PACIO Sample Data Depot, published by MITRE. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/paciowg/sample-data-fsh/ and changes regularly. See the Directory of published versions

• Narrative Content
• XML
• JSON

: 46349c26-30b3-4f36-94a6-f9ddfe4b7426 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="46349c26-30b3-4f36-94a6-f9ddfe4b7426"/>
  <meta>
    <lastUpdated value="2025-06-20T16:47:25.389+00:00"/>
  </meta>
  <type value="searchset"/>
  <total value="3"/>
  <link>
    <relation value="self"/>
    <url value="https://gw.interop.community/cmspqrs/open/Questionnaire"/>
  </link>
  <entry>
    <fullUrl
             value="https://gw.interop.community/cmspqrs/open/Questionnaire/44249-1"/>
    <resource>
      <Questionnaire>
        <id value="44249-1"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2025-05-28T18:06:29.000+00:00"/>
          <source value="#aLYUC2N4J9eLQ33k"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Questionnaire_44249-1"> </a><p class="res-header-id"><b>Generated Narrative: Questionnaire 44249-1</b></p><a name="44249-1"> </a><a name="hc44249-1"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1; Last updated: 2025-05-28 18:06:29+0000; </p><p style="margin-bottom: 0px">Information Source: #aLYUC2N4J9eLQ33k</p></div><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> PHQ_quick_depression_assessment_panel</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://loinc.org/q/44249-1</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.14363" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> 14363</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">PHQ-9.1. Little interest or pleasure in doing things</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.14363">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.14364" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> 14364</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">PHQ-9.2. Feeling down, depressed, or hopeless</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.14364">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.14365" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> 14365</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Trouble falling or staying asleep, or sleeping too much</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.14365">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.14366" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> 14366</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Feeling tired or having little energy</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.14366">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.14367" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> 14367</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Poor appetite or overeating</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.14367">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.14368" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> 14368</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Feeling bad about yourself-or that you are a failure or have let yourself or your family down</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.14368">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.14369" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> 14369</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Trouble concentrating on things, such as reading the newspaper or watching television</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.14369">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.14370" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> 14370</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Moving or speaking so slowly that other people could have noticed. Or the opposite-being so fidgety or restless that you have been moving around a lot more than usual</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.14370">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.14371" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> 14371</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Thoughts that you would be better off dead, or of hurting yourself in some way</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.14371">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.57492" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> 57492</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.57492">4 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.14372" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-decimal.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="decimal" class="hierarchy"/> 14372</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Patient health questionnaire 9 item total score</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item.14363"> </a><p><b>Answer options for 14363 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 (&quot;Not at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6569-3 (&quot;Several days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6570-1 (&quot;More than half the days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6571-9 (&quot;Nearly every day&quot;)</li></ul><a name="opt-item.14364"> </a><p><b>Answer options for 14364 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 (&quot;Not at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6569-3 (&quot;Several days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6570-1 (&quot;More than half the days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6571-9 (&quot;Nearly every day&quot;)</li></ul><a name="opt-item.14365"> </a><p><b>Answer options for 14365 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 (&quot;Not at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6569-3 (&quot;Several days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6570-1 (&quot;More than half the days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6571-9 (&quot;Nearly every day&quot;)</li></ul><a name="opt-item.14366"> </a><p><b>Answer options for 14366 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 (&quot;Not at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6569-3 (&quot;Several days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6570-1 (&quot;More than half the days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6571-9 (&quot;Nearly every day&quot;)</li></ul><a name="opt-item.14367"> </a><p><b>Answer options for 14367 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 (&quot;Not at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6569-3 (&quot;Several days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6570-1 (&quot;More than half the days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6571-9 (&quot;Nearly every day&quot;)</li></ul><a name="opt-item.14368"> </a><p><b>Answer options for 14368 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 (&quot;Not at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6569-3 (&quot;Several days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6570-1 (&quot;More than half the days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6571-9 (&quot;Nearly every day&quot;)</li></ul><a name="opt-item.14369"> </a><p><b>Answer options for 14369 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 (&quot;Not at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6569-3 (&quot;Several days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6570-1 (&quot;More than half the days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6571-9 (&quot;Nearly every day&quot;)</li></ul><a name="opt-item.14370"> </a><p><b>Answer options for 14370 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 (&quot;Not at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6569-3 (&quot;Several days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6570-1 (&quot;More than half the days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6571-9 (&quot;Nearly every day&quot;)</li></ul><a name="opt-item.14371"> </a><p><b>Answer options for 14371 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6568-5 (&quot;Not at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6569-3 (&quot;Several days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6570-1 (&quot;More than half the days&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6571-9 (&quot;Nearly every day&quot;)</li></ul><a name="opt-item.57492"> </a><p><b>Answer options for 57492 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA6572-7 (&quot;Not difficult at all&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6573-5 (&quot;Somewhat difficult&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6575-0 (&quot;Very difficult&quot;)</li><li style="font-size: 11px">http://loinc.org#LA6574-3 (&quot;Extremely difficult&quot;)</li></ul></div>
