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2-006 - Patient Australian State/Territory
2-007 - Patient New Zealand Province
2-008 - Patient postcode
2-009 - Patient country of birth
2-010 - Patient country of birth: Other - detail
2-011 - Urgency category
2-012 - Patient requires interpreter
2-013 - Patient interpreter language
2-014 - Patient requires communication assistance
2-015 - Patient hearing or vision impaired
2-016 - Patient's indigenous status
2-017 - Patient ethnicity: New Zealand European
2-018 - Patient ethnicity: Samoan
2-019 - Patient ethnicity: Tongan
2-020 - Patient ethnicity: Chinese
2-021 - Patient ethnicity: Maori
2-022 - Patient ethnicity: Cook Islands Maori
2-023 - Patient ethnicity: Niuean
2-024 - Patient ethnicity: Indian
2-025 - Patient ethnicity: Not stated
2-026 - Patient ethnicity: Other
2-027 - Patient ethnicity: Other - detail
2-028 - EpisodeID
2-029 - Episode identifier
2-030 - Episode referral date
2-031 - Episode referral source
2-032 - Episode referral source: Other - detail
2-033 - Episode for cancer pain
2-034 - Episode start date
2-035 - Episode start mode
2-036 - Episode pain source
2-037 - Episode pain source: Other - detail
2-038 - Pain duration
2-039 - Episode end date
2-040 - Episode end mode
2-041 - Episode end mode: Other - detail
2-042 - Comorbidity: heart and circulation problems
2-043 - Comorbidity: high blood pressure
2-044 - Comorbidity: high cholesterol
2-045 - Comorbidity: respiratory problems
2-046 - Comorbidity: diabetes
2-047 - Comorbidity: digestive problems
2-048 - Comorbidity: liver, kidney and pancreas problems
2-049 - Comorbidity: mental health
2-050 - Comorbidity: PTSD
2-051 - Comorbidity: anxiety
2-052 - Comorbidity: depression
2-053 - Comorbidity: other mental health
2-054 - Comorbidity: cancer
2-055 - Comorbidity: arthritis
2-056 - Comorbidity: muscle, bone and joint problems
2-057 - Comorbidity: neurological problems
2-058 - Comorbidity: thyroid problems
2-059 - Comorbidity: other
2-060 - Comorbidity: other, detail
2-061 - DVA client
2-062 - Australian defence force service
2-063 - Episode compensation case
2-064 - Episode compensation case type
2-065 - Compensation case type: other - detail
2-066 - Episode funded by ACC
2-067 - PathwayID
2-068 - Pathway identifier
2-069 - Pathway type
2-070 - Pathway start date
2-071 - Pathway end date
2-072 - Group program start date
2-073 - Group program end date
2-074 - Service event id
2-075 - Service event identifier
2-076 - Service event type
2-077 - Service event type: Other - detail
2-078 - Date of service
2-079 - Duration of service event
2-080 - Flag telehealth
2-081 - Questionnaire schedule identifier
2-082 - Questionnaire identifier
2-083 - Questionnaire completion date
2-084 - Questionnaire generation date
2-085 - Questionnaire sent status
2-086 - Questionnaire completion status
2-087 - Questionnaire type
2-088 - Ad-hoc questionnaire type
2-089 - Ad-hoc questionnaire type: Other - detail
2-090 - Survey mode
2-091 - Height
2-092 - Weight
2-093 - Pain description
2-094 - Health service use: general practitioner
2-095 - Health service use: specialist
2-096 - Health service use: allied health
2-097 - Health service use: emergency department
2-098 - Health service use: hospital
2-099 - Health service use: diagnostic tests
2-100 - Site of main pain
2-101 - Pain site: head
2-102 - Pain site: face
2-103 - Pain site: neck
2-104 - Pain site: chest
2-105 - Pain site: abdomen
2-106 - Pain site: groin
2-107 - Pain site: upper back
2-108 - Pain site: mid back
2-109 - Pain site: low back
2-110 - Pain site: left shoulder
2-111 - Pain site: right shoulder
2-112 - Pain site: left upper arm
2-113 - Pain site: right upper arm
2-114 - Pain site: left elbow
2-115 - Pain site: right elbow
2-116 - Pain site: left forearm
2-117 - Pain site: right forearm
2-118 - Pain site: left wrist
2-119 - Pain site: right wrist
2-120 - Pain site: left hand
2-121 - Pain site: right hand
2-122 - Pain site: left hip
2-123 - Pain site: right hip
2-124 - Pain site: left thigh
2-125 - Pain site: right thigh
2-126 - Pain site: left knee
2-127 - Pain site: right knee
2-128 - Pain site: left calf
2-129 - Pain site: right calf
2-130 - Pain site: left ankle
2-131 - Pain site: right ankle
2-132 - Pain site: left foot
2-133 - Pain site: right foot
2-134 - Brief Pain Inventory: Severity - worst pain
2-135 - Brief Pain Inventory: Severity - least pain
2-136 - Brief Pain Inventory: Severity - average pain
2-137 - Brief Pain Inventory: Severity - current pain
2-138 - Brief Pain Inventory: Interference - general activity
2-139 - Brief Pain Inventory: Interference - mood
2-140 - Brief Pain Inventory: Interference - walking
2-141 - Brief Pain Inventory: Interference - work
2-142 - Brief Pain Inventory: Interference - relations
2-143 - Brief Pain Inventory: Interference - sleep
2-144 - Brief Pain Inventory: Interference - enjoyment
2-145 - Depression Anxiety Stress Scale: Q1
2-146 - Depression Anxiety Stress Scale: Q2
2-147 - Depression Anxiety Stress Scale: Q3
2-148 - Depression Anxiety Stress Scale: Q4
2-149 - Depression Anxiety Stress Scale: Q5
2-150 - Depression Anxiety Stress Scale: Q6
2-151 - Depression Anxiety Stress Scale: Q7
2-152 - Depression Anxiety Stress Scale: Q8
2-153 - Depression Anxiety Stress Scale: Q9
2-154 - Depression Anxiety Stress Scale: Q10
2-155 - Depression Anxiety Stress Scale: Q11
2-156 - Depression Anxiety Stress Scale: Q12
2-157 - Depression Anxiety Stress Scale: Q13
2-158 - Depression Anxiety Stress Scale: Q14
2-159 - Depression Anxiety Stress Scale: Q15
2-160 - Depression Anxiety Stress Scale: Q16
2-161 - Depression Anxiety Stress Scale: Q17
2-162 - Depression Anxiety Stress Scale: Q18
2-163 - Depression Anxiety Stress Scale: Q19
2-164 - Depression Anxiety Stress Scale: Q20
2-165 - Depression Anxiety Stress Scale: Q21
2-166 - Pain Self-Efficacy Questionnaire: Q1
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2-086 - Questionnaire completion status
2-086 - Questionnaire completion status
Linda Foskett
Samuel Allingham (Unlicensed)
Owned by
Linda Foskett
Last updated:
28-08-2022
by
Samuel Allingham (Unlicensed)
Analytics
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Item name
Questionnaire completion status
epiCentre name
Derived_CompletedStatusID
Definition
This item is created by epiCentre, and provides information regarding the
completion status of a sent questionnaire
Usage
*Note that individual pain management services may change the default period of two and four weeks
ID
2-086
Mandatory
Source
ePPOC
Business rules
Nil
Dependencies
Data type
Numeric
Format
N
Maximum length
1
Data domain
Code
Description
1
Awaiting response
(the patient is yet to complete the questionnaire)
2
To be followed up
(the questionnaire was sent more than two weeks ago and has not been returned by the patient)*
3
Reissued awaiting response
(a questionnaire has been reissued)
4
Expired
(the questionnaire was sent more than four weeks ago and has not been returned by the patient)*
5
Received
(the patient has returned the questionnaire)
6
Completed
(the PMS has completed the questions regarding medication and opioid use).
Conditions
Nil
Level
Survey
Derived item
Derived by
Not applicable
, multiple selections available,
v2
adult
australia
new-zealand
{"serverDuration": 44, "requestCorrelationId": "6dbf9ef53c02410d8ffbbca5b4149d97"}