An example to illustrate a questionnaire regarding an in-patient survey

Table View

Questionnaire.id[0]UKCore-Questionnaire-InpatientSurvey-Example
Questionnaire.text[0].status[0]additional
Questionnaire.text[0].div[0]<div xmlns="http://www.w3.org/1999/xhtml">An example to illustrate an in-patient questionnaire</div>
Questionnaire.url[0]https://example.com/base/Questionnaire/UKCore-Questionnaire-InpatientSurvey-Example
Questionnaire.title[0]Inpatient Survey (Mock up)
Questionnaire.status[0]draft
Questionnaire.experimental[0]True
Questionnaire.subjectType[0]Patient
Questionnaire.date[0]2023-11-13T11:50:00+00:00
Questionnaire.purpose[0]A questionnaire used as part of a survey of new patient admissions to Acute Medicine. Purely for demonstration purposes.
Questionnaire.effectivePeriod[0].start[0]2023-11-13T11:50:00+00:00
Questionnaire.effectivePeriod[0].end[0]2023-12-13T11:50:00+00:00
Questionnaire.item[0].linkId[0]1
Questionnaire.item[0].text[0]Do you have allergies?
Questionnaire.item[0].type[0]string
Questionnaire.item[1].linkId[0]2
Questionnaire.item[1].text[0]General questions
Questionnaire.item[1].type[0]group
Questionnaire.item[1].item[0].linkId[0]2.1
Questionnaire.item[1].item[0].text[0]What is your gender?
Questionnaire.item[1].item[0].type[0]string
Questionnaire.item[1].item[1].linkId[0]2.2
Questionnaire.item[1].item[1].text[0]What is your date of birth?
Questionnaire.item[1].item[1].type[0]date
Questionnaire.item[1].item[2].linkId[0]2.3
Questionnaire.item[1].item[2].text[0]What is your country of birth?
Questionnaire.item[1].item[2].type[0]string
Questionnaire.item[1].item[3].linkId[0]2.4
Questionnaire.item[1].item[3].text[0]What is your marital status?
Questionnaire.item[1].item[3].type[0]string
Questionnaire.item[2].linkId[0]3
Questionnaire.item[2].text[0]Intoxications
Questionnaire.item[2].type[0]group
Questionnaire.item[2].item[0].linkId[0]3.1
Questionnaire.item[2].item[0].text[0]Do you smoke?
Questionnaire.item[2].item[0].type[0]boolean
Questionnaire.item[2].item[1].linkId[0]3.2
Questionnaire.item[2].item[1].text[0]Do you drink alcohol?
Questionnaire.item[2].item[1].type[0]boolean

XML View

<Questionnaire xmlns="http://hl7.org/fhir">
<id value="UKCore-Questionnaire-InpatientSurvey-Example" />
<status value="additional" />
--- We have skipped the narrative for better readability of the resource ---
</text>
<url value="https://example.com/base/Questionnaire/UKCore-Questionnaire-InpatientSurvey-Example" />
<title value="Inpatient Survey (Mock up)" />
<status value="draft" />
<experimental value="true" />
<subjectType value="Patient" />
<date value="2023-11-13T11:50:00+00:00" />
<purpose value="A questionnaire used as part of a survey of new patient admissions to Acute Medicine. Purely for demonstration purposes." />
<start value="2023-11-13T11:50:00+00:00" />
<end value="2023-12-13T11:50:00+00:00" />
</effectivePeriod>
<linkId value="1" />
<text value="Do you have allergies?" />
<type value="string" />
</item>
<linkId value="2" />
<text value="General questions" />
<type value="group" />
<linkId value="2.1" />
<text value="What is your gender?" />
<type value="string" />
</item>
<linkId value="2.2" />
<text value="What is your date of birth?" />
<type value="date" />
</item>
<linkId value="2.3" />
<text value="What is your country of birth?" />
<type value="string" />
</item>
<linkId value="2.4" />
<text value="What is your marital status?" />
<type value="string" />
</item>
</item>
<linkId value="3" />
<text value="Intoxications" />
<type value="group" />
<linkId value="3.1" />
<text value="Do you smoke?" />
<type value="boolean" />
</item>
<linkId value="3.2" />
<text value="Do you drink alcohol?" />
<type value="boolean" />
</item>
</item>
</Questionnaire>

JSON View

{
"resourceType": "Questionnaire",
"id": "UKCore-Questionnaire-InpatientSurvey-Example",
"text": {
"status": "additional",
--- We have skipped the narrative for better readability of the resource ---
},
"url": "https://example.com/base/Questionnaire/UKCore-Questionnaire-InpatientSurvey-Example",
"title": "Inpatient Survey (Mock up)",
"status": "draft",
"experimental": true,
"Patient"
],
"date": "2023-11-13T11:50:00+00:00",
"purpose": "A questionnaire used as part of a survey of new patient admissions to Acute Medicine. Purely for demonstration purposes.",
"start": "2023-11-13T11:50:00+00:00",
"end": "2023-12-13T11:50:00+00:00"
},
"item": [
{
"linkId": "1",
"text": "Do you have allergies?",
"type": "string"
},
{
"linkId": "2",
"text": "General questions",
"type": "group",
"item": [
{
"linkId": "2.1",
"text": "What is your gender?",
"type": "string"
},
{
"linkId": "2.2",
"text": "What is your date of birth?",
"type": "date"
},
{
"linkId": "2.3",
"text": "What is your country of birth?",
"type": "string"
},
{
"linkId": "2.4",
"text": "What is your marital status?",
"type": "string"
}
]
},
{
"linkId": "3",
"text": "Intoxications",
"type": "group",
"item": [
{
"linkId": "3.1",
"text": "Do you smoke?",
"type": "boolean"
},
{
"linkId": "3.2",
"text": "Do you drink alcohol?",
"type": "boolean"
}
]
}
]
}