        </text>
        <url value="http://loinc.org/q/44249-1"/>
        <name value="PHQ_quick_depression_assessment_panel"/>
        <title value="PHQ-9 quick depression assessment panel"/>
        <status value="draft"/>
        <subjectType value="Patient"/>
        <publisher value="Regenstrief Institute, Inc."/>
        <contact>
          <name value="Regenstrief Institute, Inc."/>
          <telecom>
            <system value="url"/>
            <value value="http://loinc.org"/>
          </telecom>
        </contact>
        <copyright
                   value="This content from LOINC® is copyright © 1995 Regenstrief Institute, Inc. and the LOINC Committee, and available at no cost under the license at https://loinc.org/license/
Copyright © Pfizer Inc. All rights reserved. Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute."/>
        <code>
          <system value="http://loinc.org"/>
          <code value="44249-1"/>
          <display
                   value="PHQ-9 quick depression assessment panel [Reported.PHQ]"/>
        </code>
        <item>
          <linkId value="14363"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="44250-9"/>
            <display
                     value="Little interest or pleasure in doing things in last 2 weeks"/>
          </code>
          <prefix value="PHQ-9.1"/>
          <text value="Little interest or pleasure in doing things"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6568-5"/>
              <display value="Not at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6569-3"/>
              <display value="Several days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6570-1"/>
              <display value="More than half the days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6571-9"/>
              <display value="Nearly every day"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <linkId value="14364"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="44255-8"/>
            <display
                     value="Feeling down, depressed, or hopeless in last 2 weeks"/>
          </code>
          <prefix value="PHQ-9.2"/>
          <text value="Feeling down, depressed, or hopeless"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6568-5"/>
              <display value="Not at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6569-3"/>
              <display value="Several days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6570-1"/>
              <display value="More than half the days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6571-9"/>
              <display value="Nearly every day"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <linkId value="14365"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="44259-0"/>
            <display
                     value="Trouble falling or staying asleep, or sleeping too much in last 2 weeks [Reported.PHQ]"/>
          </code>
          <text
                value="Trouble falling or staying asleep, or sleeping too much"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6568-5"/>
              <display value="Not at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6569-3"/>
              <display value="Several days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6570-1"/>
              <display value="More than half the days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6571-9"/>
              <display value="Nearly every day"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <linkId value="14366"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="44254-1"/>
            <display
                     value="Feeling tired or having little energy in last 2 weeks [Reported.PHQ]"/>
          </code>
          <text value="Feeling tired or having little energy"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6568-5"/>
              <display value="Not at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6569-3"/>
              <display value="Several days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6570-1"/>
              <display value="More than half the days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6571-9"/>
              <display value="Nearly every day"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <linkId value="14367"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="44251-7"/>
            <display
                     value="Poor appetite or overeating in last 2 weeks [Reported.PHQ]"/>
          </code>
          <text value="Poor appetite or overeating"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6568-5"/>
              <display value="Not at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6569-3"/>
              <display value="Several days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6570-1"/>
              <display value="More than half the days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6571-9"/>
              <display value="Nearly every day"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <linkId value="14368"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="44258-2"/>
            <display
                     value="Feeling bad about yourself - or that you are a failure or have let yourself or your family down in last 2 weeks [Reported.PHQ]"/>
          </code>
          <text
                value="Feeling bad about yourself-or that you are a failure or have let yourself or your family down"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6568-5"/>
              <display value="Not at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6569-3"/>
              <display value="Several days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6570-1"/>
              <display value="More than half the days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6571-9"/>
              <display value="Nearly every day"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <linkId value="14369"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="44252-5"/>
            <display
                     value="Trouble concentrating on things, such as reading the newspaper or watching television in last 2 weeks [Reported.PHQ]"/>
          </code>
          <text
                value="Trouble concentrating on things, such as reading the newspaper or watching television"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6568-5"/>
              <display value="Not at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6569-3"/>
              <display value="Several days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6570-1"/>
              <display value="More than half the days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6571-9"/>
              <display value="Nearly every day"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <linkId value="14370"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="44253-3"/>
            <display
                     value="Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual in last 2 weeks [Reported.PHQ]"/>
          </code>
          <text
                value="Moving or speaking so slowly that other people could have noticed. Or the opposite-being so fidgety or restless that you have been moving around a lot more than usual"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6568-5"/>
              <display value="Not at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6569-3"/>
              <display value="Several days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6570-1"/>
              <display value="More than half the days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6571-9"/>
