70674-7
Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
Active
Reference Information
| Type | Source | Reference |
|---|---|---|
| Citation | David Cella, PhDCopyright Copyright © 2010 David Cella, PhD. | FACIT Copyright FACIT Copyright |
Panel Hierarchy
Details for each LOINC in Panel LHC-Forms
| LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
|---|---|---|---|---|
| 70674-7 | Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel | |||
| Indent70676-2 | Functional Assessment of Anorexia-Cachexia Treatment Questionnaire - version 4 (FAACT) [FACIT] | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70893-3 | Additional concerns - FAACT [FACIT] | |||
| Indent Indent Indent70350-4 | I have a good appetite | |||
| Indent Indent Indent70677-0 | The amount I eat is sufficient to meet my needs | |||
| Indent Indent Indent70678-8 | I am worried about my weight | |||
| Indent Indent Indent70679-6 | Most food tastes unpleasant to me | |||
| Indent Indent Indent70680-4 | I am concerned about how thin I look | |||
| Indent Indent Indent70681-2 | My interest in food drops as soon as I try to eat | |||
| Indent Indent Indent70682-0 | I have difficulty eating rich or heavy foods | |||
| Indent Indent Indent70683-8 | My family or friends are pressuring me to eat | |||
| Indent Indent Indent70479-1 | I have been vomiting | |||
| Indent Indent Indent70684-6 | When I eat, I seem to get full quickly | |||
| Indent Indent Indent70301-7 | I have a pain in my stomach area | |||
| Indent Indent Indent70685-3 | My general health is improving | |||
| Indent70686-1 | Functional Assessment of Chronic Illness Therapy for patients with abdominal symptoms questionnaire - version 4 (FACIT-AD) | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70904-8 | Additional concerns - FACIT-AD [FACIT] | |||
| Indent Indent Indent70480-9 | I have cramps in my stomach area | |||
| Indent Indent Indent70301-7 | I have a pain in my stomach area | |||
| Indent Indent Indent70687-9 | Stomach pain interferes with my daily functioning | |||
| Indent70688-7 | Functional Assessment of Chronic Illness Therapy for patients with ascites questionnaire (FACIT-AI) | |||
| Indent Indent70350-4 | I have a good appetite | |||
| Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent70320-7 | I am able to get around by myself | |||
| Indent Indent70305-8 | I have been short of breath | |||
| Indent Indent70406-4 | I have nausea | |||
| Indent Indent70479-1 | I have been vomiting | |||
| Indent Indent70301-7 | I have a pain in my stomach area | |||
| Indent Indent70478-3 | I have swelling in my stomach area | |||
| Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent70684-6 | When I eat, I seem to get full quickly | |||
| Indent Indent70315-7 | I urinate more frequently than usual | |||
| Indent Indent70365-2 | I am bothered by constipation | |||
| Indent Indent70689-5 | I have been emotionally distressed | |||
| Indent70690-3 | Functional Assessment of Chronic Illness Therapy for patients with cervical dysplasia questionnaire - version 4 (FACIT-CD) | |||
| Indent Indent70905-5 | Physical well-being - FACIT-CD [FACIT] | |||
| Indent Indent Indent70841-2 | I have discomfort in my pelvic area | |||
| Indent Indent Indent70842-0 | I have pain in my pelvic area | |||
| Indent Indent Indent70843-8 | I have cramping in my pelvic area | |||
| Indent Indent Indent70360-3 | I am bothered by discharge or bleeding from my vagina | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70844-6 | Are you sexually active or would you like to be sexually active? | |||
| Indent Indent Indent70382-7 | I have pain or discomfort with intercourse | |||
| Indent Indent Indent70694-5 | I have to limit my sexual activity because of the infection | |||
| Indent Indent Indent70695-2 | I worry about spreading the infection | |||
| Indent Indent70691-1 | Treatment satisfaction [FACIT] | |||
| Indent Indent Indent70845-3 | I have confidence in my doctors | |||
| Indent Indent Indent70846-1 | I feel that I received the treatment that was right for me | |||
| Indent Indent Indent70847-9 | My doctor gave me explanations that I could understand | |||
| Indent Indent Indent70848-7 | My doctor explained the possible benefits of my treatmen | |||
| Indent Indent70692-9 | General perceptions [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70696-0 | I am hopeful about the future | |||
