TEMPLATE PROMIS-29 (PROMIS-29)

TEMPLATE IDPROMIS-29
ConceptPROMIS-29
DescriptionTo record the PROMIS-29 Profile v2.1.
UseUse to record the PROMIS-29 Profile v2.1. While openEHR templates are all freely available under an open license, the specific content of this template is copyright protected. Any use of this archetype within implementations must be in compliance with the terms established by the copyright owners. Copyright statement: PROMIS tests, test protocols, test items, norms, norms tables, scoring programs, scoring keys (including scoring algorithms, scale definitions, scale membership, and scoring directions), score reports, software, and other PROMIS-related materials are ©2006-2017 PROMIS Health Organization or other individuals/entities that have contributed information and materials, and are being used with the permission of the copyright holders. Terms and conditions for use: https://www.healthmeasures.net/images/PROMIS/Terms_of_Use_HM_approved_1-12-17_-_Updated_Copyright_Notices.pdf
PurposeTo record the PROMIS-29 Profile v2.1.
References
Authorsname: Silje Ljosland Bakke; organisation: Helse Vest IKT AS; email: silje.ljosland.bakke@helse-vest-ikt.no; date: 2020-06-08
Other Details Languagename: Silje Ljosland Bakke; organisation: Helse Vest IKT AS; email: silje.ljosland.bakke@helse-vest-ikt.no; date: 2020-06-08
Other Details (Language Independent)
  • MD5-CAM-1.0.1: ab2a4065244d625b7d13e1815143ebf7
  • PARENT:MD5-CAM-1.0.1: FB4CAD8BA863221EF4499E9A0E7B59AC
  • Original Language: ISO_639-1::en
Language useden
Citeable Identifier1013.26.302
Root archetype idopenEHR-EHR-OBSERVATION.promis.v0
PROMIS-29PROMIS-29: Patient Reported Outcomes Measurement Information System®, a set of over 300 measures of physical, mental, and social health for use with the general population and with individuals living with chronic conditions.
Data
Any eventAny event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Data
Assessment or test nameAssessment or test name: The name of the PROMIS assessment or test performed.
For example: 'PROMIS-29' or 'PROMIS-57'.
  • PROMIS-29
Default value: PROMIS-29
PROMIS Bank v2.0 - Physical FunctionPROMIS Bank v2.0 - Physical Function: The PROMIS item bank v2.0 for physical function.
Are you able to do chores such as vacuuming or yard work?Are you able to do chores such as vacuuming or yard work?: Are you able to do chores such as vacuuming or yard work?
Optional[{item_code=PFA11}]
  • 5: Without any difficulty 
  • 4: With a little difficulty 
  • 3: With some difficulty 
  • 2: With much difficulty 
  • 1: Unable to do 

Annotations

  • Item Code: PFA11
Are you able to go up and down stairs at a normal pace?Are you able to go up and down stairs at a normal pace?: *
Optional[{item_code=PFA21}]
  • 5: Without any difficulty 
  • 4: With a little difficulty 
  • 3: With some difficulty 
  • 2: With much difficulty 
  • 1: Unable to do 

Annotations

  • Item Code: PFA21
Are you able to go for a walk of at least 15 minutes?Are you able to go for a walk of at least 15 minutes?: Are you able to go for a walk of at least 15 minutes?
Optional[{item_code=PFA23}]
  • 5: Without any difficulty 
  • 4: With a little difficulty 
  • 3: With some difficulty 
  • 2: With much difficulty 
  • 1: Unable to do 

Annotations

  • Item Code: PFA23
Are you able to run errands and shop?Are you able to run errands and shop?: *
Optional[{item_code=PFA53}]
  • 5: Without any difficulty 
  • 4: With a little difficulty 
  • 3: With some difficulty 
  • 2: With much difficulty 
  • 1: Unable to do 

Annotations

  • Item Code: PFA53
PROMIS Item Bank v1.0 - AnxietyPROMIS Item Bank v1.0 - Anxiety: The PROMIS item bank v1.0 for anxiety.
In the past 7 days: I felt fearfulIn the past 7 days: I felt fearful: I felt fearful.
Optional[{item_code=EDANX01}]
  • 1: Never 
  • 2: Rarely 
  • 3: Sometimes 
  • 4: Often 
  • 5: Always 

Annotations

  • Item Code: EDANX01
In the past 7 days: I found it hard to focus on anything other than my anxietyIn the past 7 days: I found it hard to focus on anything other than my anxiety: I found it hard to focus on anything other than my anxiety.
Optional[{item_code=EDANX40}]
  • 1: Never 
  • 2: Rarely 
  • 3: Sometimes 
  • 4: Often 
  • 5: Always 