              <display value="Nearly every day"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <linkId value="14371"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="44260-8"/>
            <display
                     value="Thoughts that you would be better off dead, or of hurting yourself in some way in last 2 weeks [Reported.PHQ]"/>
          </code>
          <text
                value="Thoughts that you would be better off dead, or of hurting yourself in some way"/>
          <type value="choice"/>
          <repeats value="false"/>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6568-5"/>
              <display value="Not at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6569-3"/>
              <display value="Several days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6570-1"/>
              <display value="More than half the days"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6571-9"/>
              <display value="Nearly every day"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <linkId value="57492"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="69722-7"/>
            <display
                     value="How difficult have these made it for you to do your work, take care of things at home, or get along with other people [Reported.PHQ]"/>
          </code>
          <text
                value="How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?"/>
          <type value="choice"/>
          <repeats value="false"/>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6572-7"/>
              <display value="Not difficult at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6573-5"/>
              <display value="Somewhat difficult"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6575-0"/>
              <display value="Very difficult"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="LA6574-3"/>
              <display value="Extremely difficult"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <linkId value="14372"/>
          <text value="Patient health questionnaire 9 item total score"/>
          <type value="decimal"/>
        </item>
      </Questionnaire>
    </resource>
    <search>
      <mode value="match"/>
    </search>
  </entry>
  <entry>
    <fullUrl
             value="https://gw.interop.community/cmspqrs/open/Questionnaire/52"/>
    <resource>
      <Questionnaire>
        <id value="52"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2025-06-10T19:04:47.000+00:00"/>
          <source value="#zOBHLc4oJjsM2fkp"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Questionnaire_52"> </a><p class="res-header-id"><b>Generated Narrative: Questionnaire 52</b></p><a name="52"> </a><a name="hc52"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1; Last updated: 2025-06-10 19:04:47+0000; </p><p style="margin-bottom: 0px">Information Source: #zOBHLc4oJjsM2fkp</p></div><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Other attributes of the item">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> ZBI-22</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Zarit Burden Interview (ZBI) </td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">https://globalalliantinc.com/fhir/questionnaires/ZBI-22#1.0.0</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.mbi" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> mbi</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is this patient's Medicare Beneficiary Identifier (MBI)?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.first_name" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> first_name</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is the patient's first name?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Max Length: 100</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.last_name" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> last_name</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is the patient's last name?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Max Length: 100</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.date_of_birth" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="." style="background-color: white; background-color: inherit" title="date" class="hierarchy"/> date_of_birth</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is this patient's date of birth?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.pcg_first_name" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> pcg_first_name</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is the primary caregiver's first name?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Max Length: 100</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.pcg_last_name" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> pcg_last_name</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is the primary caregiver's last name?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Max Length: 100</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.assessment_date" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="date" class="hierarchy"/> assessment_date</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Please report the date this assessment was complete.</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ask_more" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> ask_more</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that your relative asks for more help than he/she needs?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ask_more">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.enough_time" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> enough_time</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that because of the time you spend with your relative that you don't have enough time for yourself?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.enough_time">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.stressed" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> stressed</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel stressed between caring for your relative and trying to meet other responsibilities for your family or work?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.stressed">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.embarrassed" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> embarrassed</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel embarrassed over your relative's behavior?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.embarrassed">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.angry" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> angry</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel angry when you are around your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.angry">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.affects_relationships" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> affects_relationships</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that your relative currently affects your relationship with other family members or friends in a negative way?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.affects_relationships">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.afraid_future" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> afraid_future</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Are you afraid what the future holds for your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.afraid_future">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.dependent" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> dependent</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel your relative is dependent upon you?