Version 2.77

70496-5 Functional Assessment of Cancer Therapy for patients with breast cancer questionnaire - version 4 (FACT-B) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Breast cancer
Source: Regenstrief LOINC

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with breast cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70868-5 Additional concerns - FACT-B [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-B
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

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
99357-6 COVID-19 health questions panel
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
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
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70306-6 I am self-conscious about the way I dress

Observation ID in Form

B2

Fully-Specified Name

Component
I am self-conscious about the way I dress 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 self-conscious about the way I dress
Source
B2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70307-4 One or more of my arms are swollen or tender

Observation ID in Form

B3

Fully-Specified Name

Component
One or more of my arms are swollen or tender 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
One or more of my arms are swollen or tender
Source
B3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70308-2 I feel sexually attractive

Observation ID in Form

B4

Fully-Specified Name

Component
I feel sexually attractive 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 sexually attractive
Source
B4

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
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

70309-0 I am bothered by hair loss

Observation ID in Form

B5

Fully-Specified Name

Component
I am bothered by hair loss 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 bothered by hair loss
Source
B5

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
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

70310-8 I worry that other members of my family might someday get the same illness I have

Observation ID in Form

B6

Fully-Specified Name

Component
I worry that other members of my family might someday get the same illness I have 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 worry that other members of my family might someday get the same illness I have
Source
B6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70311-6 I worry about the effect of stress on my illness

Observation ID in Form

B7

Fully-Specified Name

Component
I worry about the effect of stress on 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 worry about the effect of stress on my illness
Source
B7

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
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

70312-4 I am bothered by a change in weight

Observation ID in Form

B8

Fully-Specified Name

Component
I am bothered by a change in weight 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 bothered by a change in weight
Source
B8

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
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

70313-2 I am able to feel like a woman

Observation ID in Form

B9

Fully-Specified Name

Component
I am able to feel like a woman 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 able to feel like a woman
Source
B9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70481-7 I have certain parts of my body where I experience pain

Observation ID in Form

P2

Fully-Specified Name

Component
I have certain parts of my body where I experience pain 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 have certain parts of my body where I experience pain
Source
P2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70497-3 Functional Assessment of Cancer Therapy for patients with bladder cancer questionnaire - version 4 (FACT-Bl) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Bladder cancer
Source: Regenstrief LOINC

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with bladder cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70869-3 Additional concerns - FACT-Bl [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-Bl
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70314-0 I have trouble controlling my urine

Observation ID in Form

BL1

Fully-Specified Name

Component
I have trouble controlling my urine 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 have trouble controlling my urine
Source
BL1

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
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

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight 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 losing weight
Source
C2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70347-0 I have control of my bowels

Observation ID in Form

C3

Fully-Specified Name

Component
I have control of my bowels 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 have control of my bowels
Source
C3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70315-7 I urinate more frequently than usual

Observation ID in Form

BL2

Fully-Specified Name

Component
I urinate more frequently than usual 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 urinate more frequently than usual
Source
BL2

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
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

70349-6 I have diarrhea

Observation ID in Form

C5

Fully-Specified Name

Component
I have diarrhea 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 have diarrhea
Source
C5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

70351-2 I like the appearance of my body

Observation ID in Form

C7

Fully-Specified Name

Component
I like the appearance of my body 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 like the appearance of my body
Source
C7

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70316-5 It burns when I urinate

Observation ID in Form

BL3

Fully-Specified Name

Component
It burns when I urinate 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
It burns when I urinate
Source
BL3

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

70317-3 I am interested in sex

Observation ID in Form

BL4

Fully-Specified Name

Component
I am interested in sex 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 interested in sex
Source
BL4

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
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

70318-1 (For men only) I am able to have and maintain an erection

Observation ID in Form

BL5

Fully-Specified Name

Component
For men only - I am able to have and maintain an erection 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
(For men only) I am able to have and maintain an erection
Source
BL5

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

70482-5 Do you have an ostomy appliance?

Observation ID in Form

Q2

Fully-Specified Name

Component
Do you have an ostomy appliance
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
Do you have an ostomy appliance?
Source
Q2

Normative Answer List LL251-0

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70352-0 I am embarrassed by my ostomy appliance

Observation ID in Form

C8

Fully-Specified Name

Component
I am embarrassed by my ostomy appliance 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 embarrassed by my ostomy appliance
Source
C8

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

70353-8 Caring for my ostomy appliance is difficult

Observation ID in Form

C9

Fully-Specified Name

Component
Caring for my ostomy appliance is difficult 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
Caring for my ostomy appliance is difficult
Source
C9

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

70503-8 Functional Assessment of Cancer Therapy for patients with brain cancer questionnaire - version 4 (FACT-Br) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Brain cancer - version 4
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with brain cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70870-1 Additional concerns - FACT-Br [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-Br
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70323-1 I am able to concentrate

Observation ID in Form

Br1

Fully-Specified Name

Component
I am able to concentrate 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 able to concentrate
Source
Br1

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70334-8 I have had seizures (convulsions)

Observation ID in Form

Br2

Fully-Specified Name

Component
I have had seizures - convulsions - 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 have had seizures (convulsions)
Source
Br2

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

70337-1 I can remember new things

Observation ID in Form

Br3

Fully-Specified Name

Component
I can remember new things 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 can remember new things
Source
Br3

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

70338-9 I get frustrated that I cannot do the things I used to

Observation ID in Form

Br4

Fully-Specified Name

Component
I get frustrated that I cannot do the things I used to 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 frustrated that I cannot do the things I used to
Source
Br4

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

70339-7 I am afraid of having a seizure (convulsion)

Observation ID in Form

Br5

Fully-Specified Name

Component
I am afraid of having a seizure - convulsion - 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 afraid of having a seizure (convulsion)
Source
Br5

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

70340-5 I have trouble with my eyesight

Observation ID in Form

Br6

Fully-Specified Name

Component
I have trouble with my eyesight 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 have trouble with my eyesight
Source
Br6

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

70341-3 I feel independent

Observation ID in Form

Br7

Fully-Specified Name

Component
I feel independent 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 independent
Source
Br7

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70477-5 I have trouble hearing

Observation ID in Form

NTX6

Fully-Specified Name

Component
I have trouble hearing 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 have trouble hearing
Source
NTX6

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70342-1 I am able to find the right words to say what I mean

Observation ID in Form

Br8

Fully-Specified Name

Component
I am able to find the right words to say what I mean 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 able to find the right words to say what I mean
Source
Br8

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

70343-9 I have difficulty expressing my thoughts

Observation ID in Form

Br9

Fully-Specified Name

Component
I have difficulty expressing my thoughts 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 have difficulty expressing my thoughts
Source
Br9

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

70324-9 I am bothered by the change in my personality

Observation ID in Form

Br10

Fully-Specified Name

Component
I am bothered by the change in my personality 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 bothered by the change in my personality
Source
Br10

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

70325-6 I am able to make decisions and take responsibility

Observation ID in Form

Br11

Fully-Specified Name

Component
I am able to make decisions and take responsibility 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 able to make decisions and take responsibility
Source
Br11

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

70326-4 I am bothered by the drop in my contribution to the family

Observation ID in Form

Br12

Fully-Specified Name

Component
I am bothered by the drop in my contribution to the 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 am bothered by the drop in my contribution to the family
Source
Br12

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

70327-2 I am able to put my thoughts together

Observation ID in Form

Br13

Fully-Specified Name

Component
I am able to put my thoughts together 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 able to put my thoughts together
Source
Br13

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

70328-0 I need help caring for myself - bathing, dressing, eating, etc.