| Indent Indent Indent70697-8 | I find comfort in my faith or spiritual beliefs | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent Indent70698-6 | I feel that I can manage things that come up around this infection | |||
| Indent Indent Indent70699-4 | I have accepted that I have this infection | |||
| Indent Indent70906-3 | Emotional well being - FACIT-CD [FACIT] | |||
| Indent Indent Indent70700-0 | I worry that the infection will get worse | |||
| Indent Indent Indent70701-8 | I have hidden this problem so others will not notice | |||
| Indent Indent Indent70702-6 | I have concerns about my ability to become pregnant | |||
| Indent Indent Indent70648-1 | The cost of my treatment is a burden on me or my family | |||
| Indent Indent Indent70703-4 | I worry about other peoples attitudes towards me | |||
| Indent Indent Indent70704-2 | I feel embarrassed about the infection | |||
| Indent Indent Indent70705-9 | I tend to blame myself for the infection | |||
| Indent Indent Indent70706-7 | I was careful who I told about the infection | |||
| Indent Indent Indent70707-5 | I have had difficulty telling my partner/spouse about the infection | |||
| Indent Indent Indent70708-3 | I am frustrated by the infection | |||
| Indent Indent Indent70709-1 | I am depressed about the infection | |||
| Indent Indent70693-7 | Relationships [FACIT] | |||
| Indent Indent Indent70710-9 | I have told my partner/spouse about my infection | |||
| Indent Indent Indent70711-7 | I get emotional support from my partner/spouse | |||
| Indent Indent Indent70712-5 | I have told family members about my infection | |||
| Indent Indent Indent70713-3 | I get emotional support from family members | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70714-1 | I have people to help me if I need it | |||
| Indent70715-8 | Functional Assessment of Chronic Illness Therapy-Diarrhea Questionnaire - version 4 (FACIT-D) | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70894-1 | Additional concerns - FACIT-D [FACIT] | |||
| Indent Indent Indent70347-0 | I have control of my bowels | |||
| Indent Indent Indent70716-6 | I move my bowels more frequently than usual | |||
| Indent Indent Indent70717-4 | I am afraid to be far from a toilet | |||
| Indent Indent Indent70718-2 | I have to limit my social activity because of diarrhea | |||
| Indent Indent Indent70719-0 | I have to limit my physical activity because of diarrhea | |||
| Indent Indent Indent70720-8 | I have to limit my sexual activity because of diarrhea | |||
| Indent Indent Indent70721-6 | I am embarrassed by having diarrhea | |||
| Indent Indent Indent70722-4 | I have abdominal cramps or discomfort due to my diarrhea | |||
| Indent Indent Indent70723-2 | My problem with diarrhea keeps/wakes me up at night | |||
| Indent Indent Indent70724-0 | I must move my bowels frequently to avoid accidents | |||
| Indent Indent Indent70725-7 | I wear protection for soiling of stool | |||
| Indent70726-5 | Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire - version 4 (FACIT-F) | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70895-8 | Additional concerns - FACIT-F [FACIT] | |||
| Indent Indent Indent70426-2 | I feel fatigued | |||
| Indent Indent Indent70425-4 | I feel weak all over | |||
| Indent Indent Indent70727-3 | I feel listless ("washed out") | |||
| Indent Indent Indent70304-1 | I feel tired | |||
| Indent Indent Indent70728-1 | I have trouble starting things because I am tired | |||
| Indent Indent Indent70729-9 | I have trouble finishing things because I am tired | |||
| Indent Indent Indent70730-7 | I have energy | |||
| Indent Indent Indent61890-0 | During the past 7 days - I am able to do my usual activities | |||
| Indent Indent Indent70731-5 | I need to sleep during the day | |||
| Indent Indent Indent70732-3 | I am too tired to eat | |||
| Indent Indent Indent70303-3 | I need help doing my usual activities | |||
| Indent Indent Indent70733-1 | I am frustrated by being too tired to do the things I want to do | |||
| Indent Indent Indent70734-9 | I have to limit my social activity because I am tired | |||
| Indent70735-6 | Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire -13 items - version 4 (FACIT - fatigue 13) | |||
| Indent Indent70426-2 | I feel fatigued | |||