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.dependent">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.strained" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> strained</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel strained when you are around your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.strained">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.health_suffered" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> health_suffered</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel your health has suffered because of your involvement with your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.health_suffered">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.privacy" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> privacy</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that you don't have as much privacy as you would like, because of your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.privacy">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.social_life" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> social_life</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that your social life has suffered because you are caring for your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.social_life">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.uncomfortable" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> uncomfortable</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel uncomfortable about having friends over, because of your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.uncomfortable">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.expectation" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> expectation</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that your relative seems to expect you to take care of him/her, as if you were the only one he/she could depend on?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.expectation">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.enough_money" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> enough_money</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that you don't have enough money to care for your relative, in addition to the rest of your expenses?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.enough_money">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.much_longer" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> much_longer</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that you will be unable to take care of your relative much longer?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.much_longer">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.lost_control" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> lost_control</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel you have lost control of your life since your relative's illness?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.lost_control">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.leave_care" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> leave_care</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you wish you could just leave the care of your relative to someone else?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.leave_care">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.uncertain" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> uncertain</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel uncertain about what to do about your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.uncertain">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.do_more" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> do_more</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel you should be doing more for your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.do_more">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.better_job" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> better_job</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel you could do a better job in caring for your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.better_job">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.overall_burden" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> overall_burden</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Overall, how burdened do you feel in caring for your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.overall_burden">5 options</a></td></tr>
<tr><td colspan="6" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item.ask_more"> </a><p><b>Answer options for ask_more </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.enough_time"> </a><p><b>Answer options for enough_time </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.stressed"> </a><p><b>Answer options for stressed </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.embarrassed"> </a><p><b>Answer options for embarrassed </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.angry"> </a><p><b>Answer options for angry </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.affects_relationships"> </a><p><b>Answer options for affects_relationships </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.afraid_future"> </a><p><b>Answer options for afraid_future </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.dependent"> </a><p><b>Answer options for dependent </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.strained"> </a><p><b>Answer options for strained </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.health_suffered"> </a><p><b>Answer options for health_suffered </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.privacy"> </a><p><b>Answer options for privacy </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.social_life"> </a><p><b>Answer options for social_life </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.uncomfortable"> </a><p><b>Answer options for uncomfortable </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.expectation"> </a><p><b>Answer options for expectation </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.enough_money"> </a><p><b>Answer options for enough_money </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.much_longer"> </a><p><b>Answer options for much_longer </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.lost_control"> </a><p><b>Answer options for lost_control </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.leave_care"> </a><p><b>Answer options for leave_care </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.uncertain"> </a><p><b>Answer options for uncertain </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.do_more"> </a><p><b>Answer options for do_more </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.better_job"> </a><p><b>Answer options for better_job </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.overall_burden"> </a><p><b>Answer options for overall_burden </b></p><ul><li style="font-size: 11px">null#0 (&quot;Not at all&quot;)</li><li style="font-size: 11px">null#1 (&quot;A little bit&quot;)</li><li style="font-size: 11px">null#2 (&quot;Moderately&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite a bit&quot;)</li><li style="font-size: 11px">null#4 (&quot;Extremely&quot;)</li></ul></div>
        </text>
        <url value="https://globalalliantinc.com/fhir/questionnaires/ZBI-22"/>
        <version value="1.0.0"/>
        <name value="ZBI-22"/>
        <title value="ZBI-22"/>
        <status value="draft"/>
        <publisher value="Global Alliant Inc."/>
        <description value="Zarit Burden Interview (ZBI) "/>
        <purpose
                 value="The ZBI-22 uses a scale of 0-4 to gauge the  degree of burden Primary Caregivers experience related to the demands of providing daily care  to a dependent adult."/>
        <lastReviewDate value="2024-04-11"/>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/regex">
            <valueString
                         value="^[1-9]((?![SLOIBZ])[A-Z])((?![SLOIBZ])[0-9A-Z])[0-9]((?![SLOIBZ])[A-Z])((?![SLOIBZ])[0-9A-Z])[0-9]((?![SLOIBZ])[A-Z])((?![SLOIBZ])[A-Z])[0-9][0-9]$"/>
          </extension>
          <linkId value="mbi"/>
          <text
                value="What is this patient's Medicare Beneficiary Identifier (MBI)?"/>
          <type value="string"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
        </item>
        <item>
          <linkId value="first_name"/>
          <text value="What is the patient's first name?"/>
          <type value="string"/>
          <required value="true"/>
          <repeats value="false"/>
          <maxLength value="100"/>
        </item>
        <item>
          <linkId value="last_name"/>