Observation ID in Form

Br14

Fully-Specified Name

Component
I need help caring for myself - bathing, dressing, eating, etc 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 need help caring for myself - bathing, dressing, eating, etc.
Source
Br14

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

70329-8 I am able to put my thoughts into action

Observation ID in Form

Br15

Fully-Specified Name

Component
I am able to put my thoughts into action 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 able to put my thoughts into action
Source
Br15

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

70330-6 I am able to read like I used to

Observation ID in Form

Br16

Fully-Specified Name

Component
I am able to read like I used to 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 able to read like I used to
Source
Br16

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

70331-4 I am able to write like I used to

Observation ID in Form

Br17

Fully-Specified Name

Component
I am able to write like I used to 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 able to write like I used to
Source
Br17

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

70332-2 I am able to drive my vehicle (my car, truck, etc)

Observation ID in Form

Br18

Fully-Specified Name

Component
I am able to drive a vehicle - my car, truck, etc - 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 able to drive my vehicle (my car, truck, etc)
Source
Br18

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

70333-0 I have trouble feeling sensation in my arms, hands or legs

Observation ID in Form

Br19

Fully-Specified Name

Component
I have trouble feeling sensation in my arms, hands or legs 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 have trouble feeling sensation in my arms, hands or legs
Source
Br19

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

70335-5 I have weakness in my arms or legs

Observation ID in Form

Br20

Fully-Specified Name

Component
I have weakness in my arms or legs 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 have weakness in my arms or legs
Source
Br20

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

70336-3 I have trouble with coordination

Observation ID in Form

Br21

Fully-Specified Name

Component
I have trouble with coordination 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 have trouble with coordination
Source
Br21

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

70302-5 I get headaches

Observation ID in Form

An10

Fully-Specified Name

Component
I get headaches 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 headaches
Source
An10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70507-9 Functional Assessment of Cancer Therapy for patients with colorectal cancer questionnaire - version 4 (FACT-C) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with colorectal cancer
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with colorectal cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70871-9 Additional concerns - FACT-C [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-C
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70345-4 I have swelling or cramps in my stomach

Observation ID in Form

C1

Fully-Specified Name

Component
I have swelling or cramps in my stomach area 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 have swelling or cramps in my stomach
Source
C1

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

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight 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 losing weight
Source
C2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70347-0 I have control of my bowels

Observation ID in Form

C3

Fully-Specified Name

Component
I have control of my bowels 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 have control of my bowels
Source
C3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70348-8 I can digest my food well

Observation ID in Form

C4

Fully-Specified Name

Component
I can digest my food well 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 can digest my food well
Source
C4

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

70349-6 I have diarrhea

Observation ID in Form

C5

Fully-Specified Name

Component
I have diarrhea 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 have diarrhea
Source
C5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

70351-2 I like the appearance of my body

Observation ID in Form

C7

Fully-Specified Name

Component
I like the appearance of my body 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 like the appearance of my body
Source
C7

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70482-5 Do you have an ostomy appliance?

Observation ID in Form

Q2

Fully-Specified Name

Component
Do you have an ostomy appliance
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
Do you have an ostomy appliance?
Source
Q2

Normative Answer List LL251-0

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70352-0 I am embarrassed by my ostomy appliance

Observation ID in Form

C8

Fully-Specified Name

Component
I am embarrassed by my ostomy appliance 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 embarrassed by my ostomy appliance
Source
C8

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

70353-8 Caring for my ostomy appliance is difficult

Observation ID in Form

C9

Fully-Specified Name

Component
Caring for my ostomy appliance is difficult 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
Caring for my ostomy appliance is difficult
Source
C9

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

70508-7 Functional Assessment of Cancer Therapy for patients with cancer in the central nervous system questionnaire - version 4 (FACT-CNS) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with cancer in the Central Nervous System
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with cancer in the central nervous system questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70872-7 Additional concerns - FACT-CNS [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-CNS
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70302-5 I get headaches

Observation ID in Form

An10

Fully-Specified Name

Component
I get headaches 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 headaches
Source
An10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70337-1 I can remember new things

Observation ID in Form

Br3

Fully-Specified Name

Component
I can remember new things 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 can remember new things
Source
Br3

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

70354-6 I am able to maintain my balance

Observation ID in Form

CNS1

Fully-Specified Name

Component
I am able to maintain my balance 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 able to maintain my balance
Source
CNS1

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

70355-3 I am able to walk

Observation ID in Form

CNS2

Fully-Specified Name

Component
I am able to walk 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 able to walk
Source
CNS2

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

70340-5 I have trouble with my eyesight

Observation ID in Form

Br6

Fully-Specified Name

Component
I have trouble with my eyesight 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 have trouble with my eyesight
Source
Br6

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

70343-9 I have difficulty expressing my thoughts

Observation ID in Form

Br9

Fully-Specified Name

Component
I have difficulty expressing my thoughts 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 have difficulty expressing my thoughts
Source
Br9

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

70356-1 I have strength in my arms

Observation ID in Form

CNS4

Fully-Specified Name

Component
I have strength in my arms 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 have strength in my arms
Source
CNS4

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

70357-9 I have strength in my legs

Observation ID in Form

CNS5

Fully-Specified Name

Component
I have strength in my legs 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 have strength in my legs
Source
CNS5

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

70358-7 I have numbness in my legs

Observation ID in Form

CNS6

Fully-Specified Name

Component
I have numbness in my legs 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 have numbness in my legs
Source
CNS6

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

70359-5 I have a pain in my back

Observation ID in Form

CNS7

Fully-Specified Name

Component
I have pain in my back 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 have a pain in my back
Source
CNS7

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

70314-0 I have trouble controlling my urine

Observation ID in Form

BL1

Fully-Specified Name

Component
I have trouble controlling my urine 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 have trouble controlling my urine
Source
BL1

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
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

70347-0 I have control of my bowels

Observation ID in Form

C3

Fully-Specified Name

Component
I have control of my bowels 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 have control of my bowels
Source
C3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70509-5 Functional Assessment of Cancer Therapy for patients with cancer of the cervix questionnaire - version 4 (FACT-Cx) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with cancer of the Cervix
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with cancer of the cervix questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70873-5 Additional concerns - FACT-Cx [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-Cx
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70360-3 I am bothered by discharge or bleeding from my vagina

Observation ID in Form

Cx1

Fully-Specified Name

Component
I am bothered by discharge or bleeding from my vagina 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 bothered by discharge or bleeding from my vagina
Source
Cx1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70361-1 I am bothered by an odor coming from my vagina

Observation ID in Form

Cx2

Fully-Specified Name

Component
I am bothered by odor coming from my vagina 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 bothered by an odor coming from my vagina
Source
Cx2

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

70362-9 I am afraid to have sex

Observation ID in Form

Cx3

Fully-Specified Name

Component
I am afraid to have sex 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 afraid to have sex
Source
Cx3

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

70308-2 I feel sexually attractive

Observation ID in Form

B4

Fully-Specified Name

Component
I feel sexually attractive 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 sexually attractive
Source
B4

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
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

70363-7 My vagina feels too narrow or short

Observation ID in Form

Cx4

Fully-Specified Name

Component
My vagina feels too narrow or short 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 vagina feels too narrow or short
Source
Cx4

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

70321-5 I have concerns about my ability to have children

Observation ID in Form

BMT7

Fully-Specified Name

Component
I have concerns about my ability to have children 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 have concerns about my ability to have children
Source
BMT7

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70364-5 I am afraid the treatment will harm my body

Observation ID in Form

Cx5

Fully-Specified Name

Component
I am afraid the treatment will harm my body 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 afraid the treatment will harm my body
Source
Cx5

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

70317-3 I am interested in sex

Observation ID in Form

BL4

Fully-Specified Name

Component
I am interested in sex 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 interested in sex
Source
BL4

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
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

70351-2 I like the appearance of my body

Observation ID in Form

C7

Fully-Specified Name

Component
I like the appearance of my body 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 like the appearance of my body
Source
C7

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70365-2 I am bothered by constipation

Observation ID in Form

Cx6

Fully-Specified Name

Component
I am bothered by constipation 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 bothered by constipation
Source
Cx6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

70314-0 I have trouble controlling my urine

Observation ID in Form

BL1

Fully-Specified Name

Component
I have trouble controlling my urine 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 have trouble controlling my urine
Source
BL1

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
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

70316-5 It burns when I urinate

Observation ID in Form

BL3

Fully-Specified Name

Component
It burns when I urinate 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
It burns when I urinate
Source
BL3

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

70366-0 I have discomfort when I urinate

Observation ID in Form

Cx7

Fully-Specified Name

Component
I have discomfort when I urinate 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 have discomfort when I urinate
Source
Cx7

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

70427-0 I am able to eat the foods that I like

Observation ID in Form

HN1

Fully-Specified Name

Component
I am able to eat the foods that I like 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 able to eat the foods that I like
Source
HN1

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

70510-3 Functional Assessment of Cancer Therapy for patients with esophageal cancer questionnaire - version 4 (FACT-E) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Esophageal cancer
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with esophageal cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70874-3 Additional concerns - FACT-E [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-E
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70427-0 I am able to eat the foods that I like

Observation ID in Form

HN1

Fully-Specified Name

Component
I am able to eat the foods that I like 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 able to eat the foods that I like
Source
HN1