| Indent Indent70425-4 | I feel weak all over | |||
| Indent Indent70727-3 | I feel listless ("washed out") | |||
| Indent Indent70304-1 | I feel tired | |||
| Indent Indent70728-1 | I have trouble starting things because I am tired | |||
| Indent Indent70729-9 | I have trouble finishing things because I am tired | |||
| Indent Indent70730-7 | I have energy | |||
| Indent Indent61890-0 | During the past 7 days - I am able to do my usual activities | |||
| Indent Indent70731-5 | I need to sleep during the day | |||
| Indent Indent70732-3 | I am too tired to eat | |||
| Indent Indent70303-3 | I need help doing my usual activities | |||
| Indent Indent70733-1 | I am frustrated by being too tired to do the things I want to do | |||
| Indent Indent70734-9 | I have to limit my social activity because I am tired | |||
| Indent70736-4 | Functional Assessment of Cancer Therapy for patients with anemia - fatigue questionnaire - version 4 (FACT-An) [FACIT] | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70896-6 | Additional concerns - FACT-An [FACIT] | |||
| Indent Indent Indent70426-2 | I feel fatigued | |||
| Indent Indent Indent70425-4 | I feel weak all over | |||
| Indent Indent Indent70727-3 | I feel listless ("washed out") | |||
| Indent Indent Indent70304-1 | I feel tired | |||
| Indent Indent Indent70728-1 | I have trouble starting things because I am tired | |||
| Indent Indent Indent70729-9 | I have trouble finishing things because I am tired | |||
| Indent Indent Indent70730-7 | I have energy | |||
| Indent Indent Indent70632-5 | I have trouble walking | |||
| Indent Indent Indent61890-0 | During the past 7 days - I am able to do my usual activities | |||
| Indent Indent Indent70731-5 | I need to sleep during the day | |||
| Indent Indent Indent70560-8 | I feel light-headed (dizzy) | |||
| Indent Indent Indent70302-5 | I get headaches | |||
| Indent Indent Indent70305-8 | I have been short of breath | |||
| Indent Indent Indent70737-2 | I have pain in my chest | |||
| Indent Indent Indent70732-3 | I am too tired to eat | |||
| Indent Indent Indent70317-3 | I am interested in sex | |||
| Indent Indent Indent70738-0 | I am motivated to do my usual activities | |||
| Indent Indent Indent70303-3 | I need help doing my usual activities | |||
| Indent Indent Indent70733-1 | I am frustrated by being too tired to do the things I want to do | |||
| Indent Indent Indent70734-9 | I have to limit my social activity because I am tired | |||
| Indent70739-8 | Functional Assessment of Cancer Therapy for Patients with lymphedema questionnaire - version 4 (FACT-B + 4) [FACIT] | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70897-4 | Additional concerns - FACT-B+4 [FACIT] | |||
| Indent Indent Indent70305-8 | I have been short of breath | |||
| Indent Indent Indent70306-6 | I am self-conscious about the way I dress | |||
| Indent Indent Indent70307-4 | One or more of my arms are swollen or tender | |||
| Indent Indent Indent70308-2 | I feel sexually attractive | |||
| Indent Indent Indent70309-0 | I am bothered by hair loss | |||
| Indent Indent Indent70310-8 | I worry that other members of my family might someday get the same illness I have | |||
| Indent Indent Indent70311-6 | I worry about the effect of stress on my illness | |||
| Indent Indent Indent70312-4 | I am bothered by a change in weight | |||
| Indent Indent Indent70313-2 | I am able to feel like a woman | |||
| Indent Indent Indent70481-7 | I have certain parts of my body where I experience pain | |||
| Indent Indent Indent70740-6 | On which side was your breast operation | |||
| Indent Indent Indent70741-4 | Movement of my arm on this side is painful | |||
| Indent Indent Indent70742-2 | I have a poor range of arm movements on this side | |||
| Indent Indent Indent70743-0 | My arm on this side feels numb | |||
| Indent Indent Indent70744-8 | I have stiffness of my arm on this side | |||
| Indent70745-5 | Functional Assessment of Cancer Therapy for patients with bone pain questionnaire (FACT-BP) [FACIT] | |||
| Indent Indent70746-3 | In how many places in your body have you felt bone pain | |||
| Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70481-7 | I have certain parts of my body where I experience pain | |||
| Indent Indent70322-3 | I have bone pain | |||
