting: intensity

Tipo de datos

integer

20. while dressing/undressing: frequency
Descripción

20. while dressing/undressing: frequency

Tipo de datos

integer

20. while dressing/undressing: intensity
Descripción

20. while dressing/undressing: intensity

Tipo de datos

integer

21. during transfers or position changes: frequency
Descripción

21. during transfers or position changes: frequency

Tipo de datos

integer

21. during transfers or position changes: intensity
Descripción

21. during transfers or position changes: intensity

Tipo de datos

integer

22. while seated: frequency
Descripción

22. while seated: frequency

Tipo de datos

integer

22. while seated: intensity
Descripción

22. while seated: intensity

Tipo de datos

integer

23. while lying down in bed: frequency
Descripción

23. while lying down in bed: frequency

Tipo de datos

integer

23. while lying down in bed: intensity
Descripción

23. while lying down in bed: intensity

Tipo de datos

integer

24. that disturbed your child’s sleep: frequency
Descripción

24. that disturbed your child’s sleep: frequency

Tipo de datos

integer

24. that disturbed your child’s sleep: intensity
Descripción

24. that disturbed your child’s sleep: intensity

Tipo de datos

integer

3A. during other activity
Descripción

3A. during other activity

Tipo de datos

text

3A. during other activity: frequency
Descripción

3A. during other activity: frequency

Tipo de datos

integer

3A. during other activity: intensity
Descripción

3A. during other activity: intensity

Tipo de datos

integer

3B. during other activity
Descripción

3B. during other activity

Tipo de datos

text

3B. during other activity: frequency
Descripción

3B. during other activity: frequency

Tipo de datos

integer

3B. during other activity: intensity
Descripción

3B. during other activity: intensity

Tipo de datos

integer

25. agitated, upset, or angry: frequency
Descripción

25. agitated, upset, or angry: frequency

Tipo de datos

integer

25. agitated, upset, or angry: intensity
Descripción

25. agitated, upset, or angry: intensity

Tipo de datos

integer

26. unhappy or sad: frequency
Descripción

26. unhappy or sad: frequency

Tipo de datos

integer

26. unhappy or sad: intensity
Descripción

26. unhappy or sad: intensity

Tipo de datos

integer

Part 3: frequency score
Descripción

Part 3: frequency score

Tipo de datos

text

Part 3: intensity score
Descripción

Part 3: intensity score

Tipo de datos

text

Part 3: total score
Descripción

Part 3: total score

Tipo de datos

text

4. Communication & Social Interaction
Descripción

4. Communication & Social Interaction

27. understanding you: difficulty
Descripción

27. understanding you: difficulty

Tipo de datos

integer

28. being understood by you: difficulty
Descripción

28. being understood by you: difficulty

Tipo de datos

integer

29. communicating with strangers: difficulty
Descripción

29. communicating with strangers: difficulty

Tipo de datos

integer

30. playing alone: difficulty
Descripción

30. playing alone: difficulty

Tipo de datos

integer

31. playing with others: difficulty
Descripción

31. playing with others: difficulty

Tipo de datos

integer

32. attending school/child care: difficulty
Descripción

32. attending school/child care: difficulty

Tipo de datos

integer

33. participating in recreational activities: difficulty
Descripción

33. participating in recreational activities: difficulty

Tipo de datos

integer

4A. other social activity
Descripción

4A. other social activity

Tipo de datos

text

4A. other social activity: difficulty
Descripción

4A. other social activity: difficulty

Tipo de datos

integer

4B. other social activity
Descripción

4B. other social activity

Tipo de datos

text

4B. other social activity: difficulty
Descripción

4B. other social activity: difficulty

Tipo de datos

integer

Part 4: total score
Descripción

Part 4: total score

Tipo de datos

text

5. Health
Descripción

5. Health

34. Visits of doctor/hospital: frequency
Descripción

34. Visits of doctor/hospital: frequency

Tipo de datos

integer

35. Overall health
Descripción

35. Overall health

Tipo de datos

integer

36. List of medications
Descripción

36. List of medications

Tipo de datos

text

Part 5: total score
Descripción

Part 5: total score

Tipo de datos

text

6. Overall Quality of Life
Descripción

6. Overall Quality of Life

37. Overall quality of life