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

70431-2 My mouth is dry

Observation ID in Form

HN2

Fully-Specified Name

Component
My mouth is dry 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 mouth is dry
Source
HN2

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

70432-0 I have trouble breathing

Observation ID in Form

HN3

Fully-Specified Name

Component
I have trouble breathing 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 have trouble breathing
Source
HN3

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

70433-8 My voice has its usual quality and strength

Observation ID in Form

HN4

Fully-Specified Name

Component
My voice has its usual quality and strength 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 voice has its usual quality and strength
Source
HN4

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

70434-6 I am able to eat as much food as I want

Observation ID in Form

HN5

Fully-Specified Name

Component
I am able to eat as much food as I want 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 able to eat as much food as I want
Source
HN5

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

70428-8 I am able to communicate with others

Observation ID in Form

HN10

Fully-Specified Name

Component
I am able to communicate with others 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 able to communicate with others
Source
HN10

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

70436-1 I can swallow naturally and easily

Observation ID in Form

HN7

Fully-Specified Name

Component
I can swallow naturally and easily 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 can swallow naturally and easily
Source
HN7

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

70367-8 I have difficulty swallowing solid foods

Observation ID in Form

E1

Fully-Specified Name

Component
I have difficulty swallowing solid foods 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 have difficulty swallowing solid foods
Source
E1

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

70368-6 I have difficulty swallowing soft or mashed foods

Observation ID in Form

E2

Fully-Specified Name

Component
I have difficulty swallowing soft or mashed foods 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 have difficulty swallowing soft or mashed foods
Source
E2

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

70369-4 I have difficulty swallowing liquids

Observation ID in Form

E3

Fully-Specified Name

Component
I have difficulty swallowing liquids 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 have difficulty swallowing liquids
Source
E3

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

70370-2 I have a pain in my chest when I swallow

Observation ID in Form

E4

Fully-Specified Name

Component
I have a pain in my chest when I swallow 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 have a pain in my chest when I swallow
Source
E4

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

70371-0 I choke when I swallow

Observation ID in Form

E5

Fully-Specified Name

Component
I choke when I swallow 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 choke when I swallow
Source
E5

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

70372-8 I am able to enjoy meals with family or friends

Observation ID in Form

E6

Fully-Specified Name

Component
I am able to enjoy meals with family or 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 am able to enjoy meals with family or friends
Source
E6

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

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

70373-6 I wake at night because of coughing

Observation ID in Form

E7

Fully-Specified Name

Component
I wake at night because of coughing 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 wake at night because of coughing
Source
E7

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

70301-7 I have a pain in my stomach area

Observation ID in Form

ACT11

Fully-Specified Name

Component
I have pain in my stomach area 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 have a pain in my stomach area
Source
ACT11

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight 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 losing weight
Source
C2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70511-1 Functional Assessment of Cancer Therapy for patients with endometrial cancer questionnaire - version 4 (FACT-En) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Endometrial cancer
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with endometrial cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70875-0 Additional concerns - FACT-En [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-En
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70478-3 I have swelling in my stomach area

Observation ID in Form

O1

Fully-Specified Name

Component
I have swelling in my stomach area 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 have swelling in my stomach area
Source
O1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70480-9 I have cramps in my stomach area

Observation ID in Form

O3

Fully-Specified Name

Component
I have cramps in my stomach area 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 have cramps in my stomach area
Source
O3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70424-7 I have discomfort or pain in my stomach area

Observation ID in Form

Hep8

Fully-Specified Name

Component
I have discomfort or pain in my stomach area 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 have discomfort or pain in my stomach area
Source
Hep8

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

70381-9 I have vaginal bleeding or spotting

Observation ID in Form

ES6

Fully-Specified Name

Component
I have vaginal bleeding or spotting 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 have vaginal bleeding or spotting
Source
ES6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70380-1 I have vaginal discharge

Observation ID in Form

ES4

Fully-Specified Name

Component
I have vaginal discharge 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 have vaginal discharge
Source
ES4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70419-7 I am unhappy about a change in my appearance

Observation ID in Form

Hep1

Fully-Specified Name

Component
I am unhappy about a change in my appearance 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 unhappy about a change in my appearance
Source
Hep1

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

70376-9 I have hot flashes

Observation ID in Form

ES1

Fully-Specified Name

Component
I have hot flashes 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 have hot flashes
Source
ES1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70378-5 I have cold sweats

Observation ID in Form

ES2

Fully-Specified Name

Component
I have cold sweats 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 have cold sweats
Source
ES2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70379-3 I have night sweats

Observation ID in Form

ES3

Fully-Specified Name

Component
I have night sweats 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 have night sweats
Source
ES3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued 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 fatigued
Source
HI7

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
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

70382-7 I have pain or discomfort with intercourse

Observation ID in Form

ES8

Fully-Specified Name

Component
I have pain or discomfort with intercourse 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 have pain or discomfort with intercourse
Source
ES8

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70374-4 I have trouble digesting food

Observation ID in Form

En1

Fully-Specified Name

Component
I have trouble digesting food 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 have trouble digesting food
Source
En1

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

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

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
99357-6 COVID-19 health questions panel
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
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
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70365-2 I am bothered by constipation

Observation ID in Form

Cx6

Fully-Specified Name

Component
I am bothered by constipation 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 bothered by constipation
Source
Cx6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70315-7 I urinate more frequently than usual

Observation ID in Form

BL2

Fully-Specified Name

Component
I urinate more frequently than usual 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 urinate more frequently than usual
Source
BL2

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
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

70375-1 I have discomfort or pain in my pelvic area

Observation ID in Form

En2

Fully-Specified Name

Component
I have discomfort or pain in my pelvic area 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 have discomfort or pain in my pelvic area
Source
En2

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

70512-9 Functional Assessment of Cancer Therapy for patients with gastric cancer questionnaire - version 4 (FACT-Ga) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Gastric cancer
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with gastric cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70876-8 Additional concerns - FACT-Ga [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-Ga
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight 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 losing weight
Source
C2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70383-5 I have a loss of appetite

Observation ID in Form

Ga1

Fully-Specified Name

Component
I have a loss of appetite 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 have a loss of appetite
Source
Ga1

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

70387-6 I am bothered by reflux or heartburn

Observation ID in Form

Ga2

Fully-Specified Name

Component
I am bothered by reflux or heartburn 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 bothered by reflux or heartburn
Source
Ga2

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

70427-0 I am able to eat the foods that I like

Observation ID in Form

HN1

Fully-Specified Name

Component
I am able to eat the foods that I like 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 able to eat the foods that I like
Source
HN1

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

70389-2 I have discomfort or pain when I eat

Observation ID in Form

Ga6

Fully-Specified Name

Component
I have discomfort or pain when I eat 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 have discomfort or pain when I eat
Source
Ga6

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

70525-1 I have a feeling of fullness or heaviness in my stomach area

Observation ID in Form

Ga5

Fully-Specified Name

Component
I have a feeling of fullness or heaviness in my stomach area 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 have a feeling of fullness or heaviness in my stomach area
Source
Ga5

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

70345-4 I have swelling or cramps in my stomach

Observation ID in Form

C1

Fully-Specified Name

Component
I have swelling or cramps in my stomach area 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 have swelling or cramps in my stomach
Source
C1

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

70385-0 I have trouble swallowing food

Observation ID in Form

Ga12

Fully-Specified Name

Component
I have trouble swallowing food 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 have trouble swallowing food
Source
Ga12

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

70388-4 I am bothered by a change in my eating habits

Observation ID in Form

Ga4

Fully-Specified Name

Component
I am bothered by a change in my eating habits 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 bothered by a change in my eating habits
Source
Ga4

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

70372-8 I am able to enjoy meals with family or friends

Observation ID in Form

E6

Fully-Specified Name

Component
I am able to enjoy meals with family or 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 am able to enjoy meals with family or friends
Source
E6

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

70384-3 My digestive problems interfere with my usual activities

Observation ID in Form

Ga10

Fully-Specified Name

Component
My digestive problems interfere with my usual activities 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 digestive problems interfere with my usual activities
Source
Ga10

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

70391-8 I avoid going out to eat because of my illness

Observation ID in Form

Ga9

Fully-Specified Name

Component
I avoid going out to eat because of 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 avoid going out to eat because of my illness
Source
Ga9