| Indent Indent70747-1 | It hurts when I put weight or pressure on the place where I have bone pain | |||
| Indent Indent70748-9 | I have bone pain even when I sit or lie still | |||
| Indent Indent70749-7 | I need help doing my usual activities because of bone pain | |||
| Indent Indent70750-5 | I am forced to rest during the day because of bone pain | |||
| Indent Indent70751-3 | I have trouble walking because of bone pain | |||
| Indent Indent70752-1 | Bone pain interferes with my ability to care for myself (bathing, dressing, eating, etc.) | |||
| Indent Indent70753-9 | Bone pain interferes with my social activities | |||
| Indent Indent70754-7 | Bone pain wakes me up at night | |||
| Indent Indent70755-4 | I am frustrated by my bone pain | |||
| Indent Indent70756-2 | I feel depressed about my bone pain | |||
| Indent Indent70757-0 | I worry that my bone pain will get worse | |||
| Indent Indent70758-8 | My family has trouble understanding when my bone pain interferes with my activity | |||
| Indent70759-6 | Functional Assessment of Cancer Therapy for patients with cognitive function issues questionnaire - version 3 (FACT-Cog) [FACIT] | |||
| Indent Indent70849-5 | Perceived cognitive impairments [FACIT] | |||
| Indent Indent Indent70760-4 | I have had trouble forming thoughts | |||
| Indent Indent Indent70761-2 | My thinking has been slow | |||
| Indent Indent Indent70762-0 | I have had trouble concentrating | |||
| Indent Indent Indent70763-8 | I have had trouble finding my way to a familiar place | |||
| Indent Indent Indent70764-6 | I have had trouble remembering where I put things, like my keys or my wallet | |||
| Indent Indent Indent70765-3 | I have had trouble remembering new information, like phone numbers or simple instructions | |||
| Indent Indent Indent70766-1 | I have had trouble recalling the name of an object while talking to someone | |||
| Indent Indent Indent70767-9 | I have had trouble finding the right words to express myself | |||
| Indent Indent Indent70768-7 | I have used the wrong word when I referred to an object | |||
| Indent Indent Indent70769-5 | I have had trouble saying what I mean in conversations with others | |||
| Indent Indent Indent70770-3 | I have walked into a room and forgotten what I meant to get or do there | |||
| Indent Indent Indent70771-1 | I have had to work really hard to pay attention or I would make a mistake | |||
| Indent Indent Indent70772-9 | I have forgotten names of people soon after being introduced | |||
| Indent Indent Indent70773-7 | My reactions in everyday situations have been slow | |||
| Indent Indent Indent70776-0 | I have had to work harder than usual to keep track of what I was doing | |||
| Indent Indent Indent70777-8 | My thinking has been slower than usual | |||
| Indent Indent Indent70778-6 | I have had to work harder than usual to express myself clearly | |||
| Indent Indent Indent70779-4 | I have had to use written lists more often than usual so I would not forget things | |||
| Indent Indent Indent70781-0 | I have trouble shifting back and forth between different activities that require thinking | |||
| Indent Indent70774-5 | Comments from others [FACIT] | |||
| Indent Indent Indent70775-2 | Other people have told me I seemed to have trouble remembering information | |||
| Indent Indent Indent70782-8 | Other people have told me I seemed to have trouble speaking clearly | |||
| Indent Indent Indent70783-6 | Other people have told me I seemed to have trouble thinking clearly | |||
| Indent Indent Indent70784-4 | Other people have told me I seemed confused | |||
| Indent Indent70785-1 | Perceived cognitive abilities [FACIT] | |||
| Indent Indent Indent70786-9 | I have been able to concentrate | |||
| Indent Indent Indent70787-7 | I have been able to bring to mind words that I wanted to use while talking to someone | |||
| Indent Indent Indent70788-5 | I have been able to remember things, like where I left my keys or wallet | |||
| Indent Indent Indent70789-3 | I have been able to remember to do things, like take medicine or buy something I needed | |||
| Indent Indent Indent70790-1 | I am able to pay attention and keep track of what I am doing without extra effort | |||
| Indent Indent Indent70791-9 | My mind is as sharp as it has always been | |||
| Indent Indent Indent70792-7 | My memory is as good as it has always been | |||
