SLING-INF.content.Questionnaires.SC.xml Maven / Gradle / Ivy
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See the License for the specific language governing permissions and limitations under the License. --> <node> <name>SC</name> <primaryNodeType>cards:Questionnaire</primaryNodeType> <property> <name>title</name> <value>Smoking cessation</value> <type>String</type> </property> <property> <name>paginate</name> <value>True</value> <type>Boolean</type> </property> <property> <name>requireCompletion</name> <value>True</value> <type>Boolean</type> </property> <property> <name>hideAnswerInstructions</name> <value>True</value> <type>Boolean</type> </property> <property> <name>requiredSubjectTypes</name> <values> <value>/SubjectTypes/Patient/Visit</value> </values> <type>Reference</type> </property> <property> <name>maxPerSubject</name> <value>1</value> <type>Long</type> </property> <node> <name>smoking-history-v1-section-1</name> <primaryNodeType>cards:Section</primaryNodeType> <property> <name>description</name> <value>There are major health benefits to quitting smoking. The next few questions will ask you about your smoking.</value> <type>String</type> </property> <property> <name>initialNumberOfInstances</name> <value>0</value> <type>Long</type> </property> <property> <name>label</name> <value>Tobacco Use Survey</value> <type>String</type> </property> <property> <name>recurrent</name> <value>False</value> <type>Boolean</type> </property> <node> <name>smoking_history_v1_has_patient_used_tobacco_products_in_past_6_months</name> <primaryNodeType>cards:Question</primaryNodeType> <property> <name>minAnswers</name> <value>1</value> <type>Long</type> </property> <property> <name>text</name> <value>Have you used tobacco products, such as cigarettes, pipes, cigars, or chewing tobacco in the past 6 months?</value> <type>String</type> </property> <property> <name>maxAnswers</name> <value>1</value> <type>Long</type> </property> <property> <name>enableUnknown</name> <value>False</value> <type>Boolean</type> </property> <property> <name>compact</name> 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<type>Boolean</type> </property> </node> <node> <name>operandB</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>1</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>False</value> <type>Boolean</type> </property> </node> </node> <property> <name>initialNumberOfInstances</name> <value>0</value> <type>Long</type> </property> <property> <name>recurrent</name> <value>False</value> <type>Boolean</type> </property> <node> <name>smoking-history-v1-section-2-description</name> <primaryNodeType>cards:Information</primaryNodeType> <property> <name>text</name> <value>## Quitting is an important part of health care. ### The benefits start right away and can last a long time. We know that quitting can be difficult. Your healthcare team is here to support you. ### What are the benefits of quitting smoking and using tobacco products? * help your body respond better to radiation and chemotherapy treatments * make your surgery safe and help you heal faster * improve some of your side effects * lower your risk of getting cancer * lower your risk of a cancer coming back (recurring)</value> <type>String</type> </property> </node> <node> <name>smoking-history-v1-patient-wants-to-learn-about-quitting-benefits</name> <primaryNodeType>cards:Question</primaryNodeType> <property> <name>minAnswers</name> <value>0</value> <type>Long</type> </property> <property> <name>text</name> <value>I want to find out more about the benefits of quitting</value> <type>String</type> </property> <property> <name>maxAnswers</name> <value>1</value> <type>Long</type> </property> <property> <name>enableUnknown</name> <value>False</value> <type>Boolean</type> </property> <property> <name>compact</name> <value>True</value> <type>Boolean</type> </property> <property> <name>displayMode</name> <value>input</value> <type>String</type> </property> <property> <name>dataType</name> <value>boolean</value> <type>String</type> </property> </node> </node> <node> <name>smoking-history-v1-disease-risks</name> <primaryNodeType>cards:Section</primaryNodeType> <node> <name>condition</name> <primaryNodeType>cards:Conditional</primaryNodeType> <property> <name>comparator</name> <value>=</value> <type>String</type> </property> <node> <name>operandA</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>smoking-history-v1-patient-wants-to-learn-about-quitting-benefits</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>True</value> <type>Boolean</type> </property> </node> <node> <name>operandB</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>1</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>False</value> <type>Boolean</type> </property> </node> </node> <node> <name>smoking-history-v1-disease-risk-description</name> <primaryNodeType>cards:Information</primaryNodeType> <property> <name>text</name> <value>## Quitting smoking will decrease your risk of the