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

70390-0 I have stomach problems that worry me

Observation ID in Form

Ga7

Fully-Specified Name

Component
I have stomach problems that worry me 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 have stomach problems that worry me
Source
Ga7

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

70424-7 I have discomfort or pain in my stomach area

Observation ID in Form

Hep8

Fully-Specified Name

Component
I have discomfort or pain in my stomach area 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 have discomfort or pain in my stomach area
Source
Hep8

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

70386-8 I am bothered by gas (flatulence)

Observation ID in Form

Ga14

Fully-Specified Name

Component
I am bothered by gas - flatulence - 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 bothered by gas (flatulence)
Source
Ga14

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

70349-6 I have diarrhea

Observation ID in Form

C5

Fully-Specified Name

Component
I have diarrhea 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 have diarrhea
Source
C5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70304-1 I feel tired

Observation ID in Form

An2

Fully-Specified Name

Component
I feel tired 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 tired
Source
An2/pF1

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70728-1 I have trouble starting things because I am tired

Observation ID in Form

An3

Fully-Specified Name

Component
I have trouble starting things because I am tired 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 have trouble starting things because I am tired
Source
An3

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
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

70425-4 I feel weak all over

Observation ID in Form

HI12

Fully-Specified Name

Component
I feel weak all over 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 2.67
Change Reason
Release 2.67: SURVEY_QUEST_TEXT: Corrected the omission of "over" from Survey Question Text; Previous Releases: 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 weak all over
Source
HI12

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
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

70447-8 Because of my illness, I have difficulty planning for the future

Observation ID in Form

Leu4

Fully-Specified Name

Component
Because of my illness, I have difficulty planning for the future 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
Because of my illness, I have difficulty planning for the future
Source
Leu4

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

70514-5 Functional Assessment of Cancer Therapy for patients with hepatobiliary cancer - version 4 (FACT-Hep) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Hepatobiliary cancer (liver, bile duct and pancreas)
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with hepatobiliary cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70877-6 Additional concerns - FACT-Hep [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-Hep
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70345-4 I have swelling or cramps in my stomach

Observation ID in Form

C1

Fully-Specified Name

Component
I have swelling or cramps in my stomach area 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 have swelling or cramps in my stomach
Source
C1

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

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight 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 losing weight
Source
C2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70347-0 I have control of my bowels

Observation ID in Form

C3

Fully-Specified Name

Component
I have control of my bowels 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 have control of my bowels
Source
C3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70348-8 I can digest my food well

Observation ID in Form

C4

Fully-Specified Name

Component
I can digest my food well 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 can digest my food well
Source
C4

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

70349-6 I have diarrhea

Observation ID in Form

C5

Fully-Specified Name

Component
I have diarrhea 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 have diarrhea
Source
C5

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

70419-7 I am unhappy about a change in my appearance

Observation ID in Form

Hep1

Fully-Specified Name

Component
I am unhappy about a change in my appearance 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 unhappy about a change in my appearance
Source
Hep1

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

70359-5 I have a pain in my back

Observation ID in Form

CNS7

Fully-Specified Name

Component
I have pain in my back 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 have a pain in my back
Source
CNS7

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

70365-2 I am bothered by constipation

Observation ID in Form

Cx6

Fully-Specified Name

Component
I am bothered by constipation 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 bothered by constipation
Source
Cx6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued 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 fatigued
Source
HI7

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
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

61890-0 During the past 7 days - I am able to do my usual activities

Observation ID in Form

An7

Fully-Specified Name

Component
I am able to do my usual activities in past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.54

Survey Question

Text
During the past 7 days - I am able to do my usual activities
Source
An7

Normative Answer List LL1017-4

Answer Code Score Answer ID
Not at all 1 LA6568-5
A little bit 2 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 4 LA13902-4
Very much 5 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
61795-1 PROMIS item bank - fatigue - version 1.0

70420-5 I am bothered by jaundice or yellow color to my skin

Observation ID in Form

Hep2

Fully-Specified Name

Component
I am bothered by jaundice or yellow color to my skin 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 bothered by jaundice or yellow color to my skin
Source
Hep2

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

70421-3 I have had fevers (episodes of high body temperature)

Observation ID in Form

Hep3

Fully-Specified Name

Component
I have had fevers - episodes of high body temperature - 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 have had fevers (episodes of high body temperature)
Source
Hep3

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

70526-9 I have had itching

Observation ID in Form

Hep4

Fully-Specified Name

Component
I have had itching 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 have had itching
Source
Hep4

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

70422-1 I have had a change in the way food tastes

Observation ID in Form

Hep5

Fully-Specified Name

Component
I have had a change in the way food tastes 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 have had a change in the way food tastes
Source
Hep5

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

70423-9 I have had chills

Observation ID in Form

Hep6

Fully-Specified Name

Component
I have had chills 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 have had chills
Source
Hep6

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

70431-2 My mouth is dry

Observation ID in Form

HN2

Fully-Specified Name

Component
My mouth is dry 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 mouth is dry
Source
HN2

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

70424-7 I have discomfort or pain in my stomach area

Observation ID in Form

Hep8

Fully-Specified Name

Component
I have discomfort or pain in my stomach area 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 have discomfort or pain in my stomach area
Source
Hep8

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

70513-7 Functional Assessment of Cancer Therapy for patients with head and neck cancer questionnaire - version 4 (FACT H and N) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Head & Neck cancer
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with head and neck cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70878-4 Additional concerns - FACT-H and N [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-H&N
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70427-0 I am able to eat the foods that I like

Observation ID in Form

HN1

Fully-Specified Name

Component
I am able to eat the foods that I like 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 able to eat the foods that I like
Source
HN1

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

70431-2 My mouth is dry

Observation ID in Form

HN2

Fully-Specified Name

Component
My mouth is dry 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 mouth is dry
Source
HN2

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

70432-0 I have trouble breathing

Observation ID in Form

HN3

Fully-Specified Name

Component
I have trouble breathing 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 have trouble breathing
Source
HN3

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

70433-8 My voice has its usual quality and strength

Observation ID in Form

HN4

Fully-Specified Name

Component
My voice has its usual quality and strength 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 voice has its usual quality and strength
Source
HN4

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

70434-6 I am able to eat as much food as I want

Observation ID in Form

HN5

Fully-Specified Name

Component
I am able to eat as much food as I want 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 able to eat as much food as I want
Source
HN5

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

70435-3 I am unhappy with how my face and neck look

Observation ID in Form

HN6

Fully-Specified Name

Component
I am unhappy with how my face and neck look 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 unhappy with how my face and neck look
Source
HN6

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

70436-1 I can swallow naturally and easily

Observation ID in Form

HN7

Fully-Specified Name

Component
I can swallow naturally and easily 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 can swallow naturally and easily
Source
HN7

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

70437-9 I smoke cigarettes of other tobacco products

Observation ID in Form

HN8

Fully-Specified Name

Component
I smoke cigarettes or other tobacco products 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 smoke cigarettes of other tobacco products
Source
HN8

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

Member of these Groups Get Info

LOINC Group Group Name
LG41856-2 Smoking-related terms

70438-7 I drink alcohol (beer, wine, etc.)

Observation ID in Form

HN9

Fully-Specified Name

Component
I drink alcohol - beer, wine, etc - 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 drink alcohol (beer, wine, etc.)
Source
HN9

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

70428-8 I am able to communicate with others

Observation ID in Form

HN10

Fully-Specified Name

Component
I am able to communicate with others 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 able to communicate with others
Source
HN10

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

70429-6 I can eat solid food

Observation ID in Form

HN11

Fully-Specified Name

Component
I can eat solid foods 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 can eat solid food
Source
HN11

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

70430-4 I have pain in my mouth, throat or neck

Observation ID in Form

HN12

Fully-Specified Name

Component
I have pain in my mouth, throat or neck 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 have pain in my mouth, throat or neck
Source
HN12

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

70515-2 Functional Assessment of Cancer Therapy for patients with lung cancer questionnaire - version 4 (FACT-L) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Lung cancer
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with lung cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70879-2 Additional concerns - FACT-L [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-L
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

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
99357-6 COVID-19 health questions panel
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
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
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight 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 losing weight
Source
C2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70441-1 My thinking is clear

Observation ID in Form

L1

Fully-Specified Name

Component
My thinking is clear 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 thinking is clear
Source
L1

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70442-9 I have been coughing

Observation ID in Form

L2

Fully-Specified Name

Component
I have been coughing 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 have been coughing
Source
L2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70309-0 I am bothered by hair loss

Observation ID in Form

B5

Fully-Specified Name

Component
I am bothered by hair loss 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 bothered by hair loss
Source
B5

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
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

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

70443-7 I feel tightness in my chest

Observation ID in Form

L3

Fully-Specified Name

Component
I feel tightness in my chest 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 tightness in my chest
Source
L3

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

70444-5 Breathing is easy for me

Observation ID in Form

L4

Fully-Specified Name

Component
Breathing is easy for me 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
Breathing is easy for me
Source
L4

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

70483-3 Have you ever smoked?

