Spouse
Item
Spouse
boolean
C0162409 (UMLS CUI [1])
Partner/Companion
Item
Partner/Companion
boolean
C0682323 (UMLS CUI [1])
Housemate/Roomate
Item
Housemate/Roommate
boolean
C3829617 (UMLS CUI [1])
C0682338 (UMLS CUI [2])
Friend
Item
Friend
boolean
C0079382 (UMLS CUI [1])
Neighbor
Item
Neighbor
boolean
C1553702 (UMLS CUI [1])
Parent/Child/Other relative
Item
Parent/Child/Other relative
boolean
C0030551 (UMLS CUI [1])
C0008059 (UMLS CUI [2])
C3174795 (UMLS CUI [3])
Other
Item
Other
boolean
C0205394 (UMLS CUI [1])
Other
Item
Other: please describe
text
C0205394 (UMLS CUI [1,1])
C0678257 (UMLS CUI [1,2])
Living with significant other
Item
2. Do you currently live with this person?
boolean
C2135569 (UMLS CUI [1])
current pain level
Item
1.Rate the level of your pain at the present moment. Scale: 0 (no pain) to 6 (very intense pain)
integer
C0518087 (UMLS CUI [1,1])
C0521116 (UMLS CUI [1,2])
pain interference daily activities
Item
2. In general, how much does your pain problem interfere with your day to day activities? Scale: 0 (no interference) to 6 (extreme interference)
integer
C0001288 (UMLS CUI [1,1])
C0030193 (UMLS CUI [1,2])
C0518214 (UMLS CUI [1,3])
pain ability to work
Item
3. Since the time you developed a pain problem, how much has your pain changed your ability to work? Scale: 0 (No change) to 6 (extreme change)
integer
C4274891 (UMLS CUI [1,1])
C0030193 (UMLS CUI [1,2])
Retired for other reasons
Item
3. Check here, if you have retired for reasons other than your pain problem
boolean
C3840932 (UMLS CUI [1,1])
C0035345 (UMLS CUI [1,2])
pain quality of life
Item
4. How much has your pain changed the amount of satisfaction or enjoyment you get from participating in social and recreational activities? Scale: 0 (no change) to 6 (extreme change)
integer
C0030193 (UMLS CUI [1,1])
C0518214 (UMLS CUI [1,2])
Support significant other
Item
5. How supportive or helpful is your spouse (significant other) to you in relation to your pain? Scale: 0 (not at all supportive) to 6 (extremely supportive)
integer
C1521721 (UMLS CUI [1,1])
C0682323 (UMLS CUI [1,2])
C0030193 (UMLS CUI [1,3])
Overall mood past week
Item
6. Rate your overall mood during the PAST WEEK. Scale: 0 (extremely low mood) to 6 (extremely high mood)
integer
C0026516 (UMLS CUI [1,1])
C2987125 (UMLS CUI [1,2])
Pain severity past week
Item
7. On the average, how severe has your pain been during the LAST WEEK? Scale: 0 (not at all severe) to 6 (extremely severe)
integer
C1507013 (UMLS CUI [1,1])
C2987125 (UMLS CUI [1,2])
pain participation activities
Item
8. How much has your pain changed your ability to participate in recreational and other social activities? Scale: 0 (no change) to 6 (extreme change)
integer
C0030193 (UMLS CUI [1,1])
C0577451 (UMLS CUI [1,2])
pain satisfaction family-related activities
Item
9. How much has your pain changed the amount of satisfaction you get from family-related activities? Scale: 0 (no change) to 6 (extreme change)
integer
C0023292 (UMLS CUI [1,1])
C0015576 (UMLS CUI [1,2])
C0030193 (UMLS CUI [1,3])
C0242428 (UMLS CUI [1,4])
significant other worry pain
Item
10. How worried is your spouse (significant other) about you in relation to your pain problem? Scale: 0 (not at all worried) to 6 (extremely worried)
integer
C0682323 (UMLS CUI [1,1])
C0233481 (UMLS CUI [1,2])
C0030193 (UMLS CUI [1,3])
past week control over life
Item
11. During the PAST WEEK, how much control do you feel that you have had over your life? Scale: 0 (not at all in control) to 6 (extremely in control)
integer
C2587213 (UMLS CUI [1,1])
C0376558 (UMLS CUI [1,2])
C2987125 (UMLS CUI [1,3])
suffering pain
Item
12. How much SUFFERING do you experience because of your pain? Scale: 0 (no suffering) to 6 (extreme suffering)
integer
C0030193 (UMLS CUI [1,1])
C0518881 (UMLS CUI [1,2])
pain change relationships
Item
13. How much has your pain changed your marriage and other family relationships? Scale: 0 (no change) to 6 (extreme change)
integer
C0030193 (UMLS CUI [1,1])
C0021797 (UMLS CUI [1,2])
pain satisfaction enjoyment work
Item
14. How much has your pain changed the amount of satisfaction or enjoyment you get from work? Scale: 0 (no change) to 6 (extreme change)
integer
C0030193 (UMLS CUI [1,1])
C0022397 (UMLS CUI [1,2])