Descripción

37. Overall quality of life

Tipo de datos

integer

Part 6: total score
Descripción

Part 6: total score

Tipo de datos

text

7. Importance of items to your child's quality of life
Descripción

7. Importance of items to your child's quality of life

1. Eating / drinking or being fed
Descripción

1. Eating / drinking or being fed

Tipo de datos

integer

2. Maintaining oral hygiene
Descripción

2. Maintaining oral hygiene

Tipo de datos

integer

3. Bathing / washing
Descripción

3. Bathing / washing

Tipo de datos

integer

4. Toileting activities / hygiene
Descripción

4. Toileting activities / hygiene

Tipo de datos

integer

5. Changing diapers / underwear
Descripción

5. Changing diapers / underwear

Tipo de datos

integer

6. Putting on/taking off upper clothing
Descripción

6. Putting on/taking off upper clothing

Tipo de datos

integer

7. Putting on/taking off lower clothing
Descripción

7. Putting on/taking off lower clothing

Tipo de datos

integer

8. Putting on / wearing footwear
Descripción

8. Putting on / wearing footwear

Tipo de datos

integer

9. Hair care / grooming
Descripción

9. Hair care / grooming

Tipo de datos

integer

10. Getting in and out of bed
Descripción

10. Getting in and out of bed

Tipo de datos

integer

11. Transferring into / out of a wheel chair / chair
Descripción

11. Transferring into / out of a wheel chair / chair

Tipo de datos

integer

12. Sitting in a wheelchair / chair
Descripción

12. Sitting in a wheelchair / chair

Tipo de datos

integer

13. Standing for exercise / transfers
Descripción

13. Standing for exercise / transfers

Tipo de datos

integer

14. Moving about indoors
Descripción

14. Moving about indoors

Tipo de datos

integer

15. Moving about outdoors
Descripción

15. Moving about outdoors

Tipo de datos

integer

16. Getting in / out of a motor vehicle
Descripción

16. Getting in / out of a motor vehicle

Tipo de datos

integer

17. Visiting public places
Descripción

17. Visiting public places

Tipo de datos

integer

18. Comfort while feeding
Descripción

18. Comfort while feeding

Tipo de datos

integer

19. Comfort during toileting activities
Descripción

19. Comfort during toileting activities

Tipo de datos

integer

20. Comfort while dressing /undressing
Descripción

20. Comfort while dressing /undressing

Tipo de datos

integer

21. Comfort during transfers or position changes
Descripción

21. Comfort during transfers or position changes

Tipo de datos

integer

22. Comfort while sitting
Descripción

22. Comfort while sitting

Tipo de datos

integer

23. Comfort while lying down
Descripción

23. Comfort while lying down

Tipo de datos

integer

24. Comfort while sleeping
Descripción

24. Comfort while sleeping

Tipo de datos

integer

25. Emotional state or behavior
Descripción

25. Emotional state or behavior

Tipo de datos

integer

26. Happiness
Descripción

26. Happiness

Tipo de datos

integer

27. Able to understand you
Descripción

27. Able to understand you

Tipo de datos

integer

28. Able to be understood by you
Descripción

28. Able to be understood by you

Tipo de datos

integer

29. Able to communicate with others
Descripción

29. Able to communicate with others

Tipo de datos

integer

30. Able to play alone
Descripción

30. Able to play alone

Tipo de datos

integer

31. Able to play with others
Descripción

31. Able to play with others

Tipo de datos

integer

32. Able to attend school / child care
Descripción

32. Able to attend school / child care

Tipo de datos

integer

33. Able to participate in recreational activities
Descripción

33. Able to participate in recreational activities

Tipo de datos

integer

34. Minimizing doctor visits and hospitalization
Descripción

34. Minimizing doctor visits and hospitalization

Tipo de datos

integer

35. Overall health
Descripción

35. Overall health

Tipo de datos

integer

36. Minimizing number of medications
Descripción

36. Minimizing number of medications

Tipo de datos

integer

Part 7: total score
Descripción

Part 7: total score

Tipo de datos

text

8. Facts about your child
Descripción

8. Facts about your child

Sex
Descripción

Sex

Tipo de datos

text

Date of birth
Descripción

Date of birth

Tipo de datos

date

Highest school grade completed
Descripción

Highest school grade completed

Tipo de datos

text

If ungraded, how many years attended?
Descripción

If ungraded, how many years attended?