Observation ID in Form

Q3

Fully-Specified Name

Component
Have you ever smoked
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
Have you ever smoked?
Source
Q3

Normative Answer List LL251-0

Answer Code Score Answer ID
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 0 LA32-8
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

Member of these Groups Get Info

LOINC Group Group Name
LG41856-2 Smoking-related terms

70445-2 I regret my smoking

Observation ID in Form

L5

Fully-Specified Name

Component
I regret my smoking 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 regret my smoking
Source
L5

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

Member of these Groups Get Info

LOINC Group Group Name
LG41856-2 Smoking-related terms

70516-0 Functional Assessment of Cancer Therapy for patients with leukemia questionnaire - version 4 (FACT-Leu) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Leukemia
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with leukemia questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70880-0 Additional concerns - FACT-Leu [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-Leu
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70344-7 I am bothered by fevers (episodes of high body temperature)

Observation ID in Form

BRM3

Fully-Specified Name

Component
I am bothered by fevers - episodes of high body temperature - 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 bothered by fevers (episodes of high body temperature)
Source
BRM3

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
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

70481-7 I have certain parts of my body where I experience pain

Observation ID in Form

P2

Fully-Specified Name

Component
I have certain parts of my body where I experience pain 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 have certain parts of my body where I experience pain
Source
P2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70527-7 I am bothered by the chills

Observation ID in Form

BRM2

Fully-Specified Name

Component
I am bothered by the chills 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 bothered by the chills
Source
BRM2

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
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

70379-3 I have night sweats

Observation ID in Form

ES3

Fully-Specified Name

Component
I have night sweats 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 have night sweats
Source
ES3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70446-0 I am bothered by lumps or swelling in certain part of my body (e.g. neck, armpits, or groin)

Observation ID in Form

Leu1

Fully-Specified Name

Component
I am bothered by lumps or swelling in certain part of my body - neck, armpits, or groin - 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 bothered by lumps or swelling in certain part of my body (e.g. neck, armpits, or groin)
Source
Leu1

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

70484-1 I bleed easily

Observation ID in Form

TH1

Fully-Specified Name

Component
I bleed easily 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 bleed easily
Source
TH1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70485-8 I bruise easily

Observation ID in Form

TH2

Fully-Specified Name

Component
I bruise easily 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 bruise easily
Source
TH2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70425-4 I feel weak all over

Observation ID in Form

HI12

Fully-Specified Name

Component
I feel weak all over 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 2.67
Change Reason
Release 2.67: SURVEY_QUEST_TEXT: Corrected the omission of "over" from Survey Question Text; Previous Releases: 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 weak all over
Source
HI12

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
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

70528-5 I get tired easily

Observation ID in Form

BMT6

Fully-Specified Name

Component
I get tired easily 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 tired easily
Source
BMT6

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight 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 losing weight
Source
C2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

61890-0 During the past 7 days - I am able to do my usual activities

Observation ID in Form

An7

Fully-Specified Name

Component
I am able to do my usual activities in past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method
PROMIS

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.34
Last Updated
Version 2.54

Survey Question

Text
During the past 7 days - I am able to do my usual activities
Source
An7

Normative Answer List LL1017-4

Answer Code Score Answer ID
Not at all 1 LA6568-5
A little bit 2 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 4 LA13902-4
Very much 5 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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel
61795-1 PROMIS item bank - fatigue - version 1.0

70485-8 I bruise easily

Observation ID in Form

TH2

Fully-Specified Name

Component
I bruise easily 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 bruise easily
Source
TH2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70470-0 I worry about getting infections

Observation ID in Form

N3

Fully-Specified Name

Component
I worry about getting infections 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 worry about getting infections
Source
N3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70448-6 I feel uncertain about my future health

Observation ID in Form

Leu5

Fully-Specified Name

Component
I feel uncertain about my future health 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 uncertain about my future health
Source
Leu5

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

70449-4 I worry that I might get new symptoms of my illness

Observation ID in Form

Leu6

Fully-Specified Name

Component
I worry that I might get new symptoms of 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 worry that I might get new symptoms of my illness
Source
Leu6

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

70319-9 I have emotional ups and downs

Observation ID in Form

BRM9

Fully-Specified Name

Component
I have emotional ups and downs 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 have emotional ups and downs
Source
BRM9

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70450-2 I feel isolated from others because of my illness or treatment

Observation ID in Form

Leu7

Fully-Specified Name

Component
I feel isolated from others because of my illness or treatment 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 isolated from others because of my illness or treatment
Source
Leu7

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

70517-8 Functional Assessment of Cancer Therapy for patients with non-Hodgkins lymphoma questionnaire - version 4 (FACT-Lym) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Lymphoma (Non-Hodgkins Lymphoma)
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with non-hodgkins lymphoma questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70881-8 Additional concerns - FACT-Lym [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-Lym
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70481-7 I have certain parts of my body where I experience pain

Observation ID in Form

P2

Fully-Specified Name

Component
I have certain parts of my body where I experience pain 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 have certain parts of my body where I experience pain
Source
P2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70446-0 I am bothered by lumps or swelling in certain part of my body (e.g. neck, armpits, or groin)

Observation ID in Form

Leu1

Fully-Specified Name

Component
I am bothered by lumps or swelling in certain part of my body - neck, armpits, or groin - 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 bothered by lumps or swelling in certain part of my body (e.g. neck, armpits, or groin)
Source
Leu1

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

70344-7 I am bothered by fevers (episodes of high body temperature)

Observation ID in Form

BRM3

Fully-Specified Name

Component
I am bothered by fevers - episodes of high body temperature - 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 bothered by fevers (episodes of high body temperature)
Source
BRM3

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
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

70379-3 I have night sweats

Observation ID in Form

ES3

Fully-Specified Name

Component
I have night sweats 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 have night sweats
Source
ES3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70451-0 I am bothered by itching

Observation ID in Form

Lym1

Fully-Specified Name

Component
I am bothered by itching 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 bothered by itching
Source
Lym1

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

70452-8 I have trouble sleeping at night

Observation ID in Form

Lym2

Fully-Specified Name

Component
I have trouble sleeping at night 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 have trouble sleeping at night
Source
Lym2

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

70528-5 I get tired easily

Observation ID in Form

BMT6

Fully-Specified Name

Component
I get tired easily 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 tired easily
Source
BMT6

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight 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 losing weight
Source
C2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70383-5 I have a loss of appetite

Observation ID in Form

Ga1

Fully-Specified Name

Component
I have a loss of appetite 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 have a loss of appetite
Source
Ga1

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

70530-1 I have trouble concentrating

Observation ID in Form

HI8

Fully-Specified Name

Component
I have trouble concentrating 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 have trouble concentrating
Source
HI8

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70470-0 I worry about getting infections

Observation ID in Form

N3

Fully-Specified Name

Component
I worry about getting infections 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 worry about getting infections
Source
N3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70449-4 I worry that I might get new symptoms of my illness

Observation ID in Form

Leu6

Fully-Specified Name

Component
I worry that I might get new symptoms of 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 worry that I might get new symptoms of my illness
Source
Leu6

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

70450-2 I feel isolated from others because of my illness or treatment

Observation ID in Form

Leu7

Fully-Specified Name

Component
I feel isolated from others because of my illness or treatment 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 isolated from others because of my illness or treatment
Source
Leu7

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

70319-9 I have emotional ups and downs

Observation ID in Form

BRM9

Fully-Specified Name

Component
I have emotional ups and downs 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 have emotional ups and downs
Source
BRM9

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70447-8 Because of my illness, I have difficulty planning for the future

Observation ID in Form

Leu4

Fully-Specified Name

Component
Because of my illness, I have difficulty planning for the future 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
Because of my illness, I have difficulty planning for the future
Source
Leu4