| Indent Indent Indent70793-5 | I am able to shift back and forth between two activities that require thinking | |||
| Indent Indent Indent70794-3 | I am able to keep track of what I am doing, even if I am interrupted | |||
| Indent Indent70795-0 | Impact on quality of life [FACIT] | |||
| Indent Indent Indent70796-8 | I have been upset about these problems | |||
| Indent Indent Indent70797-6 | These problems have interfered with my ability to work | |||
| Indent Indent Indent70798-4 | These problems have interfered with my ability to do things I enjoy | |||
| Indent Indent Indent70799-2 | These problems have interfered with the quality of my life | |||
| Indent70800-8 | Functional Assessment of Cancer Therapy for patients with endocrine symptoms questionnaire - version 4 (FACT-ES) [FACIT] | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70898-2 | Additional concerns - FACT-ES [FACIT] | |||
| Indent Indent Indent70376-9 | I have hot flashes | |||
| Indent Indent Indent70378-5 | I have cold sweats | |||
| Indent Indent Indent70379-3 | I have night sweats | |||
| Indent Indent Indent70380-1 | I have vaginal discharge | |||
| Indent Indent Indent70801-6 | I have vaginal itching/irritation | |||
| Indent Indent Indent70381-9 | I have vaginal bleeding or spotting | |||
| Indent Indent Indent70802-4 | I have vaginal dryness | |||
| Indent Indent Indent70382-7 | I have pain or discomfort with intercourse | |||
| Indent Indent Indent70803-2 | I have lost interest in sex | |||
| Indent Indent Indent70377-7 | I have gained weight | |||
| Indent Indent Indent70560-8 | I feel light-headed (dizzy) | |||
| Indent Indent Indent70479-1 | I have been vomiting | |||
| Indent Indent Indent70349-6 | I have diarrhea | |||
| Indent Indent Indent70302-5 | I get headaches | |||
| Indent Indent Indent70656-4 | I feel bloated | |||
| Indent Indent Indent70804-0 | I have breast sensitivity/tenderness | |||
| Indent Indent Indent70805-7 | I have mood swings | |||
| Indent Indent Indent70806-5 | I am irritable | |||
| Indent Indent Indent70670-5 | I have pain in my joints | |||
| Indent70807-3 | Functional assessment of cancer therapy for patients with neutropenia questionnaire - version 4 (FACT-N) [FACIT] | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70899-0 | Additional concerns - FACT-N [FACIT] | |||
| Indent Indent Indent70808-1 | I worry about getting sick due to low blood counts | |||
| Indent Indent Indent70809-9 | I avoid public places for fear of getting an infection | |||
| Indent Indent Indent70810-7 | I get aches and pains that bother me | |||
| Indent Indent Indent70303-3 | I need help doing my usual activities | |||
| Indent Indent Indent70470-0 | I worry about getting infections | |||
| Indent Indent Indent70811-5 | I worry my condition will not improve if my treatment is delayed | |||
| Indent Indent Indent70730-7 | I have energy | |||
| Indent Indent Indent70344-7 | I am bothered by fevers (episodes of high body temperature) | |||
| Indent Indent Indent70527-7 | I am bothered by the chills | |||
| Indent Indent Indent70379-3 | I have night sweats | |||
| Indent Indent Indent70734-9 | I have to limit my social activity because I am tired | |||
| Indent Indent Indent70815-6 | I need to rest during the day | |||
| Indent Indent Indent70727-3 | I feel listless ("washed out") | |||
| Indent Indent Indent70738-0 | I am motivated to do my usual activities | |||
| Indent Indent Indent70561-6 | I have mouth sores | |||
| Indent Indent Indent70812-3 | My partner worries about me when my blood counts are low | |||
| Indent Indent Indent70813-1 | My low blood counts interfere with my intimate relationships | |||
| Indent Indent Indent70728-1 | I have trouble starting things because I am tired | |||
| Indent Indent Indent70814-9 | I am bothered by headaches | |||
| Indent70816-4 | Functional Assessment of Cancer Therapy for patients with thrombocytopenia questionnaire -11 items - version 4 (FACT-Th11) [FACIT] | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70900-6 | Additional concerns - FACT-Th11 [FACIT] | |||
| Indent Indent Indent70730-7 | I have energy | |||
| Indent Indent Indent61890-0 | During the past 7 days - I am able to do my usual activities | |||
| Indent Indent Indent70484-1 | I bleed easily | |||
