75743-5
Dartmouth COOP Functional Assessment Charts - 4 weeks
Active
75809-4 During the past 4 weeks, what was the hardest physical activity you could do for at least 2 minutes?
Reference Information
| Type | Source | Reference |
|---|---|---|
| Image | Dartmouth College/COOP ProjectCopyright Copyright © 2009 Trustees of Dartmouth College/COOP Project. | COOP Charts - Physical Fitness
 |
Fully-Specified Name
- Component
- During the past 4Ws, what was the hardest physical activity you could do for at least 2 minutes
- Property
- Score
- Time
- 4W
- System
- ^Patient
- Scale
- Ord
- Method
- COOP
Long Common Name
During the past 4 weeks, what was the hardest physical activity you could do for at least 2 minutes [COOP]
Basic Attributes
- Class
- SURVEY.COOP
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.54 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3081-8
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - Very heavy For example: -Run fast pace -Carry a heavy load upstairs or uphill (25 pounds or 10 kilograms) | 1 | LA21609-5 | |
| 2 - Very heavy For example: -Run fast pace -Carry a heavy load upstairs or uphill (25 pounds or 10 kilograms) | 2 | LA21721-8 | |
| 3 - Heavy For example: -Jog, slow pace -Climb stairs or a hill at moderate pace | 3 | LA21610-3 | |
| 4 - Heavy For example: -Jog, slow pace -Climb stairs or a hill at moderate pace | 4 | LA21722-6 | |
| 5 - Moderate For example: -Walk, medium pace -Carry a heavy load on level ground (25 pounds or 10 kilograms) | 5 | LA21614-5 | |
| 6 - Moderate For example: -Walk, medium pace -Carry a heavy load on level ground (25 pounds or 10 kilograms) | 6 | LA21725-9 | |
| 7 - Light For example: -Walk, medium pace -Carry a light load on level ground | 7 | LA21615-2 | |
| 8 - Light For example: -Walk, medium pace -Carry a light load on level ground | 8 | LA21723-4 | |
| 9 - Very light For example: -Walk, slow pace -Wash dishes | 9 | LA21720-0 | |
| 10 - Very light For example: -Walk, slow pace -Wash dishes | 10 | LA21613-7 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
Member of these Groups Get Info
| LOINC Group | Group Name |
|---|---|
| LG41761-4 | Exercise/Activity |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- Dartmouth College/COOP Project
- Copyright
- Copyright © 2009 Trustees of Dartmouth College/COOP Project.
- Terms of Use
- Used with permission.
- URL
- https://geiselmed.dartmouth.edu/dcpbrn/
75808-6 During the past 4 weeks, how much have you been bothered by emotional problems such as feeling anxious, depressed, irritable or downhearted and blue?
Reference Information
| Type | Source | Reference |
|---|---|---|
| Image | Dartmouth College/COOP ProjectCopyright Copyright © 2009 Trustees of Dartmouth College/COOP Project. | COOP Charts - Feelings
 |
Fully-Specified Name
- Component
- During the past 4Ws, how much have you been bothered by emotional problems such as feeling anxious, depressed, irritable or downhearted and blue
- Property
- Score
- Time
- 4W
- System
- ^Patient
- Scale
- Ord
- Method
- COOP
Long Common Name
During the past 4 weeks, how much have you been bothered by emotional problems such as feeling anxious, depressed, irritable or downhearted and blue [COOP]
Basic Attributes
- Class
- SURVEY.COOP
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.54 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3083-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - Not at all | 1 | LA16643-1 | |
| 2 - Not at all | 2 | LA21710-1 | |
| 3 - Slightly | 3 | LA21622-8 | |
| 4 - Slightly | 4 | LA21727-5 | |
| 5 - Moderately | 5 | LA21623-6 | |
| 6 - Moderately | 6 | LA21728-3 | |
| 7 - Quite a bit | 7 | LA21624-4 | |
| 8 - Quite a bit | 8 | LA21729-1 | |
| 9 - Extremely | 9 | LA21718-4 | |
| 10 - Extremely | 10 | LA21625-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- Dartmouth College/COOP Project
- Copyright
- Copyright © 2009 Trustees of Dartmouth College/COOP Project.
