Version 2.78

Term Description

For patients with Neurotoxicity - 12 items
Source: Regenstrief LOINC

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
70633-3 Functional Assessment of Cancer Therapy for patients with neurotoxicity questionnaire - 12 items - version 4 (FACT-GOG-NTX 12) [FACIT]
Indent70498-1 Physical well-being [FACIT]
IndentIndent70405-6 I have a lack of energy
IndentIndent70406-4 I have nausea
IndentIndent70407-2 Because of my physical condition, I have trouble meeting the needs of my family
IndentIndent70408-0 I have pain
IndentIndent70409-8 I am bothered by side effects of treatment
IndentIndent70410-6 I feel ill
IndentIndent70411-4 I am forced to spend time in bed
Indent70499-9 Social - family well-being [FACIT]
IndentIndent70412-2 I feel close to my friends
IndentIndent70413-0 I get emotional support from my family
IndentIndent70414-8 I get support from my friends
IndentIndent70415-5 My family has accepted my illness
IndentIndent70416-3 I am satisfied with family communication about my illness
IndentIndent70417-1 I felt close to my partner, or the person who is my main support
IndentIndent70914-7 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.
IndentIndent70418-9 I am satisfied with my sex life
Indent70500-4 Emotional well being [FACIT]
IndentIndent70392-6 I feel sad
IndentIndent70393-4 I am satisfied with how I am coping with my illness
IndentIndent70394-2 I am losing hope in the fight against my illness
IndentIndent70395-9 I am nervous
IndentIndent70396-7 I worry about dying
IndentIndent70397-5 I worry that my condition will get worse
Indent70501-2 Functional well-being [FACIT]
IndentIndent70398-3 I am able to work (include work at home)
IndentIndent70399-1 My work (include work at home) is fulfilling
IndentIndent70400-7 I am able to enjoy life
IndentIndent70401-5 I have accepted my illness
IndentIndent70402-3 I am sleeping well
IndentIndent70403-1 I am enjoying the things I usually do for fun
IndentIndent70404-9 I am content with the quality of my life right now
Indent70888-3 Additional concerns - FACT-GOG-NTX-12 [FACIT]
IndentIndent70562-4 I have numbness or tingling in my hands
IndentIndent70625-9 I have numbness or tingling in my feet
IndentIndent70626-7 I feel discomfort in my hands
IndentIndent70627-5 I feel discomfort in my feet
IndentIndent70628-3 I have joint pain or muscle cramps
IndentIndent70425-4 I feel weak all over
IndentIndent70477-5 I have trouble hearing
IndentIndent70629-1 I get a ringing or buzzing in my ears
IndentIndent70630-9 I have trouble buttoning buttons
IndentIndent70631-7 I have trouble feeling the shape of small objects when they are in my hand
IndentIndent70632-5 I have trouble walking
IndentIndent70563-2 I have pain in my hands or feet when I am exposed to cold temperatures

Fully-Specified Name

Component
Functional assessment of cancer therapy for patients with neurotoxicity questionnaire - 12 items - 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 2.68
Panel Type
Panel

Member of these Panels

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

LOINC Terminology Service (API) using HL7® FHIR® Get Info

CodeSystem lookup
https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=70633-3