{ "resourceType" : "Questionnaire", "id" : "DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire", "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire

Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeDescription & Constraints\"doco\"
\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaireA Respiratory Physiology Paediatric OSAS Screening Questionnaire.Questionnairehttps://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire#1.0
\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / caregiverdetailsCaregiver Details0..1group
\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / caregiverdetails / caregivernameCaregiver Name1..1string
\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / caregiverdetails / childrelationshipRelationship to child1..1string
\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / answeronbehalfPlease answer on behalf of your child for the past month.0..1group
\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / answeronbehalf / options_311. Does your child have any of the following0..1group
\"\"\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / answeronbehalf / options_31 / runnynoseSelect all that apply0..*choiceOptions: 6 options
\"\"\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / answeronbehalf / options_31 / specifytypePlease specify the syndrome or major health problem0..1stringEnable When: runnynose = A syndrome or other major health problem?
\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / answeronbehalf / whilesleeping2. While sleeping, does your child0..1group
\"\"\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / answeronbehalf / whilesleeping / snore_22Select all that apply0..*choiceOptions: 6 options
\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / answeronbehalf / followingoptions3. Does your child0..1group
\"\"\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / answeronbehalf / followingoptions / breathethroughmouthSelect all that apply0..*choiceOptions: 10 options
\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / answeronbehalf / childoftenhas4. My child often0..1group
\"\"\"\"\"\"\"\"\"\" DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire / answeronbehalf / childoftenhas / listenissuesSelect all that apply0..*choiceOptions: 6 options

\"doco\" Documentation for this format

Options Sets

Answer options for runnynose

Answer options for snore_22

Answer options for breathethroughmouth

Answer options for listenissues

" }, "url" : "https://build.fhir.org/ig/tewhatuora/cinc-fhir-ig/Questionnaire/DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire", "identifier" : [{ "use" : "official", "value" : "DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire" }], "version" : "1.0", "name" : "DHORespiratoryPhysiologyPaediatricOSASScreeningQuestionnaire", "title" : "Respiratory Physiology Paediatric OSAS Screening Questionnaire", "status" : "active", "date" : "2026-10-13T01:26:02+00:00", "publisher" : "Te Whatu Ora", "contact" : [{ "name" : "Te Whatu Ora", "telecom" : [{ "system" : "url", "value" : "https://www.tewhatuora.govt.nz/" }] }, { "name" : "Te Whatu Ora Integration Team", "telecom" : [{ "system" : "email", "value" : "integration@tewhatuora.govt.nz", "use" : "work" }] }], "description" : "A Respiratory Physiology Paediatric OSAS Screening Questionnaire.", "jurisdiction" : [{ "coding" : [{ "system" : "urn:iso:std:iso:3166", "code" : "NZ", "display" : "New Zealand" }] }], "item" : [{ "linkId" : "caregiverdetails", "text" : "Caregiver Details", "type" : "group", "item" : [{ "linkId" : "caregivername", "text" : "Caregiver Name", "type" : "string", "required" : true }, { "linkId" : "childrelationship", "text" : "Relationship to child", "type" : "string", "required" : true }] }, { "linkId" : "answeronbehalf", "text" : "Please answer on behalf of your child for the past month.", "type" : "group", "item" : [{ "linkId" : "options_31", "text" : "1. Does your child have any of the following", "type" : "group", "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "check-box", "display" : "Check-box" }] } }], "linkId" : "runnynose", "text" : "Select all that apply", "type" : "choice", "required" : false, "repeats" : true, "answerOption" : [{ "valueCoding" : { "display" : "A constant blocked or runny nose?" } }, { "valueCoding" : { "display" : "Recurrent chest infections/pneumonia?" } }, { "valueCoding" : { "display" : "An airway narrowing or abnormality?" } }, { "valueCoding" : { "display" : "Does your child have large tonsils?" } }, { "valueCoding" : { "display" : "Has your child had their adenoids or tonsils removed?" } }, { "valueCoding" : { "display" : "A syndrome or other major health problem?" } }] }, { "linkId" : "specifytype", "text" : "Please specify the syndrome or major health problem", "type" : "string", "enableWhen" : [{ "question" : "runnynose", "operator" : "=", "answerCoding" : { "display" : "A syndrome or other major health problem?" } }], "enableBehavior" : "all", "required" : false }] }, { "linkId" : "whilesleeping", "text" : "2. While sleeping, does your child", "type" : "group", "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "check-box", "display" : "Check-box" }] } }], "linkId" : "snore_22", "text" : "Select all that apply", "type" : "choice", "required" : false, "repeats" : true, "answerOption" : [{ "valueCoding" : { "display" : "Snore more than half the time?" } }, { "valueCoding" : { "display" : "Always snore?" } }, { "valueCoding" : { "display" : "Snore loudly?" } }, { "valueCoding" : { "display" : "Have trouble breathing, or struggle to breathe?" } }, { "valueCoding" : { "display" : "Have \"heavy\" or loud breathing?" } }, { "valueCoding" : { "display" : "Have you ever seen your child stop breathing during the night?" } }] }] }, { "linkId" : "followingoptions", "text" : "3. Does your child", "type" : "group", "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "check-box", "display" : "Check-box" }] } }], "linkId" : "breathethroughmouth", "text" : "Select all that apply", "type" : "choice", "required" : false, "repeats" : true, "answerOption" : [{ "valueCoding" : { "display" : "Tend to breathe through the mouth during the day?" } }, { "valueCoding" : { "display" : "Have a dry mouth on waking up in the morning?" } }, { "valueCoding" : { "display" : "Occasionally wet the bed?" } }, { "valueCoding" : { "display" : "Wake up feeling unrefreshed in the morning?" } }, { "valueCoding" : { "display" : "Have a problem with sleepiness during the day?" } }, { "valueCoding" : { "display" : "Has a teacher commented that your child appears sleepy during the day?" } }, { "valueCoding" : { "display" : "Is it hard to wake your child up in the morning?" } }, { "valueCoding" : { "display" : "Does your child wake up with headaches in the morning?" } }, { "valueCoding" : { "display" : "Did your child stop growing at a normal rate at any time since birth?" } }, { "valueCoding" : { "display" : "Is your child overweight?" } }] }] }, { "linkId" : "childoftenhas", "text" : "4. My child often", "type" : "group", "required" : false, "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "check-box", "display" : "Check-box" }] } }], "linkId" : "listenissues", "text" : "Select all that apply", "type" : "choice", "required" : false, "repeats" : true, "answerOption" : [{ "valueCoding" : { "display" : "Does not seem to listen when spoken to directly." } }, { "valueCoding" : { "display" : "Has difficulty organizing task and activities." } }, { "valueCoding" : { "display" : "Is easily distracted by extraneous stimuli." } }, { "valueCoding" : { "display" : "Fidgets with hands or feet or squirms in seat." } }, { "valueCoding" : { "display" : "Is 'on the go' or often acts as if 'driven by a motor'." } }, { "valueCoding" : { "display" : "Interrupts or intrudes on others (e.g. butts into conversations or games)." } }] }] }] }] }