Version 2.78

70412-2 I feel close to my friends

Observation ID in Form

GS1

Fully-Specified Name

Component
I feel close to my friends in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I feel close to my friends
Source
GS1

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70413-0 I get emotional support from my family

Observation ID in Form

GS2

Fully-Specified Name

Component
I get emotional support from my family in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get emotional support from my family
Source
GS2

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70414-8 I get support from my friends

Observation ID in Form

GS3

Fully-Specified Name

Component
I get support from my friends in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I get support from my friends
Source
GS3

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70415-5 My family has accepted my illness

Observation ID in Form

GS4

Fully-Specified Name

Component
My family has accepted my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
My family has accepted my illness
Source
GS4

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70416-3 I am satisfied with family communication about my illness

Observation ID in Form

GS5

Fully-Specified Name

Component
I am satisfied with family communication about my illness in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am satisfied with family communication about my illness
Source
GS5

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70417-1 I felt close to my partner, or the person who is my main support

Observation ID in Form

GS6

Fully-Specified Name

Component
I feel close to my partner, or the person who is my main support, in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I felt close to my partner, or the person who is my main support
Source
GS6

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70914-7 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.

Observation ID in Form

Q1

Fully-Specified Name

Component
Would you like to answer the question referring to your sex life
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.50

Survey Question

Text
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.
Source
Q1

Normative Answer List LL361-7

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) LA32-8

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70418-9 I am satisfied with my sex life

Observation ID in Form

GS7

Fully-Specified Name

Component
I am satisfied with my sex life in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
FACIT

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.66
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

Survey Question

Text
I am satisfied with my sex life
Source
GS7

Normative Answer List LL5215-0

Answer Code Score Answer ID
Not at all 0 LA6568-5
A little bit 1 LA13863-8
Somewhat 2 LA13909-9
Quite a bit 3 LA13902-4
Very much 4 LA13914-9

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel
70506-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Symptom Indexes Panel
70504-6 Functional Assessment of Chronic Illness Therapy (FACIT) - General Measures Panel
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel