106487-2 Wash dishes.

Observation ID in Form

C1

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Wash dishes
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Wash dishes

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106488-0 Mow the lawn.

Observation ID in Form

C2

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Mow the lawn
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Mow the lawn

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106489-8 Go out to eat.

Observation ID in Form

C3

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Go out to eat
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Go out to eat

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106490-6 Play cards or other games.

Observation ID in Form

C4

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Play cards or other games
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Play cards or other games

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106491-4 Go grocery shopping.

Observation ID in Form

C5

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Go grocery shopping
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Go grocery shopping

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106492-2 Work in the garden.

Observation ID in Form

C6

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Work in the garden
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Work in the garden

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106493-0 Go to a movie.

Observation ID in Form

C7

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Go to a movie
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Go to a movie

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106494-8 Visit friends.

Observation ID in Form

C8

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Visit friends
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Visit friends

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106495-5 Help with the house cleaning.

Observation ID in Form

C9

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Help with the house cleaning
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Help with the house cleaning

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106496-3 Work on the car.

Observation ID in Form

C10

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Work on the car
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Work on the car

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106497-1 Take a ride in a car.

Observation ID in Form

C11

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Take a ride in a car
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Take a ride in a car

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106498-9 Visit relatives.

Observation ID in Form

C12

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Visit relatives
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Visit relatives

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106499-7 Prepare a meal.

Observation ID in Form

C13

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Prepare a meal
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Prepare a meal

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106500-2 Wash the car.

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Wash the car
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Wash the car

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106501-0 Take a trip.

Observation ID in Form

C15

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Take a trip
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Take a trip

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106502-8 Go to a park or beach.

Observation ID in Form

C16

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Go to a park or beach
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Go to a park or beach

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106503-6 Do a load of laundry.

Observation ID in Form

C17

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Do a load of laundry
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Do a load of laundry

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Preferred Answer List LL6927-9

AnswerCodeScoreAnswer ID
0 - Never

Never

0LA34567-0
11LA6112-2
22LA34475-6
33LA6114-8
44LA6115-5
55LA10137-0
6 - Very often

Very often

6LA34568-8

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106504-4 Work on a needed house repair.

Observation ID in Form

C18

Type of Entry

Question expects user entry - requires response [Q]

Fully-Specified Name

Component
Work on a needed house repair
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method

Long Common Name

Work on a needed house repair

Basic Attributes

Class
SURVEY.PAIN
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

106505-1 Part 3 Score [WHYMPI]

Type of Entry

Question - computer calculates response [C]

Form Coding Instructions

To account for sporadic missing data, sums should be divided by the number of non-missing items. Any scale with more than 25% of its items missing should be considered missing.

Source: National Committee for Quality Assurance

Fully-Specified Name

Component
Part 3 Score
Property
Score
Time
Pt
System
^Patient
Scale
Qn
Method
WHYMPI

Basic Attributes

Class
SURVEY.WHYMPI
Type
Surveys
First Released
Version 2.81
Last Updated
Version 2.81 (ADD)
Order vs. Observation
Observation

Member of these Panels

LOINCLong Common Name
106444-3West Haven-Yale multidimensional pain inventory [WHYMPI]

Example Units

UnitSource
{score}Example UCUM Units