| Indent Indent Indent70485-8 | I bruise easily | |||
| Indent Indent Indent70817-2 | I worry about problems with bruising or bleeding | |||
| Indent Indent Indent70818-0 | I am bothered by nosebleeds | |||
| Indent Indent Indent70819-8 | I am bothered by pinpoint bruising beneath my skin | |||
| Indent Indent Indent70820-6 | I am bothered by blood in my urine or stool | |||
| Indent Indent Indent70821-4 | I avoid or limit physical activity, because of concern with bleeding or bruising | |||
| Indent Indent Indent70822-2 | I am frustrated by not being able to do my usual activities | |||
| Indent Indent Indent70823-0 | I worry that my treatment will be delayed, because of low blood counts | |||
| Indent70824-8 | Functional Assessment of Cancer Therapy for patients with thrombocytopenia questionnaire -18 items - version 4 (FACT-Th18) [FACIT] | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70901-4 | Additional concerns - FACT-Th18 [FACIT] | |||
| Indent Indent Indent70730-7 | I have energy | |||
| Indent Indent Indent61890-0 | During the past 7 days - I am able to do my usual activities | |||
| Indent Indent Indent70484-1 | I bleed easily | |||
| Indent Indent Indent70485-8 | I bruise easily | |||
| Indent Indent Indent70817-2 | I worry about problems with bruising or bleeding | |||
| Indent Indent Indent70825-5 | I worry about the possibility of serious bleeding | |||
| Indent Indent Indent70818-0 | I am bothered by nosebleeds | |||
| Indent Indent Indent70826-3 | I am bothered by bleeding in my gums or mouth | |||
| Indent Indent Indent70819-8 | I am bothered by pinpoint bruising beneath my skin | |||
| Indent Indent Indent70820-6 | I am bothered by blood in my urine or stool | |||
| Indent Indent Indent70827-1 | I am inconvenienced by platelet transfusions | |||
| Indent Indent Indent70426-2 | I feel fatigued | |||
| Indent Indent Indent70821-4 | I avoid or limit physical activity, because of concern with bleeding or bruising | |||
| Indent Indent Indent70828-9 | I avoid or limit social activity, because of concern with bleeding or bruising | |||
| Indent Indent Indent70822-2 | I am frustrated by not being able to do my usual activities | |||
| Indent Indent Indent70823-0 | I worry that my treatment will be delayed, because of low blood counts | |||
| Indent Indent Indent70829-7 | I worry that my treatment dose will be reduced, because of low blood counts | |||
| Indent Indent Indent70830-5 | (For women only) I am bothered by vaginal bleeding | |||
| Indent70831-3 | Functional Assessment of Incontinence Therapy - Fecal Questionnaire - version 4 ( [FACIT] | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70902-2 | Additional concerns - FAIT-F [FACIT] | |||
| Indent Indent Indent70832-1 | I am comfortable discussing my condition with friends | |||
| Indent Indent Indent70347-0 | I have control of my bowels | |||
| Indent Indent Indent70716-6 | I move my bowels more frequently than usual | |||
| Indent Indent Indent70717-4 | I am afraid to be far from a toilet | |||
| Indent Indent Indent70439-5 | I have to limit my social activity because of my condition | |||
| Indent Indent Indent70440-3 | I have to limit my physical activity because of my condition | |||
| Indent Indent Indent70833-9 | I have to limit my sexual activity because of my condition | |||
| Indent Indent Indent70834-7 | I am embarrassed by my condition | |||
| Indent Indent Indent70835-4 | My condition wakes or keeps me up at night | |||
| Indent Indent Indent70724-0 | I must move my bowels frequently to avoid accidents | |||
| Indent Indent Indent70836-2 | I can be far from home/work without fearing soilage | |||
| Indent Indent Indent70725-7 | I wear protection for soiling of stool | |||
| Indent70837-0 | Functional Assessment of Incontinence Therapy - Urinary Questionnaire - version 4 (FAIT-U) [FACIT] | |||
| Indent Indent70498-1 | Physical well-being [FACIT] | |||
| Indent Indent Indent70405-6 | I have a lack of energy | |||
| Indent Indent Indent70406-4 | I have nausea | |||
| Indent Indent Indent70407-2 | Because of my physical condition, I have trouble meeting the needs of my family | |||
| Indent Indent Indent70408-0 | I have pain | |||
| Indent Indent Indent70409-8 | I am bothered by side effects of treatment | |||
| Indent Indent Indent70410-6 | I feel ill | |||