Annotations

  • Item Code: EDANX40
In the past 7 days: My worries overwhelmed meIn the past 7 days: My worries overwhelmed me: My worries overwhelmed me.
Optional[{item_code=EDANX41}]
  • 1: Never 
  • 2: Rarely 
  • 3: Sometimes 
  • 4: Often 
  • 5: Always 

Annotations

  • Item Code: EDANX41
In the past 7 days: I felt uneasyIn the past 7 days: I felt uneasy: I felt uneasy.
Optional[{item_code=EDANX53}]
  • 1: Never 
  • 2: Rarely 
  • 3: Sometimes 
  • 4: Often 
  • 5: Always 

Annotations

  • Item Code: EDANX53
PROMIS Bank v1.0 - DepressionPROMIS Bank v1.0 - Depression: The PROMIS item bank v1.0 for depression.
In the past 7 days: I felt worthlessIn the past 7 days: I felt worthless: I felt worthless.
Optional[{item_code=EDDEP04}]
  • 1: Never 
  • 2: Rarely 
  • 3: Sometimes 
  • 4: Often 
  • 5: Always 

Annotations

  • Item Code: EDDEP04
In the past 7 days: I felt helplessIn the past 7 days: I felt helpless: I felt helpless.
Optional[{item_code=EDDEP06}]
  • 1: Never 
  • 2: Rarely 
  • 3: Sometimes 
  • 4: Often 
  • 5: Always 

Annotations

  • Item Code: EDDEP06
In the past 7 days: I felt depressedIn the past 7 days: I felt depressed: I felt depressed.
Optional[{item_code=EDDEP29}]
  • 1: Never 
  • 2: Rarely 
  • 3: Sometimes 
  • 4: Often 
  • 5: Always 

Annotations

  • Item Code: EDDEP29
In the past 7 days: I felt hopelessIn the past 7 days: I felt hopeless: I felt hopeless.
Optional[{item_code=EDDEP41}]
  • 1: Never 
  • 2: Rarely 
  • 3: Sometimes 
  • 4: Often 
  • 5: Always 

Annotations

  • Item Code: EDDEP41
PROMIS Item Bank v1.0 - FatiguePROMIS Item Bank v1.0 - Fatigue: The PROMIS item bank v1.0 for fatigue.
During the past 7 days: I feel fatiguedDuring the past 7 days: I feel fatigued: I feel fatigued.
Optional[{item_code=HI7}]
  • 1: Not at all 
  • 2: A little bit 
  • 3: Somewhat 
  • 4: Quite a bit 
  • 5: Very much 

Annotations

  • Item Code: HI7
During the past 7 days: I have trouble starting things because I am tiredDuring the past 7 days: I have trouble starting things because I am tired: I have trouble starting things because I am tired.
Optional[{item_code=AN3}]
  • 1: Not at all 
  • 2: A little bit 
  • 3: Somewhat 
  • 4: Quite a bit 
  • 5: Very much 

Annotations

  • Item Code: AN3
In the past 7 days: How run-down did you feel on average?In the past 7 days: How run-down did you feel on average?: How run-down did you feel on average?
Optional[{item_code=FATEXP41}]
  • 1: Not at all 
  • 2: A little bit 
  • 3: Somewhat 
  • 4: Quite a bit 
  • 5: Very much 

Annotations

  • Item Code: FATEXP41
In the past 7 days: How fatigued were you on average?In the past 7 days: How fatigued were you on average?: How fatigued were you on average?
Optional[{item_code=FATEXP40}]
  • 1: Not at all 
  • 2: A little bit 
  • 3: Somewhat 
  • 4: Quite a bit 
  • 5: Very much 

Annotations

  • Item Code: FATEXP40
PROMIS Item Bank v1.0 - Sleep DisturbancePROMIS Item Bank v1.0 - Sleep Disturbance: The PROMIS item bank v1.0 for sleep disturbance.
In the past 7 days: My sleep quality wasIn the past 7 days: My sleep quality was: My sleep quality was:
Optional[{item_code=Sleep109}]
  • 5: Very poor 
  • 4: Poor 
  • 3: Fair 
  • 2: Good 
  • 1: Very good 

Annotations

  • Item Code: Sleep109
In the past 7 days: My sleep was refreshingIn the past 7 days: My sleep was refreshing: My sleep was refreshing.
Optional[{item_code=Sleep116}]
  • 5: Not at all 
  • 4: A little bit 
  • 3: Somewhat 
  • 2: Quite a bit 
  • 1: Very much 

Annotations

  • Item Code: Sleep116
In the past 7 days: I had a problem with my sleepIn the past 7 days: I had a problem with my sleep: I had a problem with my sleep.
Optional[{item_code=Sleep20}]
  • 1: Not at all 
  • 2: A little bit 
  • 3: Somewhat 
  • 4: Quite a bit 
  • 5: Very much 