Tipo de datos

text

9. Facts about you
Descripción

9. Facts about you

Sex
Descripción

Sex

Tipo de datos

text

Date of birth
Descripción

Date of birth

Tipo de datos

date

Current work status: Not working due to child’s health
Descripción

Current work status: Not working due to child’s health

Tipo de datos

boolean

Current work status: Not working for other reasons
Descripción

Current work status: Not working for other reasons

Tipo de datos

boolean

Current work status: Looking for work outside the home
Descripción

Current work status: Looking for work outside the home

Tipo de datos

boolean

Current work status: Working full or part time
Descripción

Current work status: Working full or part time

Tipo de datos

boolean

Current work status: Full time homemaker
Descripción

Current work status: Full time homemaker

Tipo de datos

boolean

Relationship to child: Biological Parent
Descripción

Relationship to child: Biological Parent

Tipo de datos

boolean

Relationship to child: Step Parent
Descripción

Relationship to child: Step Parent

Tipo de datos

boolean

Relationship to child: Foster Parent
Descripción

Relationship to child: Foster Parent

Tipo de datos

boolean

Relationship to child: Adoptive Parent
Descripción

Relationship to child: Adoptive Parent

Tipo de datos

boolean

Relationship to child: Guardian
Descripción

Relationship to child: Guardian

Tipo de datos

boolean

Relationship to child: Professional caregiver
Descripción

Relationship to child: Professional caregiver

Tipo de datos

boolean

Relationship to child: Other
Descripción

Relationship to child: Other

Tipo de datos

boolean

Relationship to child: Other (please explain)
Descripción

Relationship to child: Other (please explain)

Tipo de datos

text

Care giving (days per week)
Descripción

Care giving (days per week)

Tipo de datos

integer

Highest level of school completed
Descripción

Highest level of school completed

Tipo de datos

text

CPChild result
Descripción

CPChild result

CPChild Result
Descripción

CPChild Result

Tipo de datos

text

Similar models

KIORTH CPChild MS University Hospital Muenster (UKM)

