Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.7 - release New Zealand flag

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.7) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Example QuestionnaireResponse: ActiveMonitoringDay3SurveyQuestionnaireResponse

version: 1; Last updated: 2024-04-21 22:07:18+0000

LinkIDTextDefinitionAnswerdoco
ActiveMonitoringDay3SurveyQuestionnaireResponseQuestionnaire:Post Vaccine Symptom Check day 3 survey
ActiveMonitoringDay3SurveyQuestionnaireResponse / p01-IntroThis is the first of two surveys about your experience with receiving your vaccine. This survey will take approximately five minutes to complete. You will be asked about any reactions you had after your vaccination(s). If you did not have any there is also a section at the end for you to comment on any other parts of your vaccination experience. Your responses are important and will help contribute to the safety monitoring of vaccines in New Zealand. The information you provide is confidential and is protected by the Privacy Act 2020 and data security safeguards. Please remember this is a survey only, your answers will not result in a medical response to your situation. If you have any concerns about your health after your vaccination, call Healthline at 0800 611 116 or speak to your healthcare professional. If you experience any of the following symptoms, you should seek medical help urgently and tell them about your vaccinations: tightness, heaviness, discomfort, pressure or pain in your chest or neck difficulty breathing or catching your breath feeling faint, dizzy, or light-headed fluttering, racing, or pounding heart, or feeling like it’s ‘skipping beats’Immunization/452fb7d0-8d3d-4534-a147-25560206edc2
ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-ScreeningScreening
ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / p02-q01-VaccineTypePlease confirm the vaccine(s) that you or your dependent (e.g., child) received 3 days ago[not stated]: Only flu vaccine (Only flu vaccine)
ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / p02-q02-SideEffectsWe would like to confirm your answer to the invitation text message. Did you experience any side effects after vaccination?[not stated]: Yes (Yes)
ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / p02-q03-SideEffectsScreening
ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / p02-q03-SideEffectsScreening / p02-q03.1-WhoReceivedWho received the vaccine?[not stated]: Myself (Myself)
ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / p02-q03-SideEffectsScreening / p02-q03.2-WhereReceivedWhere did you/they go to receive your/their vaccination?[not stated]: Community vaccination centre (Community vaccination centre)
ActiveMonitoringDay3SurveyQuestionnaireResponse / p02-Screening / p02-q03-SideEffectsScreening / p02-q03.3-PregnantWere you/they pregnant/Hapu at the time of your/their vaccination?false
ActiveMonitoringDay3SurveyQuestionnaireResponse / p03-EarlyOnsetReactionsEarly onset reactions
ActiveMonitoringDay3SurveyQuestionnaireResponse / p03-EarlyOnsetReactions / p03-q01-SelectedSideEffectsDid you/they experience any of the following after vaccination? (choose all that apply)[not stated]: None of the above (None of the above)
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-ReactionsReactions
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q01-ReactionsIntroPlease choose all the reactions that you/they experienced, and if yes describe, on a scale from Minor, Mild, Moderate, Serious, to Severe. For your rating take into account levels of pain, how long symptoms lasted and impact on daily life.
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q02-InjectionSiteDisorderInjection site reaction (pain, redness, swelling, or itching at or near the injection site)false
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q04-FeverFever (a temperature of 38°C or higher)false
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q06-SwellingSwelling of glands (i.e., lymph nodes)false
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q09-ChillsChills, shivering, or cold sweatsfalse
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q11-HeadachesHeadachesfalse
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q13-RashRash (not at the injection site)false
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q15-AchesPainsAches and painsfalse
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q17-DigestiveDisorderStomach symptoms (nausea, vomiting, diarrhoea, abdominal pain or loss of appetite)false
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q19-FatigueFatigue or tirednessfalse
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q21-ChestSymptomsChest symptoms (chest pain/heaviness/tightness or heart palpitations/pounding/racing)false
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q23-DifficultyBreathingDifficulty breathingfalse
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q25-DizzinessDizziness or feeling lightheadedfalse
ActiveMonitoringDay3SurveyQuestionnaireResponse / p04-Reactions / p04-q27-OtherSymptomsDid you/they experience any symptoms that were not listed above?false
ActiveMonitoringDay3SurveyQuestionnaireResponse / p05-DailyImpactImpact on daily activities
ActiveMonitoringDay3SurveyQuestionnaireResponse / p05-DailyImpact / p05-q01-MissedWorkDid any of the symptoms that you/they reported cause you/them to miss work, study, or normal daily activities?true
ActiveMonitoringDay3SurveyQuestionnaireResponse / p05-DailyImpact / p05-q02-MissedWorkDetailHow many days did you miss?[not stated]: Less than 1 day (Less than 1 day)
ActiveMonitoringDay3SurveyQuestionnaireResponse / p06-CareSoughtMedical advice/care sought
ActiveMonitoringDay3SurveyQuestionnaireResponse / p06-CareSought / p06-q01-SymptomReliefDid any of the symptoms cause you/them to seek advice or care from a healthcare professional?true
ActiveMonitoringDay3SurveyQuestionnaireResponse / p06-CareSought / p06-q02-SymptomReliefDetailPlease choose the type of advice or care you/they sought. Please choose all that apply
ActiveMonitoringDay3SurveyQuestionnaireResponse / p07-VaccinationExperienceVaccination experience
ActiveMonitoringDay3SurveyQuestionnaireResponse / p07-VaccinationExperience / p07-q01-OverallExperienceHow would you/they rate the overall experience at the vaccination site? For your rating take into account informed consent process, staff helpfulness, vaccination site cleanliness etc.[not stated]: Average (Average)
ActiveMonitoringDay3SurveyQuestionnaireResponse / p07-VaccinationExperience / p07-q02-CommentsDo you/they have any comments about your/their vaccine experience?true
ActiveMonitoringDay3SurveyQuestionnaireResponse / p07-VaccinationExperience / p07-q03-CommentsDetailPlease explainASsA
ActiveMonitoringDay3SurveyQuestionnaireResponse / p08-ThanksThank you for completing the Day 3 post vaccine survey, your answers have been submitted. You will receive your next survey 42 days after your vaccination. The data collected by these surveys will be made available online on the Health NZ website. Survey data provided online are not identifiable and individual responses are confidential.

doco Documentation for this format