Search results - Portal of Medical Data Models (MDM-Portal)

Itemgroups: General Info, Current health limitations, Physical Health related problems during past 4 weeks, Emotional problems during past 4 weeks, Past 4 weeks, Emotions in past 4 weeks, General statements

This document contains the 36-Item Short Form Survey Instrument Version 1 (SF-36) form, developed at RAND as part of the Medical Outcomes Study. RAND owns the copyright. All of the surveys and tools from RAND Health are public documents, available without charge. For more information - e.g. on terms and conditions for use or scoring instructions: https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form.html Changes made to the questionnaire should be made clearly identifiable.

HADS - Hospital Anxiety and Depression Scale (HADS)

- 11/16/18 - 1 form, 1 itemgroup, 14 items, 1 language

Itemgroup: In the past week

Hospital Anxiety and Depression Scale (HADS) was originally developed by [Zigmond, AS; Snaith, RP (1983). "The hospital anxiety and depression scale". Acta Psychiatrica Scandinavica 67 (6): 361–370] and is commonly used by doctors to determine the levels of anxiety and depression that a patient is experiencing. Also used for routine documentation at the University Hospital Muenster (UKM) see http://en.wikipedia.org/wiki/Hospital_Anxiety_and_Depression_Scale

DLQI - Dermatology Life Quality Index (DLQI)

- 9/7/16 - 1 form, 1 itemgroup, 12 items, 17 languages

Itemgroup: Skin problems past week

Details and Conditions of Use see: Finlay A.Y., Khan G.K. Dermatology Life Quality Index (DLQI) - A simple practical measure for routine clinical use. Clinical and Experimental Derm 1994; 19:210-16 Used as routine documentation at the University Hospital in Muenster (UKM).

KIORTH CPChild MS University Hospital Muenster (UKM)

- 4/13/21 - 1 form, 11 itemgroups, 159 items, 1 language

Itemgroups: General information, 1. Personal care/ Activities of daily living, 2. Positioning, Transferring & Mobility, 3. Comfort & Emotions, 4. Communication & Social Interaction, 5. Health, 6. Overall Quality of Life, 7. Importance of items to your child's quality of life, 8. Facts about your child, 9. Facts about you, CPChild result

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

Breast Cancer NCT00024102 Quality of Life - CALGB: Y-ME COUNSELOR TELEPHONE CONTACT FORM - 2044777v3.0 - CALGB: Y-ME COUNSELOR TELEPHONE CONTACT FORM

- 4/13/21 - 1 form, 2 itemgroups, 31 items, 1 language

Itemgroups: General Info, Telephone Interview

CALGB: Y-ME COUNSELOR TELEPHONE CONTACT FORM Comparison of Combination Chemotherapy Regimens in Treating Older Women Who Have Undergone Surgery for Breast Cancer Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A50CF1AD-5DEE-3887-E034-080020C9C0E0

Colorectal cancer metastases (NCT00268463) - Quality of Life Form Colorectal Cancer (NSABP C-09 NCT00268463)

- 4/10/21 - 1 form, 8 itemgroups, 94 items, 1 language

Itemgroups: Header, Treatment satisfaction, PHYSICAL WELL-BEING, Social and family well being, EMOTIONAL WELL-BEING, Functional Health, ADDITIONAL CONCERNS, Activity

NSABP Protocol C-09: Quality of Life Form Oxaliplatin and Capecitabine With or Without an Hepatic Arterial Infusion With Floxuridine in Treating Patients Who Are Undergoing Surgery and/or Ablation for Liver Metastases Due to Colorectal Cancer NCT00268463 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FC7E0FCB-064A-58CD-E034-0003BA3F9857

Breast Cancer (NCT00053898) - Quality of Life Questionnaire Breast Cancer (NCT00053898)

- 4/10/21 - 1 form, 6 itemgroups, 70 items, 1 language

Itemgroups: Header, Symptom frequency, Problems past 4 weeks, Overall health, Mood, Sexual activity