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Allgemeines
Name of child
Item
Name des Kindes
text
Name of parents or caregiver
Item
Name der Eltern oder Pflegeperson, die den Bogen ausfüllt
text
Date
Item
date
Item Group
Teil 1: Körperpflege / Aktivitäten des täglichen Lebens
Item
1 Essen/Trinken oder gefüttert werden (wie im Alltag gemacht wird z.B. über den Mund oder über Sonde oder beides): Schwierigkeit
integer
Code List
1 Essen/Trinken oder gefüttert werden (wie im Alltag gemacht wird z.B. über den Mund oder über Sonde oder beides): Schwierigkeit
CL Item
nicht möglich (0 )
CL Item
sehr schwierig (1 )
CL Item
schwierig (2 )
CL Item
etwas schwierig (3 )
CL Item
leicht (4 )
CL Item
sehr leicht (5 )
CL Item
völlig unproblematisch (6 )
Item
1 Essen/Trinken oder gefüttert werden (wie im Alltag gemacht wird z.B. über den Mund oder über Sonde oder beides): Grad der Hilfestellung
integer
Code List
1 Essen/Trinken oder gefüttert werden (wie im Alltag gemacht wird z.B. über den Mund oder über Sonde oder beides): Grad der Hilfestellung
CL Item
vollständig (0 )
CL Item
mäßig (1 )
CL Item
gering/zuschauend (2 )
CL Item
unabhängig (3 )
Item
2 Mundhygiene (Zähne putzen): Schwierigkeit
integer
Code List
2 Mundhygiene (Zähne putzen): Schwierigkeit
CL Item
nicht möglich (0 )
CL Item
sehr schwierig (1 )
CL Item
schwierig (2 )
CL Item
etwas schwierig (3 )
CL Item
leicht (4 )
CL Item
sehr leicht (5 )
CL Item
völlig unproblematisch (6 )
Item
2 Mundhygiene (Zähne putzen): Grad der Hilfestellung
integer
Code List
2 Mundhygiene (Zähne putzen): Grad der Hilfestellung
CL Item
vollständig (0 )
CL Item
mäßig (1 )
CL Item
gering/zuschauend (2 )
CL Item
unabhängig (3 )
Item
3 Waschen/Baden: Schwierigkeit
integer
Code List
3 Waschen/Baden: Schwierigkeit
CL Item
nicht möglich (0 )
CL Item
sehr schwierig (1 )
CL Item
schwierig (2 )
CL Item
etwas schwierig (3 )
CL Item
leicht (4 )
CL Item
sehr leicht (5 )
CL Item
völlig unproblematisch (6 )
Item
3 Waschen/Baden: Schwierigkeit
integer
Code List
3 Waschen/Baden: Schwierigkeit
CL Item
nicht möglich (0 )
CL Item
sehr schwierig (1 )
CL Item
schwierig (2 )
CL Item
etwas schwierig (3 )
Code List
4. toileting activities: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
4. toileting activities: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
5. changing diapers/underwear: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
5. changing diapers/underwear: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
6. putting on/taking off upper body clothing: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
6. putting on/taking off upper body clothing: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
7. putting on/taking off lower body clothing: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
7. putting on/taking off lower body clothing: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
8. putting on/wearing footwear: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
8. putting on/wearing footwear: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
9. hair care: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
9. hair care: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
1A. other personal care activity
Item
text
Code List
1A. other personal care activity: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
1A. other personal care activity: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
1B. other personal care activity
Item
text
Code List
1B. other personal care activity: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
1B. other personal care activity: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Part 1: difficulty score
Item
text
Part 1: level of assistance score
Item
text
Part 1: total score
Item
text
Code List
10. getting in and out of bed: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
10. getting in and out of bed: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
11. transferring into /out of a wheelchair/chair: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
11. transferring into /out of a wheelchair/chair: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
12. sitting in a wheelchair/chair: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
12. sitting in a wheelchair/chair: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
13. standing for exercise/transfers: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
13. standing for exercise/transfers: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
14. moving about in the home: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
14. moving about in the home: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
15. moving about outdoors: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
15. moving about outdoors: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
16. getting in and out of a motor vehicle: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
16. getting in and out of a motor vehicle: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
17. visiting public places: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
17. visiting public places: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
2A. other activity
Item
text
Code List
2A. other activity: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
2A. other activity: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
2B. other activity
Item
text
Code List
2B. other activity: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
CL Item
 (6 )
Code List
2B. other activity: level of assistance
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Part 2: difficulty score
Item
text
Part 2: level of assistance score
Item
text
Part 2: total score
Item
text
Code List
18. while eating/drinking or being fed: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
18. while eating/drinking or being fed: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
19. during toileting: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
19. during toileting: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
20. while dressing/undressing: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
20. while dressing/undressing: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
21. during transfers or position changes: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
21. during transfers or position changes: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
22. while seated: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
22. while seated: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
23. while lying down in bed: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
23. while lying down in bed: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
24. that disturbed your child’s sleep: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
24. that disturbed your child’s sleep: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
3A. during other activity
Item
text
Code List