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

70518-6 Functional Assessment of Cancer Therapy for patients with melanoma questionnaire - version 4 (FACT-M) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Melanoma
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with melanoma questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70882-6 Additional concerns - FACT-M [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-M
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70453-6 I have pain at my melanoma site or surgical site

Observation ID in Form

M1

Fully-Specified Name

Component
I have pain at my melanoma site or surgical site 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 have pain at my melanoma site or surgical site
Source
M1

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

70462-7 I have noticed new changes in my skin (lumps, bumps, color)

Observation ID in Form

M2

Fully-Specified Name

Component
I have noticed new changes in my skin - lumps, bumps, color 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 have noticed new changes in my skin (lumps, bumps, color)
Source
M2

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

70463-5 I worry about the appearance of surgical scars

Observation ID in Form

M3

Fully-Specified Name

Component
I worry about the appearance of surgical scars 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 worry about the appearance of surgical scars
Source
M3

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

70305-8 I have been short of breath

Observation ID in Form

B1

Fully-Specified Name

Component
I have been short of breath in the past 7D
Property
Find
Time
7D
System
^Patient
Scale
Ord
Method

Basic Attributes

Class
SURVEY.GNHLTH
Type
Surveys
First Released
Version 2.40
Last Updated
Version 2.72
Change Reason
Release 2.72: SURVEY_QUEST_TEXT: Moved to Form Data table.; METHOD_TYP: Removed Method to increase usability.; Previous Releases: Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.

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
99357-6 COVID-19 health questions panel
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
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
98520-0 PROMIS item bank - dyspnea characteristics - version 1.0

70440-3 I have to limit my physical activity because of my condition

Observation ID in Form

ITU4

Fully-Specified Name

Component
I have to limit my physical activity because of my condition 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 have to limit my physical activity because of my condition
Source
ITU4

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70302-5 I get headaches

Observation ID in Form

An10

Fully-Specified Name

Component
I get headaches 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 headaches
Source
An10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70421-3 I have had fevers (episodes of high body temperature)

Observation ID in Form

Hep3

Fully-Specified Name

Component
I have had fevers - episodes of high body temperature - 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 have had fevers (episodes of high body temperature)
Source
Hep3

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

70345-4 I have swelling or cramps in my stomach

Observation ID in Form

C1

Fully-Specified Name

Component
I have swelling or cramps in my stomach area 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 have swelling or cramps in my stomach
Source
C1

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

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

70464-3 I have aches and pains in my bones

Observation ID in Form

M5

Fully-Specified Name

Component
I have aches and pains in my bones 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 have aches and pains in my bones
Source
M5

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

70465-0 I have noticed blood in my stool

Observation ID in Form

M6

Fully-Specified Name

Component
I have noticed blood in my stool 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 have noticed blood in my stool
Source
M6

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

70439-5 I have to limit my social activity because of my condition

Observation ID in Form

ITU3

Fully-Specified Name

Component
I have to limit my social activity because of my condition 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 have to limit my social activity because of my condition
Source
ITU3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70469-2 I feel overwhelmed by my condition

Observation ID in Form

MS8

Fully-Specified Name

Component
I feel overwhelmed by my condition 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 overwhelmed by my condition
Source
MS8

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

70466-8 I isolate myself from others because of my condition

Observation ID in Form

M8

Fully-Specified Name

Component
I isolate myself from others because of my condition 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 isolate myself from others because of my condition
Source
M8

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

70467-6 I have difficulty thinking clearly - remembering, concentrating

Observation ID in Form

M9

Fully-Specified Name

Component
I have difficulty thinking clearly - remembering, concentrating - 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 have difficulty thinking clearly - remembering, concentrating
Source
M9

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

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued 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 fatigued
Source
HI7

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
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

70454-4 I have swelling at my melanoma site

Observation ID in Form

M10

Fully-Specified Name

Component
I have swelling at my melanoma site 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 have swelling at my melanoma site
Source
M10

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

70455-1 I have swelling as a result of surgery

Observation ID in Form

M11

Fully-Specified Name

Component
I have swelling as a result of surgery 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 have swelling as a result of surgery
Source
M11

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

70456-9 I am bothered by the amount of swelling

Observation ID in Form

M12

Fully-Specified Name

Component
I am bothered by the amount of swelling 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 bothered by the amount of swelling
Source
M12

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

70457-7 Movement of my swollen area is painful

Observation ID in Form

M13

Fully-Specified Name

Component
Movement of my swollen area is painful 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
Movement of my swollen area is painful
Source
M13

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

70458-5 Swelling keeps me from doing the things I want to do

Observation ID in Form

M14

Fully-Specified Name

Component
Swelling keeps me from doing the things I want to do 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
Swelling keeps me from doing the things I want to do
Source
M14

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

70459-3 Swelling keeps me from wearing clothes or shoes I want to wear

Observation ID in Form

M15

Fully-Specified Name

Component
Swelling keeps me from wearing clothes or shoes I want to wear 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
Swelling keeps me from wearing clothes or shoes I want to wear
Source
M15

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

70460-1 I feel numbness at my surgical site

Observation ID in Form

M16

Fully-Specified Name

Component
I feel numbness at my surgical site 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 numbness at my surgical site
Source
M16

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

70461-9 I have good range of movement in my arm or leg

Observation ID in Form

M17

Fully-Specified Name

Component
I have good range of movement in my arm or leg 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 have good range of movement in my arm or leg
Source
M17

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

70519-4 Functional Assessment of Cancer Therapy for patient with multiple myeloma questionnaire - version 4 (FACT-MM) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patient with Multiple Myeloma
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patient with multiple myeloma questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70883-4 Additional concerns - FACT-MM [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-MM
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70481-7 I have certain parts of my body where I experience pain

Observation ID in Form

P2

Fully-Specified Name

Component
I have certain parts of my body where I experience pain 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 have certain parts of my body where I experience pain
Source
P2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70425-4 I feel weak all over

Observation ID in Form

HI12

Fully-Specified Name

Component
I feel weak all over 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 2.67
Change Reason
Release 2.67: SURVEY_QUEST_TEXT: Corrected the omission of "over" from Survey Question Text; Previous Releases: 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 weak all over
Source
HI12

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
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

70528-5 I get tired easily

Observation ID in Form

BMT6

Fully-Specified Name

Component
I get tired easily 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 tired easily
Source
BMT6

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70530-1 I have trouble concentrating

Observation ID in Form

HI8

Fully-Specified Name

Component
I have trouble concentrating 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 have trouble concentrating
Source
HI8

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70470-0 I worry about getting infections

Observation ID in Form

N3

Fully-Specified Name

Component
I worry about getting infections 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 worry about getting infections
Source
N3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70531-9 I feel discouraged about my illness

Observation ID in Form

Leu3

Fully-Specified Name

Component
I feel discouraged 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 feel discouraged about my illness
Source
Leu3

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

70447-8 Because of my illness, I have difficulty planning for the future

Observation ID in Form

Leu4

Fully-Specified Name

Component
Because of my illness, I have difficulty planning for the future 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
Because of my illness, I have difficulty planning for the future
Source
Leu4

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

70449-4 I worry that I might get new symptoms of my illness

Observation ID in Form

Leu6

Fully-Specified Name

Component
I worry that I might get new symptoms of 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 worry that I might get new symptoms of my illness
Source
Leu6

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

70319-9 I have emotional ups and downs

Observation ID in Form

BRM9

Fully-Specified Name

Component
I have emotional ups and downs 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 have emotional ups and downs
Source
BRM9

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70322-3 I have bone pain

Observation ID in Form

BP1

Fully-Specified Name

Component
I have bone pain 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 have bone pain
Source
BP1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70303-3 I need help doing my usual activities

Observation ID in Form

An14

Fully-Specified Name

Component
I need help doing my usual activities 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 need help doing my usual activities
Source
An14

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70468-4 I have trouble walking because of the pain

Observation ID in Form

MM1

Fully-Specified Name

Component
I have trouble walking because of the pain 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 have trouble walking because of the pain
Source
MM1

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

70426-2 I feel fatigued

Observation ID in Form

HI7

Fully-Specified Name

Component
I feel fatigued 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 fatigued
Source
HI7

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
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

70377-7 I have gained weight

Observation ID in Form

ES10

Fully-Specified Name

Component
I have gained weight 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 have gained weight
Source
ES10

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70520-2 Functional Assessment of Cancer Therapy for patients with nasopharyngeal cancer questionnaire - version 4 (FACT-NP) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Nasopharyngeal cancer
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with nasopharyngeal cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70884-2 Additional concerns - FACT-NP [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-NP
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70427-0 I am able to eat the foods that I like