following conditions: ![](/Questionnaires/SC/sc1.png)</value> <type>String</type> </property> </node> <property> <name>initialNumberOfInstances</name> <value>0</value> <type>Long</type> </property> <property> <name>recurrent</name> <value>False</value> <type>Boolean</type> </property> </node> <node> <name>smoking-history-v3-quitting-benefits-exposure (CEASE)</name> <primaryNodeType>cards:Section</primaryNodeType> <node> <name>condition</name> <primaryNodeType>cards:Conditional</primaryNodeType> <property> <name>comparator</name> <value>=</value> <type>String</type> </property> <node> <name>operandA</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>smoking-history-v1-patient-wants-to-learn-about-quitting-benefits</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>True</value> <type>Boolean</type> </property> </node> <node> <name>operandB</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>1</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>False</value> <type>Boolean</type> </property> </node> </node> <property> <name>initialNumberOfInstances</name> <value>0</value> <type>Long</type> </property> <property> <name>recurrent</name> <value>False</value> <type>Boolean</type> </property> <node> <name>smoking-history-v3-quitting-benefits-exposure-description</name> <primaryNodeType>cards:Information</primaryNodeType> <property> <name>text</name> <value>## Quitting reduces the negative health effects of second hand smoke on others. Effect of second hand smoke: ![](/Questionnaires/SC/sc2.png)</value> <type>String</type> </property> </node> </node> <node> <name>smoking-history-v1-quitting-benefits</name> <primaryNodeType>cards:Section</primaryNodeType> <node> <name>condition</name> <primaryNodeType>cards:Conditional</primaryNodeType> <property> <name>comparator</name> <value>=</value> <type>String</type> </property> <node> <name>operandA</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>smoking-history-v1-patient-wants-to-learn-about-quitting-benefits</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>True</value> <type>Boolean</type> </property> </node> <node> <name>operandB</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>1</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>False</value> <type>Boolean</type> </property> </node> </node> <property> <name>initialNumberOfInstances</name> <value>0</value> <type>Long</type> </property> <property> <name>recurrent</name> <value>False</value> <type>Boolean</type> </property> <node> <name>smoking-history-v1-quitting-benefits-description</name> <primaryNodeType>cards:Information</primaryNodeType> <property> <name>text</name> <value>## Quitting is very important for improving your health ### For people that quit, the benefits start right away and can last a long time. ### **Short term benefits** of quitting smoking. After: * **20 minutes:** your heart rate drops to a healthier level * **12 hours:** Carbon monoxide levels in your blood return to normal * **2 weeks to 3 months:** Your risk for heart attack is lower. Your lungs begin to work better * **1-9 months:** Your coughing and shortness of breath improve ### **Long term benefits** of quitting smoking. After: * **1 year:** Your risk of heart disease is half that of a smoker * **5 years:** Your risk of a stroke is the same as a non-smoker * **10 years:** Your risk of having and dying from lung cancer is half that of a smoker. Your risk of cancers of the mouth, throat, esophagus, bladder, kidney and pancreas is lower * **15 years:** Your risk of heart disease is the same as a non-smoker </value> <type>String</type> </property> </node> </node> <node> <name>smoking-history-v1-section-3</name> <primaryNodeType>cards:Section</primaryNodeType> <node> <name>condition</name> <primaryNodeType>cards:Conditional</primaryNodeType> <property> <name>comparator</name> <value>=</value> <type>String</type> </property> <node> <name>operandA</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>smoking_history_v1_has_patient_used_tobacco_products_in_past_6_months</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>True</value> <type>Boolean</type> </property> </node> <node> <name>operandB</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>1</value> </values> 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<value>## Get help staying smoke and tobacco free. Staying smoke free can be hard in the first few months. There may be set backs and it may take more than one try. It is easier to quit smoking and stay smoke free if you have help. Here are some programs that can help you. **Nicotine Dependence Clinic (CAMH)** **UHN Outpatient Pharmacy** **Telehealth Ontario** When you choose a program, your contact information will be sent to the program you choose. Someone from the program will call you to share more details and finish registering you in the program. Your health care team will also be informed that you have registered. On the next page, you will find information about each program. You can only choose one program. Click on the program you want to register in.