not presently working
Item
14. Check here, if you are not presently working.
boolean
C0041674 (UMLS CUI [1])
spouse attentive pain
Item
15. How attentive is your spouse (significant other) to your pain problem? Scale: 0 (not at all attentive) to 6 (extremely attentive)
integer
C0233413 (UMLS CUI [1,1])
C0682323 (UMLS CUI [1,2])
C0030193 (UMLS CUI [1,3])
past week ability to deal with problems
Item
16. During the PAST WEEK, how much do you feel that you’ve been able to deal with your problems? Scale: 0 (not at all) to 6 (extremely well)
integer
C0577645 (UMLS CUI [1,1])
C2987125 (UMLS CUI [1,2])
C0009967 (UMLS CUI [1,3])
pain ability household chores
Item
17. How much has your pain changed your ability to do household chores? Scale: 0 (no change) to 6 (extreme change)
integer
C0030193 (UMLS CUI [1,1])
C4288408 (UMLS CUI [1,2])
past week irritability
Item
18. During the PAST WEEK, how irritable have you been? Scale: 0 (not at all irritable) to 6 (extremely irritable)
integer
C0022107 (UMLS CUI [1,1])
C2987125 (UMLS CUI [1,2])
pain interference with friendships
Item
19. How much has your pain changed your friendships with people other than your family? Scale: 0 (no change) to 6 (extreme change)
integer
C0030193 (UMLS CUI [1,1])
C0815198 (UMLS CUI [1,2])
C0392747 (UMLS CUI [1,3])
past week tense anxiety
Item
20. During the PAST WEEK, how tense or anxious have you been? Scale: 0 (not at all tense or anxious) to 6 (extremely tense or anxious)
integer
C3641757 (UMLS CUI [1,1])
C2987125 (UMLS CUI [1,2])
C0003467 (UMLS CUI [2,1])
C2987125 (UMLS CUI [2,2])
Ignoring
Item
1. Ignores me.
integer
C1554079 (UMLS CUI [1])
Supportive
Item
2. Asks me what he/she can do to help.
integer
C0018896 (UMLS CUI [1])
Reading
Item
3. Reads to me.
integer
C0237429 (UMLS CUI [1])
Irritated
Item
4. Expresses irritation at me.
integer
C2700617 (UMLS CUI [1,1])
C0009452 (UMLS CUI [1,2])
Helping
Item
5. Takes over my jobs or duties.
integer
C0018896 (UMLS CUI [1])
distracting
Item
6. Talks to me about something else to take my mind off the pain.
integer
C4060717 (UMLS CUI [1])
Frustration
Item
7. Expresses frustration at me.
integer
C0016770 (UMLS CUI [1,1])
C0009452 (UMLS CUI [1,2])
Encourage resting
Item
8. Tries to get me to rest.
integer
C0035253 (UMLS CUI [1,1])
C0870494 (UMLS CUI [1,2])
Distracting
Item
9. Tries to involve me in some activity.
integer
C4060717 (UMLS CUI [1])
Angry
Item
10. Expresses anger at me.
integer
C0002957 (UMLS CUI [1,1])
C0009452 (UMLS CUI [1,2])
Pain medication
Item
11. Gets me some pain medications.
integer
C0002771 (UMLS CUI [1])
Encourage leisure activity
Item
12. Encourages me to work on a hobby.
integer
C0023292 (UMLS CUI [1,1])
C0037438 (UMLS CUI [1,2])
Bring food drinks
Item
13. Gets me something to eat or drink.
integer
C0013470 (UMLS CUI [1])
C0684271 (UMLS CUI [2])
Television distraction
Item
14. Turns on the T.V. to take my mind off my pain
integer
C0871498 (UMLS CUI [1,1])
C4060717 (UMLS CUI [1,2])
washing dishes
Item
1. Wash dishes.
integer
C4050473 (UMLS CUI [1])
mowing lawn
Item
2. Mow the lawn.
integer
C2986650 (UMLS CUI [1])
eating out
Item
3. Go out to eat.
integer
C4289683 (UMLS CUI [1])
playing games
Item
4. Play cards or other games.
integer
C0032214 (UMLS CUI [1,1])
C4042911 (UMLS CUI [1,2])
grocery shopping
Item
5. Go grocery shopping.
integer
C0518517 (UMLS CUI [1])
gardening
Item
6. Work in the garden.
integer
C0868963 (UMLS CUI [1])
go to cinema
Item
7. Go to a movie.
integer
C0442562 (UMLS CUI [1])
visiting friends
Item
8. Visit friends.
integer
C3842671 (UMLS CUI [1])
house cleaning
Item
9. Help with the house cleaning.
integer
C2372074 (UMLS CUI [1])
work on car
Item
10. Work on the car.
integer
C0577549 (UMLS CUI [1])
driving
Item
11. Take a ride in a car.
integer
C0004379 (UMLS CUI [1])
visiting relatives
Item
12. Visit relatives.
integer
C3842671 (UMLS CUI [1])
preparing a meal
Item
13. Prepare a meal.
integer
C1290962 (UMLS CUI [1])
washing car
Item
14. Wash the car.
integer
C0441648 (UMLS CUI [1,1])
C0004381 (UMLS CUI [1,2])
travel
Item
15. Take a trip.
integer
C0040802 (UMLS CUI [1])
park beach
Item
16. Go to a park or beach.
integer
C0562547 (UMLS CUI [1])
C0331781 (UMLS CUI [2])
laundry
Item
17. Do a load of laundry.
integer
C1830412 (UMLS CUI [1])
undefined item
Item
18. Work on a needed house repair.
integer
C4319951 (UMLS CUI [1,1])
C0442519 (UMLS CUI [1,2])