- Terms of Use
- Used with permission.
- URL
- https://geiselmed.dartmouth.edu/dcpbrn/
75807-8 During the past 4 weeks, how much difficulty have you had doing your usual activities or tasks, both inside and outside the house because of your physical and emotional health?
Reference Information
| Type | Source | Reference |
|---|---|---|
| Image | Dartmouth College/COOP ProjectCopyright Copyright © 2009 Trustees of Dartmouth College/COOP Project. | COOP Charts - Daily Activities
 |
Fully-Specified Name
- Component
- During the past 4Ws, how much difficulty have you had doing your usual activities or tasks, both inside and outside the house because of your physical and emotional health
- Property
- Score
- Time
- 4W
- System
- ^Patient
- Scale
- Ord
- Method
- COOP
Long Common Name
During the past 4 weeks, how much difficulty have you had doing your usual activities or tasks, both inside and outside the house because of your physical and emotional health [COOP]
Basic Attributes
- Class
- SURVEY.COOP
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.54 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3085-9
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - No difficulty at all | 1 | LA21616-0 | |
| 2 - No difficulty at all | 2 | LA21711-9 | |
| 3 - A little bit of difficulty | 3 | LA21617-8 | |
| 4 - A little bit of difficulty | 4 | LA21730-9 | |
| 5 - Some difficulty | 5 | LA21618-6 | |
| 6 - Some difficulty | 6 | LA21726-7 | |
| 7 - Much difficulty | 7 | LA21619-4 | |
| 8 - Much difficulty | 8 | LA21733-3 | |
| 9 - Could not do | 9 | LA21719-2 | |
| 10 - Could not do | 10 | LA21620-2 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- Dartmouth College/COOP Project
- Copyright
- Copyright © 2009 Trustees of Dartmouth College/COOP Project.
- Terms of Use
- Used with permission.
- URL
- https://geiselmed.dartmouth.edu/dcpbrn/
75806-0 During the past 4 weeks, has your physical and emotional health limited your social activities with family, friends, neighbors or groups?
Reference Information
| Type | Source | Reference |
|---|---|---|
| Image | Dartmouth College/COOP ProjectCopyright Copyright © 2009 Trustees of Dartmouth College/COOP Project. | COOP Charts - Social Activities
 |
Fully-Specified Name
- Component
- During the past 4Ws, has your physical and emotional health limited your social activities with family, friends, neighbors or groups
- Property
- Score
- Time
- 4W
- System
- ^Patient
- Scale
- Ord
- Method
- COOP
Long Common Name
During the past 4 weeks, has your physical and emotional health limited your social activities with family, friends, neighbors or groups [COOP]
Basic Attributes
- Class
- SURVEY.COOP
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.54 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3083-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - Not at all | 1 | LA16643-1 | |
| 2 - Not at all | 2 | LA21710-1 | |
| 3 - Slightly | 3 | LA21622-8 | |
| 4 - Slightly | 4 | LA21727-5 | |
| 5 - Moderately | 5 | LA21623-6 | |
| 6 - Moderately | 6 | LA21728-3 | |
| 7 - Quite a bit | 7 | LA21624-4 | |
| 8 - Quite a bit | 8 | LA21729-1 | |
| 9 - Extremely | 9 | LA21718-4 | |
| 10 - Extremely | 10 | LA21625-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- Dartmouth College/COOP Project
- Copyright
- Copyright © 2009 Trustees of Dartmouth College/COOP Project.
- Terms of Use
- Used with permission.
- URL
- https://geiselmed.dartmouth.edu/dcpbrn/
75805-2 During the past 4 weeks, how much bodily pain have you generally had?