</value> <type>String</type> </property> </node> </node> <node> <name>smoking-history-v2-help-quitting-intro</name> <primaryNodeType>cards:Section</primaryNodeType> <node> <name>conditionalGroup</name> <primaryNodeType>cards:ConditionalGroup</primaryNodeType> <property> <name>requireAll</name> <value>True</value> <type>Boolean</type> </property> <node> <name>condition0</name> <primaryNodeType>cards:Conditional</primaryNodeType> <property> <name>comparator</name> <value>=</value> <type>String</type> </property> <node> <name>operandA</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>smoking_history_v1_has_patient_used_tobacco_products_in_past_6_months</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>True</value> <type>Boolean</type> </property> </node> <node> <name>operandB</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>1</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>False</value> <type>Boolean</type> </property> </node> </node> <node> <name>conditionalGroup</name> <primaryNodeType>cards:ConditionalGroup</primaryNodeType> <node> <name>condition0</name> <primaryNodeType>cards:Conditional</primaryNodeType> <property> <name>comparator</name> <value>is empty</value> <type>String</type> </property> <node> <name>operandA</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>smoking-history-v1-patient-smoking-frequency</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>True</value> <type>Boolean</type> </property> </node> <node> <name>operandB</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>smoking-history-v1-patient-smoking-frequency</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>True</value> <type>Boolean</type> </property> </node> </node> <node> <name>condition1</name> <primaryNodeType>cards:Conditional</primaryNodeType> <property> <name>comparator</name> <value>=</value> <type>String</type> </property> <node> <name>operandA</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>smoking-history-v1-patient-smoking-frequency</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>True</value> <type>Boolean</type> </property> </node> <node> <name>operandB</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>I currently smoke and/or use tobacco products</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>False</value> <type>Boolean</type> </property> </node> </node> </node> </node> <property> <name>initialNumberOfInstances</name> <value>0</value> <type>Long</type> </property> <property> <name>recurrent</name> <value>False</value> <type>Boolean</type> </property> <node> <name>smoking-history-v2-help-quitting-intro-description</name> <primaryNodeType>cards:Information</primaryNodeType> <property> <name>text</name> <value>## Get started with your plan to quit smoking. It is easier to quit smoking and stay smoke free if you have help. Here are some programs that can help you quit. **Nicotine Dependence Clinic (CAMH)** **UHN Outpatient Pharmacy** **Telehealth Ontario** When you choose a program, your contact information will be sent to the program you choose. Someone from the program will call you to share more details and finish registering you in the program. Your health care team will also be informed that you have registered. On the next page, you will find information about each program. You can only choose one program. Click on the program you want to register in.</value> <type>String</type> </property> </node> </node> <node> <name>smoking-history-v2-request-referral</name> <primaryNodeType>cards:Section</primaryNodeType> <node> <name>condition</name> <primaryNodeType>cards:Conditional</primaryNodeType> <property> <name>comparator</name> <value>=</value> <type>String</type> </property> <node> <name>operandA</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>smoking_history_v1_has_patient_used_tobacco_products_in_past_6_months</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>True</value> <type>Boolean</type> </property> </node> <node> <name>operandB</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>1</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>False</value> <type>Boolean</type> </property> </node> </node> <property> <name>initialNumberOfInstances</name> <value>0</value> <type>Long</type> </property> <property> <name>recurrent</name> <value>False</value> <type>Boolean</type> </property> <node> <name>smoking_history_v2_program_referral_requested_by_patient</name> <primaryNodeType>cards:Question</primaryNodeType> <property> <name>description</name> <value>Click on the program you want to register in.</value> <type>String</type> </property> <property> <name>minAnswers</name> <value>0</value> <type>Long</type> </property> <property> <name>text</name> <value>Here is some information about each program. You can only choose one program.