3A. during other activity: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
3A. during other activity: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
3B. during other activity
Item
text
Code List
3B. during other activity: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
3B. during other activity: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
25. agitated, upset, or angry: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
25. agitated, upset, or angry: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Code List
26. unhappy or sad: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
26. unhappy or sad: intensity
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
Part 3: frequency score
Item
text
Part 3: intensity score
Item
text
Part 3: total score
Item
text
Code List
27. understanding you: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
28. being understood by you: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
29. communicating with strangers: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
30. playing alone: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
31. playing with others: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
32. attending school/child care: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
33. participating in recreational activities: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
4A. other social activity
Item
text
Code List
4A. other social activity: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
4B. other social activity
Item
text
Code List
4B. other social activity: difficulty
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Part 4: total score
Item
text
Item Group
Code List
34. Visits of doctor/hospital: frequency
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
35. Overall health
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
36. List of medications
Item
text
Part 5: total score
Item
text
Code List
37. Overall quality of life
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Part 6: total score
Item
text
Code List
1. Eating / drinking or being fed
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
2. Maintaining oral hygiene
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
3. Bathing / washing
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
4. Toileting activities / hygiene
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
5. Changing diapers / underwear
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
6. Putting on/taking off upper clothing
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
7. Putting on/taking off lower clothing
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
8. Putting on / wearing footwear
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
9. Hair care / grooming
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
10. Getting in and out of bed
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
11. Transferring into / out of a wheel chair / chair
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
12. Sitting in a wheelchair / chair
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
13. Standing for exercise / transfers
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
14. Moving about indoors
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
15. Moving about outdoors
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
16. Getting in / out of a motor vehicle
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
17. Visiting public places
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
18. Comfort while feeding
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
19. Comfort during toileting activities
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
20. Comfort while dressing /undressing
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
21. Comfort during transfers or position changes
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
22. Comfort while sitting
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
23. Comfort while lying down
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
24. Comfort while sleeping
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
25. Emotional state or behavior
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Item
integer
Code List
26. Happiness
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
27. Able to understand you
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
28. Able to be understood by you
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
29. Able to communicate with others
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
30. Able to play alone
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
31. Able to play with others
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
32. Able to attend school / child care
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
33. Able to participate in recreational activities
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
34. Minimizing doctor visits and hospitalization
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
35. Overall health
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Code List
36. Minimizing number of medications
CL Item
 (0 )
CL Item
 (1 )
CL Item
 (2 )
CL Item
 (3 )
CL Item
 (4 )
CL Item
 (5 )
Part 7: total score
Item
text
Item
text
Code List
Sex
CL Item
 (männlich)
CL Item
 (weiblich)
Date of birth
Item
date
Code List
Highest school grade completed
CL Item
 (Kindergarten)
CL Item
 (Vorschule)
CL Item
 (1. Klasse)
CL Item
 (2. Klasse)
CL Item
 (3. Klasse)
CL Item
 (4. Klasse)
CL Item
 (5. Klasse)
CL Item
 (6. Klasse)
CL Item
 (7. Klasse)
CL Item
 (8. Klasse)
CL Item
 (9. Klasse)
CL Item
 (10. Klasse)
CL Item
 (11. Klasse)
CL Item
 (12. Klasse)
CL Item
 (Keine abgeschlossen)
If ungraded, how many years attended?
Item
text
Item
text
Code List
Sex
CL Item
 (männlich)
CL Item
 (weiblich)
Date of birth
Item
date
Current work status: Not working due to child’s health
Item
boolean
Current work status: Not working for other reasons
Item
boolean
Current work status: Looking for work outside the home
Item
boolean
Current work status: Working full or part time
Item
boolean
Current work status: Full time homemaker
Item
boolean
Relationship to child: Biological Parent
Item
boolean
Relationship to child: Step Parent
Item
boolean
Relationship to child: Foster Parent
Item
boolean
Relationship to child: Adoptive Parent
Item
boolean
Relationship to child: Guardian
Item
boolean
Relationship to child: Professional caregiver
Item
boolean
Relationship to child: Other
Item
boolean
Relationship to child: Other (please explain)
Item
text
Care giving (days per week)
Item
integer
Code List
Highest level of school completed
CL Item
 (Hauptschulabschluss)
CL Item
 (Realschulabschluss)
CL Item
 (Abitur)
CL Item
 (Fachschulabschluss)
CL Item
 (Universitätsabschluss)
Item Group
CPChild Result
Item
text

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