Reference Information
| Type | Source | Reference |
|---|---|---|
| Image | Dartmouth College/COOP ProjectCopyright Copyright © 2009 Trustees of Dartmouth College/COOP Project. | COOP Charts - Pain
 |
Fully-Specified Name
- Component
- During the past 4Ws, how much bodily pain have you generally had
- Property
- Score
- Time
- 4W
- System
- ^Patient
- Scale
- Ord
- Method
- COOP
Long Common Name
During the past 4 weeks, how much bodily pain have you generally had [COOP]
Basic Attributes
- Class
- SURVEY.COOP
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.54 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3086-7
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - No pain | 1 | LA21626-9 | |
| 2 - No pain | 2 | LA21709-3 | |
| 3 - Very mild pain | 3 | LA21627-7 | |
| 4 - Very mild pain | 4 | LA21724-2 | |
| 5 - Mild pain | 5 | LA21628-5 | |
| 6 - Mild pain | 6 | LA21732-5 | |
| 7 - Moderate pain | 7 | LA21629-3 | |
| 8 - Moderate pain | 8 | LA21731-7 | |
| 9 - Severe pain | 9 | LA21717-6 | |
| 10 - Severe pain | 10 | LA21630-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- Dartmouth College/COOP Project
- Copyright
- Copyright © 2009 Trustees of Dartmouth College/COOP Project.
- Terms of Use
- Used with permission.
- URL
- https://geiselmed.dartmouth.edu/dcpbrn/
75804-5 How would you rate your overall health now compared to 4 weeks ago?
Reference Information
| Type | Source | Reference |
|---|---|---|
| Image | Dartmouth College/COOP ProjectCopyright Copyright © 2009 Trustees of Dartmouth College/COOP Project. | COOP Charts - Change In Health
 |
Fully-Specified Name
- Component
- How would you rate your overall health now compared to 4Ws ago
- Property
- Score
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- COOP
Long Common Name
How would you rate your overall health now compared to 4 weeks ago [COOP]
Basic Attributes
- Class
- SURVEY.COOP
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.54 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3089-1
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - Excellent | 1 | LA21636-8 | |
| 2 - Excellent | 2 | LA21707-7 | |
| 3 - Very good | 3 | LA21637-6 | |
| 4 - Very good | 4 | LA21737-4 | |
| 5 - Good | 5 | LA21638-4 | |
| 6 - Good | 6 | LA21738-2 | |
| 7 - Fair | 7 | LA21639-2 | |
| 8 - Fair | 8 | LA21739-0 | |
| 9 - Poor | 9 | LA21715-0 | |
| 10 - Poor | 10 | LA21640-0 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- Dartmouth College/COOP Project
- Copyright
- Copyright © 2009 Trustees of Dartmouth College/COOP Project.
- Terms of Use
- Used with permission.
- URL
- https://geiselmed.dartmouth.edu/dcpbrn/
75803-7 During the past 4 weeks, how would you rate your health in general?
Reference Information
| Type | Source | Reference |
|---|---|---|
| Image | Dartmouth College/COOP ProjectCopyright Copyright © 2009 Trustees of Dartmouth College/COOP Project. | COOP Charts - Overall Health
 |
Fully-Specified Name
- Component
- During the past 4Ws, how would you rate your health in general
- Property
- Score
- Time
- 4W
- System
- ^Patient
- Scale
- Ord
- Method
- COOP
Long Common Name
During the past 4 weeks, how would you rate your health in general [COOP]
Basic Attributes
- Class
- SURVEY.COOP
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.73 (MIN)
- Order vs. Observation
- Observation
- Common Test Rank Get Info
- 1074
Preferred Answer List LL3089-1
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - Excellent | 1 | LA21636-8 | |
| 2 - Excellent | 2 | LA21707-7 | |
| 3 - Very good | 3 | LA21637-6 | |
| 4 - Very good | 4 | LA21737-4 | |
| 5 - Good | 5 | LA21638-4 | |
| 6 - Good | 6 | LA21738-2 | |
| 7 - Fair | 7 | LA21639-2 | |
| 8 - Fair | 8 | LA21739-0 | |
| 9 - Poor | 9 | LA21715-0 | |
| 10 - Poor | 10 | LA21640-0 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- Dartmouth College/COOP Project
- Copyright
- Copyright © 2009 Trustees of Dartmouth College/COOP Project.
- Terms of Use
- Used with permission.
- URL
- https://geiselmed.dartmouth.edu/dcpbrn/
75802-9 During the past 4 weeks, was someone available to help you if you needed and wanted help?