Observation ID in Form

HN1

Fully-Specified Name

Component
I am able to eat the foods that I like 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 able to eat the foods that I like
Source
HN1

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

70431-2 My mouth is dry

Observation ID in Form

HN2

Fully-Specified Name

Component
My mouth is dry 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 mouth is dry
Source
HN2

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

70433-8 My voice has its usual quality and strength

Observation ID in Form

HN4

Fully-Specified Name

Component
My voice has its usual quality and strength 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 voice has its usual quality and strength
Source
HN4

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

70434-6 I am able to eat as much food as I want

Observation ID in Form

HN5

Fully-Specified Name

Component
I am able to eat as much food as I want 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 able to eat as much food as I want
Source
HN5

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

70436-1 I can swallow naturally and easily

Observation ID in Form

HN7

Fully-Specified Name

Component
I can swallow naturally and easily 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 can swallow naturally and easily
Source
HN7

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

70435-3 I am unhappy with how my face and neck look

Observation ID in Form

HN6

Fully-Specified Name

Component
I am unhappy with how my face and neck look 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 unhappy with how my face and neck look
Source
HN6

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

70428-8 I am able to communicate with others

Observation ID in Form

HN10

Fully-Specified Name

Component
I am able to communicate with others 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 able to communicate with others
Source
HN10

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

70429-6 I can eat solid food

Observation ID in Form

HN11

Fully-Specified Name

Component
I can eat solid foods 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 can eat solid food
Source
HN11

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

70430-4 I have pain in my mouth, throat or neck

Observation ID in Form

HN12

Fully-Specified Name

Component
I have pain in my mouth, throat or neck 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 have pain in my mouth, throat or neck
Source
HN12

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

70471-8 I have difficulty moving my neck and shoulders because of stiffness

Observation ID in Form

NP1

Fully-Specified Name

Component
I have difficulty moving my neck and shoulders because of stiffness 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 have difficulty moving my neck and shoulders because of stiffness
Source
NP1

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

70472-6 I am bothered by ringing in my ears

Observation ID in Form

NP2

Fully-Specified Name

Component
I am bothered by ringing in my ears 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 bothered by ringing in my ears
Source
NP2

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

70477-5 I have trouble hearing

Observation ID in Form

NTX6

Fully-Specified Name

Component
I have trouble hearing 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 have trouble hearing
Source
NTX6

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70473-4 I am bothered by worsening eyesight

Observation ID in Form

NP3

Fully-Specified Name

Component
I am bothered by worsening eyesight 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 bothered by worsening eyesight
Source
NP3

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

70474-2 I have trouble smelling

Observation ID in Form

NP4

Fully-Specified Name

Component
I have trouble smelling the in 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 have trouble smelling
Source
NP4

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

70475-9 I can enjoy the taste of food

Observation ID in Form

NP5

Fully-Specified Name

Component
I can enjoy the taste of food 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 can enjoy the taste of food
Source
NP5

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

70476-7 I am bothered by having a blocked nose

Observation ID in Form

NP6

Fully-Specified Name

Component
I am bothered by having a blocked nose 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 bothered by having a blocked nose
Source
NP6

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

70521-0 Functional Assessment of Cancer Therapy for patients with ovarian cancer questionnaire - version 4 (FACT-O) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Ovarian cancer
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with ovarian cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70885-9 Additional concerns - FACT-O [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-O
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70478-3 I have swelling in my stomach area

Observation ID in Form

O1

Fully-Specified Name

Component
I have swelling in my stomach area 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 have swelling in my stomach area
Source
O1

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight 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 losing weight
Source
C2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70347-0 I have control of my bowels

Observation ID in Form

C3

Fully-Specified Name

Component
I have control of my bowels 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 have control of my bowels
Source
C3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70479-1 I have been vomiting

Observation ID in Form

O2

Fully-Specified Name

Component
I have been vomiting 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 have been vomiting
Source
O2

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
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

70309-0 I am bothered by hair loss

Observation ID in Form

B5

Fully-Specified Name

Component
I am bothered by hair loss 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 bothered by hair loss
Source
B5

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
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

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

70351-2 I like the appearance of my body

Observation ID in Form

C7

Fully-Specified Name

Component
I like the appearance of my body 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 like the appearance of my body
Source
C7

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70320-7 I am able to get around by myself

Observation ID in Form

BMT5

Fully-Specified Name

Component
I am able to get around by myself 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 able to get around by myself
Source
BMT5

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
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

70313-2 I am able to feel like a woman

Observation ID in Form

B9

Fully-Specified Name

Component
I am able to feel like a woman 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 able to feel like a woman
Source
B9

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70480-9 I have cramps in my stomach area

Observation ID in Form

O3

Fully-Specified Name

Component
I have cramps in my stomach area 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 have cramps in my stomach area
Source
O3

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70317-3 I am interested in sex

Observation ID in Form

BL4

Fully-Specified Name

Component
I am interested in sex 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 interested in sex
Source
BL4

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
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

70321-5 I have concerns about my ability to have children

Observation ID in Form

BMT7

Fully-Specified Name

Component
I have concerns about my ability to have children 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 have concerns about my ability to have children
Source
BMT7

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

71433-7 Functional Assessment of Cancer Therapy for patients with prostate cancer questionnaire - version 4 (FACT-P) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Prostate cancer
Source: Regenstrief LOINC

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with prostate cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

71434-5 Additional concerns - FACT-P [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Prostate cancer
Source: Regenstrief LOINC

Fully-Specified Name

Component
Additional concerns - FACT-P
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70346-2 I am losing weight

Observation ID in Form

C2

Fully-Specified Name

Component
I am losing weight 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 losing weight
Source
C2

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
70673-9 Functional Assessment of Chronic Illness Therapy (FACIT) - Non cancer Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

71435-2 I have aches and pains that bother me

Observation ID in Form

P1

Fully-Specified Name

Component
I have aches and pains that bother me 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 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I have aches and pains that bother me
Source
P1

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

70481-7 I have certain parts of my body where I experience pain

Observation ID in Form

P2

Fully-Specified Name

Component
I have certain parts of my body where I experience pain 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 have certain parts of my body where I experience pain
Source
P2

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70558-2 My pain keeps me from doing things I want to do

Observation ID in Form

P3

Fully-Specified Name

Component
My pain keeps me from doing things I want to do 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 pain keeps me from doing things I want to do
Source
P3

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

71436-0 I am satisfied with my present level of comfort

Observation ID in Form

P4

Fully-Specified Name

Component
I am satisfied with my present level of comfort 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 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I am satisfied with my present level of comfort
Source
P4

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

71437-8 I am able to feel like a man

Observation ID in Form

P5

Fully-Specified Name

Component
I am able to feel like a man 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 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I am able to feel like a man
Source
P5

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

70567-3 I have trouble moving my bowels

Observation ID in Form

P6

Fully-Specified Name

Component
I have trouble moving my bowels 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 have trouble moving my bowels
Source
P6

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

70566-5 I have difficulty urinating

Observation ID in Form

P7

Fully-Specified Name

Component
I have difficulty urinating 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 have difficulty urinating
Source
P7

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

70315-7 I urinate more frequently than usual

Observation ID in Form

BL2

Fully-Specified Name

Component
I urinate more frequently than usual 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 urinate more frequently than usual
Source
BL2

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
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

70559-0 My problems with urinating limit my activities

Observation ID in Form

P8

Fully-Specified Name

Component
My problems with urinating limit my activities 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 problems with urinating limit my activities
Source
P8

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

71438-6 I am able to have and maintain an erection

Observation ID in Form

BL5

Fully-Specified Name

Component
I am able to have and maintain an erection 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 2.67
Change Reason
Updated the LOINC Answer list to LL5215-0. Previous Answer list had the correct Answer strings with incorrect Score values.
Order vs. Observation
Observation

Survey Question

Text
I am able to have and maintain an erection
Source
BL5

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

70522-8 Functional Assessment of Cancer Therapy for patients with vulva cancer questionnaire - version 4 (FACT-V) [FACIT]

Term Description

Functional Assessment of Cancer Therapy for patients with Vulva cancer
Source: Regenstrief LOINC

Form Coding Instructions

Please circle or mark one number per line to indicate your response as it applies to the past 7 days

Source: Functional Assessment of Chronic Illness Therapy

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with vulva cancer questionnaire - version 4
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70498-1 Physical well-being [FACIT]