          <text value="What is the patient's last name?"/>
          <type value="string"/>
          <required value="true"/>
          <repeats value="false"/>
          <maxLength value="100"/>
        </item>
        <item>
          <linkId value="date_of_birth"/>
          <text value="What is this patient's date of birth?"/>
          <type value="date"/>
          <required value="true"/>
          <repeats value="false"/>
        </item>
        <item>
          <linkId value="pcg_first_name"/>
          <text value="What is the primary caregiver's first name?"/>
          <type value="string"/>
          <required value="true"/>
          <repeats value="false"/>
          <maxLength value="100"/>
        </item>
        <item>
          <linkId value="pcg_last_name"/>
          <text value="What is the primary caregiver's last name?"/>
          <type value="string"/>
          <required value="true"/>
          <repeats value="false"/>
          <maxLength value="100"/>
        </item>
        <item>
          <linkId value="assessment_date"/>
          <text value="Please report the date this assessment was complete."/>
          <type value="date"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="ask_more"/>
          <text
                value="Do you feel that your relative asks for more help than he/she needs?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="enough_time"/>
          <text
                value="Do you feel that because of the time you spend with your relative that you don't have enough time for yourself?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="stressed"/>
          <text
                value="Do you feel stressed between caring for your relative and trying to meet other responsibilities for your family or work?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="embarrassed"/>
          <text
                value="Do you feel embarrassed over your relative's behavior?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="angry"/>
          <text value="Do you feel angry when you are around your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="affects_relationships"/>
          <text
                value="Do you feel that your relative currently affects your relationship with other family members or friends in a negative way?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
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          <linkId value="strained"/>
          <text
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          <linkId value="health_suffered"/>
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                value="Do you feel your health has suffered because of your involvement with your relative?"/>
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          <linkId value="privacy"/>
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          <answerOption>
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          <linkId value="social_life"/>
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                value="Do you feel that your social life has suffered because you are caring for your relative?"/>
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            <valueCoding>
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          <linkId value="uncomfortable"/>
          <text
                value="Do you feel uncomfortable about having friends over, because of your relative?"/>
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          <linkId value="expectation"/>
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                value="Do you feel that your relative seems to expect you to take care of him/her, as if you were the only one he/she could depend on?"/>
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          <linkId value="enough_money"/>
          <text
                value="Do you feel that you don't have enough money to care for your relative, in addition to the rest of your expenses?"/>
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          <repeats value="false"/>
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          <answerOption>
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          <answerOption>
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          <linkId value="much_longer"/>
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                value="Do you feel that you will be unable to take care of your relative much longer?"/>
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          <linkId value="lost_control"/>
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          <linkId value="leave_care"/>
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  <entry>
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             value="https://gw.interop.community/cmspqrs/open/Questionnaire/questionnaire-ZBI22"/>
    <resource>
      <Questionnaire>
        <id value="questionnaire-ZBI22"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2025-06-12T13:01:35.000+00:00"/>
          <source value="#jhl8BZ4aslKK0xGI"/>
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        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Questionnaire_questionnaire-ZBI22"> </a><p class="res-header-id"><b>Generated Narrative: Questionnaire questionnaire-ZBI22</b></p><a name="questionnaire-ZBI22"> </a><a name="hcquestionnaire-ZBI22"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1; Last updated: 2025-06-12 13:01:35+0000; </p><p style="margin-bottom: 0px">Information Source: #jhl8BZ4aslKK0xGI</p></div><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Other attributes of the item">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> ZBI-22</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Zarit Burden Interview (ZBI) </td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">https://globalalliantinc.com/fhir/questionnaires/ZBI-22#0.1.0</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.first_name" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> first_name</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is the patient's first name?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Max Length: 100</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.last_name" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> last_name</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is the patient's last name?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Max Length: 100</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.date_of_birth" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="date" class="hierarchy"/> date_of_birth</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is this patient's date of birth?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.mbi" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> mbi</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is this patient's Medicare Beneficiary Identifier (MBI)?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.pcg_first_name" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> pcg_first_name</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is the primary caregiver's first name?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Max Length: 100</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.pcg_last_name" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: white; background-color: inherit" title="string" class="hierarchy"/> pcg_last_name</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">What is the primary caregiver's last name?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Max Length: 100</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.assessment_date" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="date" class="hierarchy"/> assessment_date</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Please report the date this assessment was complete.</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ask_more" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> ask_more</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that your relative asks for more help than he/she needs?