Annotations

  • Item Code: Sleep20
In the past 7 days: I had difficulty falling asleepIn the past 7 days: I had difficulty falling asleep: I had difficulty falling asleep.
Optional[{item_code=Sleep44}]
  • 1: Not at all 
  • 2: A little bit 
  • 3: Somewhat 
  • 4: Quite a bit 
  • 5: Very much 

Annotations

  • Item Code: Sleep44
PROMIS Item Bank v2.0 - Ability to Participate in Social Roles and ActivitiesPROMIS Item Bank v2.0 - Ability to Participate in Social Roles and Activities: The PROMIS item bank v2.0 for ability to participate in social roles and activities.
I have trouble doing all of my regular leisure activities with othersI have trouble doing all of my regular leisure activities with others: I have trouble doing all of my regular leisure activities with others.
Optional[{item_code=SRPPER11 _CaPS}]
  • 5: Never 
  • 4: Rarely 
  • 3: Sometimes 
  • 2: Often 
  • 1: Always 

Annotations

  • Item Code: SRPPER11 _CaPS
I have trouble doing all of the family activities that I want to doI have trouble doing all of the family activities that I want to do: I have trouble doing all of the family activities that I want to do.
Optional[{item_code=SRPPER18 _CaPS}]
  • 5: Never 
  • 4: Rarely 
  • 3: Sometimes 
  • 2: Often 
  • 1: Always 

Annotations

  • Item Code: SRPPER18 _CaPS
I have trouble doing all of my usual work (include work at home)I have trouble doing all of my usual work (include work at home): I have trouble doing all of my usual work (include work at home).
Optional[{item_code=SRPPER23 _CaPS}]
  • 5: Never 
  • 4: Rarely 
  • 3: Sometimes 
  • 2: Often 
  • 1: Always 

Annotations

  • Item Code: SRPPER23 _CaPS
I have trouble doing all of the activities with friends that I want to doI have trouble doing all of the activities with friends that I want to do: I have trouble doing all of the activities with friends that I want to do.
Optional[{item_code=SRPPER46 _CaPS}]
  • 5: Never 
  • 4: Rarely 
  • 3: Sometimes 
  • 2: Often 
  • 1: Always 

Annotations

  • Item Code: SRPPER46 _CaPS
PROMIS Item Bank v1.1 - Pain InterferencePROMIS Item Bank v1.1 - Pain Interference: The PROMIS item bank v1.1 for pain interference.
In the past 7 days: How much did pain interfere with your day to day activities?In the past 7 days: How much did pain interfere with your day to day activities?: How much did pain interfere with your day to day activities?
Optional[{item_code=PAININ9}]
  • 1: Not at all 
  • 2: A little bit 
  • 3: Somewhat 
  • 4: Quite a bit 
  • 5: Very much 

Annotations

  • Item Code: PAININ9
In the past 7 days: How much did pain interfere with work around the home?In the past 7 days: How much did pain interfere with work around the home?: How much did pain interfere with work around the home?
Optional[{item_code=PAININ22}]
  • 1: Not at all 
  • 2: A little bit 
  • 3: Somewhat 
  • 4: Quite a bit 
  • 5: Very much 

Annotations

  • Item Code: PAININ22
In the past 7 days: How much did pain interfere with your ability to participate in social activities?In the past 7 days: How much did pain interfere with your ability to participate in social activities?: How much did pain interfere with your ability to participate in social activities?
Optional[{item_code=PAININ31}]
  • 1: Not at all 
  • 2: A little bit 
  • 3: Somewhat 
  • 4: Quite a bit 
  • 5: Very much 

Annotations

  • Item Code: PAININ31
In the past 7 days: How much did pain interfere with your household chores?In the past 7 days: How much did pain interfere with your household chores?: How much did pain interfere with your household chores?
Optional[{item_code=PAININ34}]
  • 1: Not at all 
  • 2: A little bit 
  • 3: Somewhat 
  • 4: Quite a bit 
  • 5: Very much 

Annotations

  • Item Code: PAININ34
PROMIS Scale v1.2 - Global HealthPROMIS Scale v1.2 - Global Health: The PROMIS scale v1.2 for global health.
In the past 7 days: How would you rate your pain on average?In the past 7 days: How would you rate your pain on average?: How would you rate your pain on average?
Optional[{item_code=Global07r}]
  • 0: No pain 
  • 1: - 
  • 2: - 
  • 3: - 
  • 4: - 
  • 5: - 
  • 6: - 
  • 7: - 
  • 8: - 
  • 9: - 
  • 10: Worst pain imaginable 

Annotations

  • Item Code: Global07r
Total scoreTotal score: The total score of the PROMIS assessment.