Fully-Specified Name

Component
Physical well being
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

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

70405-6 I have a lack of energy

Observation ID in Form

GP1

Fully-Specified Name

Component
I have a lack of energy 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 have a lack of energy
Source
GP1

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

70406-4 I have nausea

Observation ID in Form

GP2

Fully-Specified Name

Component
I have nausea 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 have nausea
Source
GP2

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

70407-2 Because of my physical condition, I have trouble meeting the needs of my family

Observation ID in Form

GP3

Fully-Specified Name

Component
Because of my physical condition, I have trouble meeting the needs of 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
Because of my physical condition, I have trouble meeting the needs of my family
Source
GP3

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

70408-0 I have pain

Observation ID in Form

GP4

Fully-Specified Name

Component
I have pain 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 have pain
Source
GP4

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
70675-4 Functional Assessment of Chronic Illness Therapy (FACIT) - Pediatric 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

70409-8 I am bothered by side effects of treatment

Observation ID in Form

GP5

Fully-Specified Name

Component
I am bothered by side effects of treatment 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 bothered by side effects of treatment
Source
GP5

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

70410-6 I feel ill

Observation ID in Form

GP6

Fully-Specified Name

Component
I feel ill 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 ill
Source
GP6

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

70411-4 I am forced to spend time in bed

Observation ID in Form

GP7

Fully-Specified Name

Component
I am forced to spend time in bed 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 forced to spend time in bed
Source
GP7

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

70499-9 Social - family well-being [FACIT]

Fully-Specified Name

Component
Social - family well being
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

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

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

70500-4 Emotional well being [FACIT]

Fully-Specified Name

Component
Emotional well being
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

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

70392-6 I feel sad

Observation ID in Form

GE1

Fully-Specified Name

Component
I feel sad 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 sad
Source
GE1

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

70393-4 I am satisfied with how I am coping with my illness

Observation ID in Form

GE2

Fully-Specified Name

Component
I am satisfied with how I am coping with 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 how I am coping with my illness
Source
GE2

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

70394-2 I am losing hope in the fight against my illness

Observation ID in Form

GE3

Fully-Specified Name

Component
I am losing hope in the fight against 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 losing hope in the fight against my illness
Source
GE3

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

70395-9 I am nervous

Observation ID in Form

GE4

Fully-Specified Name

Component
I feel nervous 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 nervous
Source
GE4

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

70396-7 I worry about dying

Observation ID in Form

GE5

Fully-Specified Name

Component
I worry about dying 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 worry about dying
Source
GE5

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

70397-5 I worry that my condition will get worse

Observation ID in Form

GE6

Fully-Specified Name

Component
I worry that my condition will get worse 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 worry that my condition will get worse
Source
GE6

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

70501-2 Functional well-being [FACIT]

Fully-Specified Name

Component
Functional well being
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

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

70398-3 I am able to work (include work at home)

Observation ID in Form

GF1

Fully-Specified Name

Component
I am able to work - include work at home - 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 able to work (include work at home)
Source
GF1

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

70399-1 My work (include work at home) is fulfilling

Observation ID in Form

GF2

Fully-Specified Name

Component
My work - include work at home - is fulfilling 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 work (include work at home) is fulfilling
Source
GF2

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

70400-7 I am able to enjoy life

Observation ID in Form

GF3

Fully-Specified Name

Component
I am able to enjoy 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 able to enjoy life
Source
GF3

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

70401-5 I have accepted my illness

Observation ID in Form

GF4

Fully-Specified Name

Component
I have 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
I have accepted my illness
Source
GF4

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

70402-3 I am sleeping well

Observation ID in Form

GF5

Fully-Specified Name

Component
I am sleeping well 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 sleeping well
Source
GF5

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

70403-1 I am enjoying the things I usually do for fun

Observation ID in Form

GF6

Fully-Specified Name

Component
I am enjoying the things I usually do for fun 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 enjoying the things I usually do for fun
Source
GF6

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

70404-9 I am content with the quality of my life right now

Observation ID in Form

GF7

Fully-Specified Name

Component
I am content with the quality of my life right now 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 content with the quality of my life right now
Source
GF7

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

70886-7 Additional concerns - FACT-V [FACIT]

Fully-Specified Name

Component
Additional concerns - FACT-V
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

Member of these Panels

LOINC Long Common Name
70505-3 Functional Assessment of Chronic Illness Therapy (FACIT) - Cancer Specific Measures Panel

70486-6 I am bothered by discharge or bleeding from my vulva

Observation ID in Form

V1

Fully-Specified Name

Component
I am bothered by discharge or bleeding from my vulva 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 bothered by discharge or bleeding from my vulva
Source
V1

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

70487-4 I am bothered by odor coming from my vulva

Observation ID in Form

V2

Fully-Specified Name

Component
I am bothered by odor coming from my vulva 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 bothered by odor coming from my vulva
Source
V2

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

70362-9 I am afraid to have sex

Observation ID in Form

Cx3

Fully-Specified Name

Component
I am afraid to have sex 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 afraid to have sex
Source
Cx3

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

70488-2 I am bothered by swelling (fluid in my legs)

Observation ID in Form

V3

Fully-Specified Name

Component
I am bothered by swelling, fluid in my legs, 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 bothered by swelling (fluid in my legs)
Source
V3

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

70363-7 My vagina feels too narrow or short

Observation ID in Form

Cx4

Fully-Specified Name

Component
My vagina feels too narrow or short 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 vagina feels too narrow or short
Source
Cx4

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

70489-0 I am bothered by discomfort in my groin or legs

Observation ID in Form

V4

Fully-Specified Name

Component
I am bothered by discomfort in my groin or legs 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 bothered by discomfort in my groin or legs
Source
V4

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

70364-5 I am afraid the treatment will harm my body

Observation ID in Form

Cx5

Fully-Specified Name

Component
I am afraid the treatment will harm my body 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 afraid the treatment will harm my body
Source
Cx5

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

70317-3 I am interested in sex

Observation ID in Form

BL4

Fully-Specified Name

Component
I am interested in sex 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 interested in sex
Source
BL4

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
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

70351-2 I like the appearance of my body

Observation ID in Form

C7

Fully-Specified Name

Component
I like the appearance of my body 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 like the appearance of my body
Source
C7

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
70672-1 Functional Assessment of Chronic Illness Therapy (FACIT) - Treatment Specific Measures Panel

70365-2 I am bothered by constipation

Observation ID in Form

Cx6

Fully-Specified Name

Component
I am bothered by constipation 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 bothered by constipation
Source
Cx6

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
70674-7 Functional Assessment of Chronic Illness Therapy (FACIT) - Symptom Specific Measures Panel

70350-4 I have a good appetite

Observation ID in Form

C6

Fully-Specified Name

Component
I have a good appetite 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 have a good appetite
Source
C6

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
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

70314-0 I have trouble controlling my urine

Observation ID in Form

BL1

Fully-Specified Name

Component
I have trouble controlling my urine 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 have trouble controlling my urine
Source
BL1

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
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

70490-8 I am bothered by itching/burning in my vulva area

Observation ID in Form

V5

Fully-Specified Name

Component
I am bothered by itching - burning in my vulva area 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 bothered by itching/burning in my vulva area
Source
V5

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

70366-0 I have discomfort when I urinate

Observation ID in Form

Cx7

Fully-Specified Name

Component
I have discomfort when I urinate 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 have discomfort when I urinate
Source
Cx7

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

70491-6 I am bothered by pain or numbness in my vulva area

Observation ID in Form

V6

Fully-Specified Name

Component
I am bothered by pain or numbness in my vulva area 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 bothered by pain or numbness in my vulva area
Source
V6

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

70492-4 I have trouble bending

Observation ID in Form

V7

Fully-Specified Name

Component
I have trouble bending 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 have trouble bending
Source
V7

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

70493-2 I have discomfort when I'm sitting

Observation ID in Form

V8

Fully-Specified Name

Component
I have discomfort when I'm sitting 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 have discomfort when I'm sitting
Source
V8

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

70494-0 I am bothered by wearing compression stockings

Observation ID in Form

V9

Fully-Specified Name

Component
I am bothered by wearing compression stockings 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 bothered by wearing compression stockings
Source
V9

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

70427-0 I am able to eat the foods that I like

Observation ID in Form

HN1

Fully-Specified Name

Component
I am able to eat the foods that I like 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 able to eat the foods that I like
Source
HN1

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