questionnaire-health-check
type: Questionnaire
node role: treeRoot
id:
  v: questionnaire-health-check
meta:
  profile:
    v: https://gidsopenstandaarden.github.io/welldata-implementation-guide/StructureDefinition/WellDataQuestionnaire
    link: https://gidsopenstandaarden.github.io/welldata-implementation-guide/StructureDefinition/WellDataQuestionnaire
text:
  status:
    v: extensions
  div: Generated Narrative: Questionnaire questionnaire-health-check Profile: WellData Questionnaire Profile Structure LinkID Text Cardinality Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> GezondheidsCheckVragenlijst1_0 Questionnaire https://gidsopenstandaarden.github.io/welldata-implementation-guide/Questionnaire/questionnaire-health-check#0.1.2 #xD; section-vitals Lichamelijke metingen 0..1 group #xD; body-weight Wat is uw lichaamsgewicht? (in kg) 0..1 decimal #xD; body-height Wat is uw lichaamslengte? (in cm) 0..1 decimal #xD; waist-circumference Wat is uw tailleomvang? (in cm) 0..1 decimal #xD; systolic-bp Wat is uw bovendruk (systolische bloeddruk)? (in mmHg) 0..1 integer #xD; section-lab Laboratoriumwaarden 0..1 group #xD; cholesterol-total Wat is uw totaal cholesterolgehalte? (in mg/dL) 0..1 decimal #xD; cholesterol-hdl Wat is uw HDL cholesterolgehalte? (in mg/dL) 0..1 decimal #xD; section-wellbeing Welzijn 0..1 group #xD; mood Hoe zou u uw stemming omschrijven? 0..1 choice Options: 4 options #xD; stress Hoe ervaart u stress? 0..1 choice Options: 4 options #xD; daily-life Hoe functioneert u in het dagelijks leven? 0..1 choice Options: 4 options #xD; social-contact Hoe tevreden bent u met uw sociale contacten? 0..1 choice Options: 4 options #xD; physical-limitation Heeft u een fysieke beperking? 0..1 choice Options: 2 options #xD; section-smoking Roken 0..1 group #xD; smoking-status Rookt u? 0..1 choice Options: 3 options #xD; cigarettes-per-day Hoeveel sigaretten rookt u per dag? 0..1 integer Enable When: smoking-status = #xD; section-alcohol Alcoholgebruik (AUDIT-C) 0..1 group #xD; alcohol-status Drinkt u alcohol? 0..1 choice Options: 3 options #xD; alcohol-frequency Hoe vaak drinkt u een drankje met alcohol? 0..1 choice Options: 5 options #xD; alcohol-normal-consumption Hoeveel glazen alcohol drinkt u op een typische dag? 0..1 choice Options: 5 options #xD; alcohol-excessive-consumption Hoe vaak drinkt u 6 of meer…
url:
  v: https://gidsopenstandaarden.github.io/welldata-implementation-guide/Questionnaire/questionnaire-health-check
identifier:
  system:
    v: https://well-data.example.org/fhir/Questionnaire
  value:
    v: health-check-1-0
version:
  v: 0.1.2
name:
  v: GezondheidsCheckVragenlijst1_0
title:
  v: Gezondheidscheck Vragenlijst
status:
  v: draft
subject type:
  v: Patient
date:
  v: 2025-06-10
publisher:
  v: gidsopenstandaarden
contact:
  name:
    v: gidsopenstandaarden
  telecom:
    system:
      v: url
    value:
      v: https://www.gidsopenstandaarden.org
item:
  link id:
    v: section-vitals
  text:
    v: Lichamelijke metingen
  type:
    v: group
  item:
    link id:
      v: body-weight
    code: http://snomed.info/id/27113001
      system:
        v: http://snomed.info/sct
      code:
        v: 27113001
      display:
        v: Body weight
    text:
      v: Wat is uw lichaamsgewicht? (in kg)
    type:
      v: decimal
  item:
    link id:
      v: body-height
    code: http://snomed.info/id/50373000
      system:
        v: http://snomed.info/sct
      code:
        v: 50373000
      display:
        v: Body height
    text:
      v: Wat is uw lichaamslengte? (in cm)
    type:
      v: decimal
  item:
    link id:
      v: waist-circumference
    code: http://snomed.info/id/276361009
      system:
        v: http://snomed.info/sct
      code:
        v: 276361009
      display:
        v: Waist circumference
    text:
      v: Wat is uw tailleomvang? (in cm)
    type:
      v: decimal
  item:
    link id:
      v: systolic-bp
    code: http://snomed.info/id/271649006
      system:
        v: http://snomed.info/sct
      code:
        v: 271649006
      display:
        v: Systolic blood pressure
    text:
      v: Wat is uw bovendruk (systolische bloeddruk)? (in mmHg)
    type:
      v: integer
item:
  link id:
    v: section-lab
  text:
    v: Laboratoriumwaarden
  type:
    v: group
  item:
    link id:
      v: cholesterol-total
    code: http://snomed.info/id/77068002
      system:
        v: http://snomed.info/sct
      code:
        v: 77068002
      display:
        v: Total cholesterol
    text:
      v: Wat is uw totaal cholesterolgehalte? (in mg/dL)
    type:
      v: decimal
  item:
    link id:
      v: cholesterol-hdl
    code: http://snomed.info/id/102737005
      system:
        v: http://snomed.info/sct
      code:
        v: 102737005
      display:
        v: HDL cholesterol
    text:
      v: Wat is uw HDL cholesterolgehalte? (in mg/dL)
    type:
      v: decimal
item:
  link id:
    v: section-wellbeing
  text:
    v: Welzijn
  type:
    v: group
  item:
    link id:
      v: mood
    code: https://loinc.org/rdf/72166-2
      system:
        v: http://loinc.org
      code:
        v: 72166-2
      display:
        v: Mood
    text:
      v: Hoe zou u uw stemming omschrijven?
    type:
      v: choice
    answer option:
      value: Coding
        type: http://snomed.info/id/32504001
    answer option:
      value: Coding
        type: http://snomed.info/id/130987000
    answer option:
      value: Coding
        type: http://snomed.info/id/366979004
    answer option:
      value: Coding
        type: http://snomed.info/id/48694002
  item:
    link id:
      v: stress
    code: https://loinc.org/rdf/68011-6
      system:
        v: http://loinc.org
      code:
        v: 68011-6
      display:
        v: Stress level
    text:
      v: Hoe ervaart u stress?
    type:
      v: choice
    answer option:
      value: Coding
        type: LA6568-5
    answer option:
      value: Coding
        type: LA6751-7
    answer option:
      value: Coding
        type: LA13909-9
    answer option:
      value: Coding
        type: LA6752-5
  item:
    link id:
      v: daily-life
    code: https://loinc.org/rdf/91621-3
      system:
        v: http://loinc.org

v: 32504001

v: Gelukkig (Happy)

v: 130987000

v: Neutraal (Neutral)

v: 366979004

v: Verdrietig (Sad)

v: 48694002

v: Angstig (Anxious)

v: LA6568-5

v: Geen (None)

v: LA6751-7

v: Mild (Mild)

v: LA13909-9

v: Matig (Moderate)

v: LA6752-5

v: Ernstig (Severe)

v: 91621-3

v: Daily life functioning

v: Hoe functioneert u in het dagelijks leven?

v: choice

value: Coding
  type: LA9207-7
  system:
    v: http://loinc.org
  code:
    v: LA9207-7
  display:
    v: Uitstekend (Excellent)

value: Coding
  type: LA9206-9
  system:
    v: http://loinc.org
  code:
    v: LA9206-9
  display:
    v: Goed (Good)

value: Coding
  type: LA9205-1
  system:
    v: http://loinc.org
  code:
    v: LA9205-1
  display:
    v: Matig (Fair)

value: Coding
  type: LA9208-5
  system:
    v: http://loinc.org
  code:
    v: LA9208-5
  display:
    v: Slecht (Poor)

link id:
  v: social-contact
code: https://loinc.org/rdf/61581-5
  system:
    v: http://loinc.org
  code:
    v: 61581-5
  display:
    v: Satisfaction with social contacts
text:
  v: Hoe tevreden bent u met uw sociale contacten?
type:
  v: choice
answer option:
  value: Coding
    type: LA9207-7
    system:
      v: http://loinc.org
    code:
      v: LA9207-7
    display:
      v: Uitstekend (Excellent)
answer option:
  value: Coding
    type: LA9206-9
    system:
      v: http://loinc.org
    code:
      v: LA9206-9
    display:
      v: Goed (Good)
answer option:
  value: Coding
    type: LA9205-1
    system:
      v: http://loinc.org
    code:
      v: LA9205-1
    display:
      v: Matig (Fair)
answer option:
  value: Coding
    type: LA9208-5
    system:
      v: http://loinc.org
    code:
      v: LA9208-5
    display:
      v: Slecht (Poor)

link id:
  v: physical-limitation
code: http://snomed.info/id/32572006
  system:
    v: http://snomed.info/sct
  code:
    v: 32572006
  display:
    v: Physical disability
text:
  v: Heeft u een fysieke beperking?
type:
  v: choice
answer option:
  value: Coding
    type: http://snomed.info/id/373066001
    system:
      v: http://snomed.info/sct
    code:
      v: 373066001
    display:
      v: Ja (Yes)
answer option:
  value: Coding
    type: http://snomed.info/id/373067005
    system:
      v: http://snomed.info/sct
    code:
      v: 373067005
    display:
      v: Nee (No)

link id:
  v: section-smoking
text:
  v: Roken
type:
  v: group
item:
  link id:
    v: smoking-status
  code: https://loinc.org/rdf/63638-1
    system:
      v: http://loinc.org
    code:
      v: 63638-1
    display:
      v: Smoking status
  text:
    v: Rookt u?
  type:
    v: choice
  answer option:
    value: Coding
      type: http://snomed.info/id/77176002
      system:
        v: http://snomed.info/sct
      code:
        v: 77176002
      display:
        v: Roker (Smoker)
  answer option:
    value: Coding
      type: http://snomed.info/id/8517006
      system:
        v: http://snomed.info/sct
      code:
        v: 8517006
      display:
        v: Ex-roker (Ex-smoker)
  answer option:
    value: Coding
      type: http://snomed.info/id/266919005
      system:
        v: http://snomed.info/sct
      code:
        v: 266919005
      display:
        v: Nooit gerookt (Never smoked)
item:
  link id:
    v: cigarettes-per-day
  code: https://loinc.org/rdf/63640-7
    system:
      v: http://loinc.org
    code:
      v: 63640-7
    display:
      v: Cigarettes smoked per day
  text:
    v: Hoeveel sigaretten rookt u per dag?
  type:
    v: integer
  enable when:
    question:
      v: smoking-status
    operator:
      v: =
    answer: Coding
      type: http://snomed.info/id/77176002
      system:
        v: http://snomed.info/sct
      code:
        v: 77176002

link id:
  v: section-alcohol
text:
  v: Alcoholgebruik (AUDIT-C)
type:
  v: group
item:
  link id:
    v: alcohol-status
  code: http://snomed.info/id/897148007
    system:
      v: http://snomed.info/sct
    code:
      v: 897148007
    display:
      v: Alcohol drinking behavior
  text:
    v: Drinkt u alcohol?
  type:
    v: choice
  answer option:
    value: Coding
      type: http://snomed.info/id/219006
      system:
        v: http://snomed.info/sct
      code:
        v: 219006
      display:
        v: Huidige drinker (Current drinker)
  answer option:
    value: Coding
      type: http://snomed.info/id/105542008
      system:
        v: http://snomed.info/sct
      code:
        v: 105542008
      display:
        v: Ex-drinker (Ex-drinker)
  answer option:
    value: Coding
      type: http://snomed.info/id/105542003
      system:
        v: http://snomed.info/sct
      code:
        v: 105542003
      display:
        v: Drinkt niet (Non-drinker)
item:
  link id:
    v: alcohol-frequency
  code: https://loinc.org/rdf/68518-0
    system:
      v: http://loinc.org
    code:
      v: 68518-0
    display:
      v: How often do you have a drink containing alcohol
  text:
    v: Hoe vaak drinkt u een drankje met alcohol?
  type:
    v: choice
  answer option:
    value: Coding
      type: LA6270-8
      system:
        v: http://loinc.org
      code:
        v: LA6270-8
      display:
        v: Nooit (Never)
  answer option:
    value: Coding
      type: LA18926-8
      system:
        v: http://loinc.org
      code:
        v: LA18926-8
      display:
        v: Maandelijks of minder (Monthly or less)
  answer option:
    value: Coding
      type: LA18927-6
      system:
        v: http://loinc.org
      code:
        v: LA18927-6
      display:
        v: 2-4 keer per maand (2-4 times a month)
  answer option:
    value: Coding
      type: LA18930-0
      system:
        v: http://loinc.org
      code:
        v: LA18930-0
      display:
        v: 2-3 keer per week (2-3 times a week)
  answer option:
    value: Coding
      type: LA18929-2
      system:
        v: http://loinc.org
      code:
        v: LA18929-2
      display:
        v: 4 of meer keer per week (4+ times a week)
item:
  link id:
    v: alcohol-normal-consumption
  code: https://loinc.org/rdf/68519-8
    system:
      v: http://loinc.org
    code:
      v: 68519-8
    display:
      v: How many standard drinks containing alcohol do you have on a typical day
  text:
    v: Hoeveel glazen alcohol drinkt u op een typische dag?
  type:
    v: choice
  answer option:
    value: Coding
      type: LA15694-5
      system:
        v: http://loinc.org
      code:
        v: LA15694-5
      display:
        v: 1 of 2
  answer option:
    value: Coding
      type: LA15695-2
      system:
        v: http://loinc.org
      code:
        v: LA15695-2
      display:
        v: 3 of 4
  answer option:
    value: Coding
      type: LA15696-0
      system:
        v: http://loinc.org
      code:
        v: LA15696-0
      display:
        v: 5 of 6
  answer option:
    value: Coding
      type: LA15697-8
      system:
        v: http://loinc.org
      code:
        v: LA15697-8
      display:
        v: 7 tot 9
  answer option:
    value: Coding
      type: LA15698-6
      system:
        v: http://loinc.org
      code:
        v: LA15698-6
      display:
        v: 10 of meer
item:
  link id:
    v: alcohol-excessive-consumption
  code: https://loinc.org/rdf/68520-6
    system:
      v: http://loinc.org
    code:
      v: 68520-6
    display:
      v: How often do you have 6 or more drinks on 1 occasion
  text:
    v: Hoe vaak drinkt u 6 of meer glazen bij één gelegenheid?
  type:
    v: choice
  answer option:
    value: Coding
      type: LA6270-8
      system:
        v: http://loinc.org
      code:
        v: LA6270-8
      display:
        v: Nooit (Never)
  answer option:
    value: Coding
      type: LA18933-4
      system:
        v: http://loinc.org
      code:
        v: LA18933-4
      display:
        v: Minder dan maandelijks (Less than monthly)
  answer option:
    value: Coding
      type: LA18934-2
      system:
        v: http://loinc.org
      code:
        v: LA18934-2

v: Maandelijks (Monthly)

value: Coding
  type: LA18935-9
  system:
    v: http://loinc.org
  code:
    v: LA18935-9
  display:
    v: Wekelijks (Weekly)

value: Coding
  type: LA18936-7
  system:
    v: http://loinc.org
  code:
    v: LA18936-7
  display:
    v: Dagelijks of bijna dagelijks (Daily or almost daily)

link id:
  v: section-activity
text:
  v: Lichamelijke activiteit
type:
  v: group
item:
  link id:
    v: physical-exercise
  code: http://snomed.info/id/228450008
    system:
      v: http://snomed.info/sct
    code:
      v: 228450008
    display:
      v: Physical activity
  text:
    v: Hoeveel minuten per week sport of beweegt u matig tot intensief?
  type:
    v: integer