Reference Information
| Type | Source | Reference |
|---|---|---|
| Image | Dartmouth College/COOP ProjectCopyright Copyright © 2009 Trustees of Dartmouth College/COOP Project. | COOP Charts - Social Support
 |
Fully-Specified Name
- Component
- During the past 4Ws, was someone available to help you if you needed and wanted help
- Property
- Score
- Time
- 4W
- System
- ^Patient
- Scale
- Ord
- Method
- COOP
Long Common Name
During the past 4 weeks, was someone available to help you if you needed and wanted help [COOP]
Basic Attributes
- Class
- SURVEY.COOP
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.54 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3090-9
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - Yes, as much as I wanted | 1 | LA21641-8 | |
| 2 - Yes, as much as I wanted | 2 | LA21706-9 | |
| 3 - Yes, quite a bit | 3 | LA21642-6 | |
| 4 - Yes, quite a bit | 4 | LA21740-8 | |
| 5 - Yes, some | 5 | LA21643-4 | |
| 6 - Yes, some | 6 | LA21741-6 | |
| 7 - Yes, a little | 7 | LA21644-2 | |
| 8 - Yes, a little | 8 | LA21742-4 | |
| 9 - No, not at all | 9 | LA21714-3 | |
| 10 - No, not at all | 10 | LA21645-9 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
Member of these Groups Get Info
| LOINC Group | Group Name |
|---|---|
| LG51306-5 | SDOH |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- Dartmouth College/COOP Project
- Copyright
- Copyright © 2009 Trustees of Dartmouth College/COOP Project.
- Terms of Use
- Used with permission.
- URL
- https://geiselmed.dartmouth.edu/dcpbrn/
75801-1 How have things been going for you during the past 2 weeks?
Reference Information
| Type | Source | Reference |
|---|---|---|
| Image | Dartmouth College/COOP ProjectCopyright Copyright © 2009 Trustees of Dartmouth College/COOP Project. | COOP Charts - Quality Of Life
 |
Fully-Specified Name
- Component
- How have things been going for you during the past 4Ws
- Property
- Score
- Time
- 4W
- System
- ^Patient
- Scale
- Ord
- Method
- COOP
Long Common Name
How have things been going for you during the past 4 weeks [COOP]
Basic Attributes
- Class
- SURVEY.COOP
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.54 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3091-7
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 - Very well: could hardly be better | 1 | LA21646-7 | |
| 2 - Very well: could hardly be better | 2 | LA21705-1 | |
| 3 - Pretty good | 3 | LA21647-5 | |
| 4 - Pretty good | 4 | LA21743-2 | |
| 5 - Good & bad parts about equal | 5 | LA21648-3 | |
| 6 - Good & bad parts about equal | 6 | LA21744-0 | |
| 7 - Pretty bad | 7 | LA21649-1 | |
| 8 - Pretty bad | 8 | LA21745-7 | |
| 9 - Very bad: could hardly be worse | 9 | LA21713-5 | |
| 10 - Very bad: could hardly be worse | 10 | LA21650-9 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- Dartmouth College/COOP Project
- Copyright
- Copyright © 2009 Trustees of Dartmouth College/COOP Project.
- Terms of Use
- Used with permission.
- URL
- https://geiselmed.dartmouth.edu/dcpbrn/
75810-2 Total score [COOP]
Term Description
The developers of the COOP instruments do not recommend a summative score. Typically, the patient's answers, or scores, for each Chart are simply recorded as-is in the patient's medical record; no scoring algorithm or computing is necessary.
Fully-Specified Name
- Component
- Total score
- Property
- Score
- Time
- Pt
- System
- ^Patient
- Scale
- Qn
- Method
- COOP
Basic Attributes
- Class
- SURVEY.COOP
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.58 (MIN)
- Order vs. Observation
- Both
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 75743-5 | Dartmouth COOP Functional Assessment Charts - 4 weeks |
Example Units
| Unit | Source |
|---|---|
| {score} | Example UCUM Units |
Copyright
- Organization
- Dartmouth College/COOP Project
- Copyright
- Copyright © 2009 Trustees of Dartmouth College/COOP Project.
- Terms of Use
- Used with permission.
- URL
- https://geiselmed.dartmouth.edu/dcpbrn/