| Indent Indent Indent70411-4 | I am forced to spend time in bed | |||
| Indent Indent70499-9 | Social - family well-being [FACIT] | |||
| Indent Indent Indent70412-2 | I feel close to my friends | |||
| Indent Indent Indent70413-0 | I get emotional support from my family | |||
| Indent Indent Indent70414-8 | I get support from my friends | |||
| Indent Indent Indent70415-5 | My family has accepted my illness | |||
| Indent Indent Indent70416-3 | I am satisfied with family communication about my illness | |||
| Indent Indent Indent70417-1 | I felt close to my partner, or the person who is my main support | |||
| Indent Indent Indent70914-7 | Regardless of your current level of sexual activity, please answer the following question. If you prefer not to answer it, please mark this box and go to the next section. | |||
| Indent Indent Indent70418-9 | I am satisfied with my sex life | |||
| Indent Indent70500-4 | Emotional well being [FACIT] | |||
| Indent Indent Indent70392-6 | I feel sad | |||
| Indent Indent Indent70393-4 | I am satisfied with how I am coping with my illness | |||
| Indent Indent Indent70394-2 | I am losing hope in the fight against my illness | |||
| Indent Indent Indent70395-9 | I am nervous | |||
| Indent Indent Indent70396-7 | I worry about dying | |||
| Indent Indent Indent70397-5 | I worry that my condition will get worse | |||
| Indent Indent70501-2 | Functional well-being [FACIT] | |||
| Indent Indent Indent70398-3 | I am able to work (include work at home) | |||
| Indent Indent Indent70399-1 | My work (include work at home) is fulfilling | |||
| Indent Indent Indent70400-7 | I am able to enjoy life | |||
| Indent Indent Indent70401-5 | I have accepted my illness | |||
| Indent Indent Indent70402-3 | I am sleeping well | |||
| Indent Indent Indent70403-1 | I am enjoying the things I usually do for fun | |||
| Indent Indent Indent70404-9 | I am content with the quality of my life right now | |||
| Indent Indent70903-0 | Additional concerns - FAIT-U [FACIT] | |||
| Indent Indent Indent70314-0 | I have trouble controlling my urine | |||
| Indent Indent Indent70832-1 | I am comfortable discussing my condition with friends | |||
| Indent Indent Indent70315-7 | I urinate more frequently than usual | |||
| Indent Indent Indent70717-4 | I am afraid to be far from a toilet | |||
| Indent Indent Indent70439-5 | I have to limit my social activity because of my condition | |||
| Indent Indent Indent70440-3 | I have to limit my physical activity because of my condition | |||
| Indent Indent Indent70833-9 | I have to limit my sexual activity because of my condition | |||
| Indent Indent Indent70834-7 | I am embarrassed by my condition | |||
| Indent Indent Indent70838-8 | My condition wakes me up at night | |||
| Indent Indent Indent70839-6 | I must urinate frequently to avoid leaking | |||
| Indent Indent Indent70840-4 | I wear protection for leakage of urine |
Fully-Specified Name
- Component
- Functional assessment of chronic illness therapy - symptom specific measures panel
- Property
- -
- Time
- Pt
- System
- ^Patient
- Scale
- -
- Method
- FACIT
Basic Attributes
- Class
- PANEL.SURVEY.GNHLTH
- Type
- Surveys
- First Released
- Version 2.40
- Last Updated
- Version 2.50
- Panel Type
- Panel
LOINC Terminology Service (API) using HL7® FHIR® Get Info
Requests to this service require a free LOINC username and password. Below is a sample of the possible capabilities. See the LOINC Terminology Service documentation for more information.
- CodeSystem lookup
- https:
//fhir.loinc.org/CodeSystem/$lookup?system=http: //loinc.org&code=70674-7 - Questionnaire definition
- https:
//fhir.loinc.org/Questionnaire/?url=http: //loinc.org/q/70674-7
Copyright
- Organization
- Functional Assessment of Chronic Illness Therapy
- Copyright
- Copyright © 2010 FACIT.org.
- Terms of Use
- Used with permission. All translations, adaptations, symptom indices, computer programs, and scoring algorithms, and any other related documents of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System, including the Functional Assessment of Cancer Therapy (FACT), are owned and copyrighted by, and the intellectual property of, David Cella, Ph.D.
- URL
- http://www.facit.org/FACITOrg/AboutUs/Copyright
LOINC Copyright
Copyright © 2024 Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright