ARCHETYPE ICIQ-UI Short Form (openEHR-EHR-OBSERVATION.iciq_ui_short.v0)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.iciq_ui_short.v0
ConceptICIQ-UI Short Form
DescriptionInternational Consultation on Incontinence (ICIQ) Urinary Incontinence (UI) Short Form.
UseUse to record ICIQ-UI Short form answers to questions and total score.
PurposeIntended to capture the result of the short form of the ICIQ (International Consultation on Incontinence Questionnaire), also referred to as ICIQ-UI Short Form. The form is used to obtain a brief yet comprehensive summary of the level, impact and perceived cause of symptoms of incontinence.
ReferencesInternational Consultation on Incontinence Modular Questionnaire http://www.iciq.net/index.html
Copyright© Clinical Models UK
AuthorsAuthor name: Hildegard Franke
Organisation: freshEHR Clinical Informatics Ltd.
Email: hildi@freshehr.com
Date originally authored: 2016-05-30
Other Details LanguageAuthor name: Hildegard Franke
Organisation: freshEHR Clinical Informatics Ltd.
Email: hildi@freshehr.com
Date originally authored: 2016-05-30
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/., custodian_organisation=UK Clinical Models, references=International Consultation on Incontinence Modular Questionnaire http://www.iciq.net/index.html, current_contact=Hildegard Franke, freshEHR Clinical Informatics Ltd., original_namespace=uk.org.clinicalmodels, original_publisher=UK Clinical Models, custodian_namespace=uk.org.clinicalmodels, MD5-CAM-1.0.1=57A40A521B6DA98E55E8F07BFA8DE34B, build_uid=1f811f48-1849-4ff3-9943-b8ef1a9a1b4f, revision=0.0.1-alpha}
Keywordsincontinence, ICIQ, score, urine, leakage, leak, questionnaire
Lifecyclein_development
UID83a0625f-b654-42e4-a779-797b6281d726
Language useden
Citeable Identifier1013.1.3325
Revision Number0.0.1-alpha
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1: About once a week or less often [Over the past 4 weeks I have leaked urine about once a week or less often on average.]
2: Two or three times a week [Over the past 4 weeks I have leaked urine two or three times a week on average.]
3: About once a day [Over the past 4 weeks I have leaked urine about once a day on average.]
4: Several times a day [Over the past 4 weeks I have leaked urine several times a day on average.]
5: All the time [Over the past 4 weeks I have leaked urine all the time.]
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2: A small amount [Over the past 4 weeks I have leaked a small amount of urine on average.]
4: A moderate amount [Over the past 4 weeks I have leaked a moderate amount of urine on average.]
6: A large amount [Over the past 4 weeks I have leaked a large amount of urine on average.]
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  • Never [Urine never leaks.]
  • Before getting to toilet [Urine leaks before you can get to the toilet.]
  • Cough or sneeze [Urine leaks when you cough or sneeze.]
  • Asleep [Urine leaks when you are asleep.]
  • Physically active/exercising [Urine leaks when you are physically active or exercising.]
  • Finished urinating and are dressed [Urine leaks when you have finished urinating and are dressed.]
  • No obvious reason [Urine leaks for no obvious reason.]
  • All the time [Urine leaks all the time.]
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