Quality of Life Questionnaire Anastrozole or Tamoxifen in Treating Postmenopausal Women With Ductal Carcinoma in Situ Who Are Undergoing Lumpectomy and Radiation Therapy NCT00053898 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A0E240A0-FD2A-46A0-E034-080020C9C0E0

Breast Cancer Chemotherapy (NCT00087178) - Quality of Life Questionnaire (NSABP Protocol B-36 NCT00087178)

- 4/10/21 - 1 form, 2 itemgroups, 94 items, 1 language

Itemgroups: Header, Quality of life

NSABP Protocol B-36 Quality of Life Questionnaire (English Version) Comparison of Two Combination Chemotherapy Regimens in Treating Women With Breast Cancer NCT00087178 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C907A026-1DAB-1D7C-E034-0003BA12F5E7

Measurement Instrument Database for the Social Science (MIDSS) - Attitude Follow-Up Scale (AFS)

- 9/30/20 - 1 form, 2 itemgroups, 19 items, 1 language

Itemgroups: Instructions, Extent

Stiggelbout, A. M., de Haes, J. C., Vree, R. van de Velde, C. J., Bruijninckx, C. M., van Groningen, K., Kievit, J. (1997). Attitude Follow-Up Scale (AFS). Measurement Instrument Database for the Social Science. Retrieved 30.09.2020, from www.midss.ie Key references: Stiggelbout, A. M., de Haes, J. C., Vree, R. van de Velde, C. J., Bruijninckx, C. M., van Groningen, K., and Kievit, J. (1997). Follow-up of colorectal cancer patients: quality of life and attitudes towards follow-up. Br J Cancer, 75(6), 914–920. Kiebert, G. M., Welvaart, K., Kievit, J. (1993). Psychological effects of routine follow up on cancer patients after surgery. Eur J Surg, 159(11–12), 601–607 Thewes, B., Butow, P., Zachariae, R., Christensen, S., Simard, S & Gotay, C. (2012). Fear of cancer recurrence: a systematic literature review of self-report measures. Psycho-Oncology, 21, 571–587 Primary use / Purpose: The Attitude Follow-Up Scale (AFS) is a 19-item inventory rated on a 4 point Likert-type scale. Its purpose is to measure the attitudes of cancer patients towards follow-up. Patients’ attitudes are measured under four dimensions: communication (with a physician), reassurance, nervous anticipation, and perceived disadvantages of the follow-up process. Background: A substantial amount of research exists on the well-being and quality of life associated with clinical samples, especially those diagnosed with cancer. However, little research has specifically studied the physical and psychological outcomes associated with follow-up procedures between patient and physician. To address this, Stiggelbout, de Haes, & Vree et al. (1997) tweaked an existing scale developed by Kiebert, Welvaart, Kievit (1993) and ended up with the Attitude Follow-Up Scale (AFS). Psychometrics: The psychometric properties of the Attitude Follow-Up Scale (AFS) are discussed in Stiggelbout, de Haes, & Vree et al. (1997). Digital Object Identifier (DOI): http://dx.doi.org/10.13072/midss.324

Patient reported outcome measures in ATTR amyloidosis - PROMs in ATTR amyloidosis

- 8/6/20 - 1 form, 8 itemgroups, 76 items, 1 language

Itemgroups: Demographic Factors, Comorbidities, Patient reported outcomes: ATTR Diagnosis, First organ system involved, Patient reported outcomes: Quality of life, Patient reported outcomes: Disability, Patient reported Outcomes: ATTR Management, ATTR Therapy

Patient reported outcome measures (PROMS) in patients with ATTR amyloidosis Dr. med. Fabian Johannes Bolte Klinik für Gastroenterologie und Hepatologie Universitätsklinikum Münster Conditions: ATTR Amyloidosis This form is used for patient reported outcome measures (PROMS) in patients with ATTR amyloidosis to understand patients challenges and needs. Use of the following Scores for this standard set: (1) Patient Reported Outcomes Measurement Information System Short Form version 1.1 Global Health (PROMIS-10) (2) World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)- 12-item Instrument

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