</value> <type>String</type> </property> <property> <name>enableSeparatorDetection</name> <value>False</value> <type>Boolean</type> </property> <property> <name>maxAnswers</name> <value>1</value> <type>Long</type> </property> <property> <name>compact</name> <value>False</value> <type>Boolean</type> </property> <property> <name>displayMode</name> <value>list</value> <type>String</type> </property> <property> <name>dataType</name> <value>text</value> <type>String</type> </property> <node> <name>AnswerOption-1508258912</name> <primaryNodeType>cards:AnswerOption</primaryNodeType> <property> <name>defaultOrder</name> <value>0</value> <type>String</type> </property> <property> <name>value</name> <value>Nicotine Dependence Clinic at the Centre for Addiction and Mental Health (CAMH) (in Toronto)</value> <type>String</type> </property> <property> <name>description</name> <value>This **self-referral** program can help you: * Get weekly counseling and treatments to help you quit or reduce your smoking * Get private support in-person and over the phone</value> <type>String</type> </property> </node> <node> <name>AnswerOption-419253836</name> <primaryNodeType>cards:AnswerOption</primaryNodeType> <property> <name>description</name> <value>This program can help you: * Get help making a plan to quit * Get medications to quit or lower the amount you smoke (if needed) * Get private advice from a pharmacist in-person, over the phone or by email</value> <type>String</type> </property> <property> <name>defaultOrder</name> <value>1</value> <type>String</type> </property> <property> <name>value</name> <value>UHN Outpatient Pharmacy (in Toronto)</value> <type>String</type> </property> </node> <node> <name>AnswerOption250917636</name> <primaryNodeType>cards:AnswerOption</primaryNodeType> <property> <name>description</name> <value>This program can help you: * Get help from a Care Coach (someone who gives you support on how to quit) * Get information and help making a plan to quit * Get support over the phone, 24 hours a day, 7 days a week</value> <type>String</type> </property> <property> <name>defaultOrder</name> <value>2</value> <type>String</type> </property> <property> <name>value</name> <value>Telehealth Ontario (across Ontario)</value> <type>String</type> </property> </node> <node> <name>AnswerOption-434220530</name> <primaryNodeType>cards:AnswerOption</primaryNodeType> <property> <name>defaultOrder</name> <value>3</value> <type>String</type> </property> <property> <name>value</name> <value>none</value> <type>String</type> </property> <property> <name>label</name> <value>I do not want to be referred</value> <type>String</type> </property> </node> </node> </node> <node> <name>smoking-history-v2-referral-summary</name> <primaryNodeType>cards:Section</primaryNodeType> <node> <name>condition</name> <primaryNodeType>cards:Conditional</primaryNodeType> <property> <name>comparator</name> <value>=</value> <type>String</type> </property> <node> <name>operandA</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>smoking_history_v1_has_patient_used_tobacco_products_in_past_6_months</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>True</value> <type>Boolean</type> </property> </node> <node> <name>operandB</name> <primaryNodeType>cards:ConditionalValue</primaryNodeType> <property> <name>value</name> <values> <value>1</value> </values> <type>String</type> </property> <property> <name>isReference</name> <value>False</value> <type>Boolean</type> </property> </node> </node> <node> <name>smoking-history-v2-referral-summary</name> <primaryNodeType>cards:Question</primaryNodeType> <property> <name>expression</name> <value> return @{smoking_history_v1_has_patient_used_tobacco_products_in_past_6_months:-0} == 0 ? null : @{smoking_history_v2_program_referral_requested_by_patient} == "Nicotine Dependence Clinic at the Centre for Addiction and Mental Health (CAMH) (in Toronto)" ? "You have selected **" + @{smoking_history_v2_program_referral_requested_by_patient} + "**. This clinic accepts **self-referral**. Please call Access CAMH at 416-535-8501 and press 2.\n\nFor more details read the UHN pamphlet *Smoking: It’s never too late to quit*" : @{smoking_history_v2_program_referral_requested_by_patient:-none} != "none" ? "You have selected **" + @{smoking_history_v2_program_referral_requested_by_patient} + "**. Someone from the program will call you to share more details and finish registering you in the program. Your health care team will also be informed that you have registered.\n\nFor more details read the UHN pamphlet *Smoking: It’s never too late to quit*" : "You have selected not to be referred to a program. Your health care team will be informed of your choice.\n\nFor more details read the UHN pamphlet on quitting smoking during your treatment." </value> <type>String</type> </property> <property> <name>displayMode</name> <value>formatted</value> <type>String</type> </property> <property> <name>text</name> <value> </value> <type>String</type> </property> <property> <name>entryMode</name> <value>computed</value> <type>String</type> </property> </node> </node> </node>