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ask_more">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.enough_time" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> enough_time</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that because of the time you spend with your relative that you don’t have enough time for yourself?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.enough_time">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.stressed" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> stressed</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel stressed between caring for your relative and trying to meet other responsibilities for your family or work?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.stressed">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.embarrassed" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> embarrassed</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel embarrassed over your relative’s behavior?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.embarrassed">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.angry" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> angry</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel angry when you are around your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.angry">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.affects_relationships" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> affects_relationships</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that your relative currently affects your relationship with other family members or friends in a negative way?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.affects_relationships">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.afraid_future" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> afraid_future</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Are you afraid what the future holds for your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.afraid_future">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.dependent" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> dependent</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel your relative is dependent upon you?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.dependent">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.strained" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> strained</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel strained when you are around your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.strained">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.health_suffered" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> health_suffered</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel your health has suffered because of your involvement with your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.health_suffered">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.privacy" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> privacy</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that you don’t have as much privacy as you would like, because of your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.privacy">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.social_life" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> social_life</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that your social life has suffered because you are caring for your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.social_life">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.uncomfortable" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> uncomfortable</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel uncomfortable about having friends over, because of your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.uncomfortable">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.expectation" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> expectation</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that your relative seems to expect you to take care of him/her, as if you were the only one he/she could depend on?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.expectation">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.enough_money" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> enough_money</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that you don’t have enough money to care for your relative, in addition to the rest of your expenses?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.enough_money">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.much_longer" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> much_longer</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel that you will be unable to take care of your relative much longer?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.much_longer">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.lost_control" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> lost_control</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel you have lost control of your life since your relative’s illness?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.lost_control">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.leave_care" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> leave_care</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you wish you could just leave the care of your relative to someone else?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.leave_care">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.uncertain" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> uncertain</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel uncertain about what to do about your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.uncertain">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.do_more" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> do_more</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel you should be doing more for your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.do_more">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.better_job" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: white; background-color: inherit" title="choice" class="hierarchy"/> better_job</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Do you feel you could do a better job in caring for your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.better_job">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.overall_burden" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-choice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="choice" class="hierarchy"/> overall_burden</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Overall, how burdened do you feel in caring for your relative?</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.overall_burden">5 options</a></td></tr>
<tr><td colspan="6" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item.ask_more"> </a><p><b>Answer options for ask_more </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.enough_time"> </a><p><b>Answer options for enough_time </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.stressed"> </a><p><b>Answer options for stressed </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.embarrassed"> </a><p><b>Answer options for embarrassed </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.angry"> </a><p><b>Answer options for angry </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.affects_relationships"> </a><p><b>Answer options for affects_relationships </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.afraid_future"> </a><p><b>Answer options for afraid_future </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.dependent"> </a><p><b>Answer options for dependent </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.strained"> </a><p><b>Answer options for strained </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.health_suffered"> </a><p><b>Answer options for health_suffered </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.privacy"> </a><p><b>Answer options for privacy </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.social_life"> </a><p><b>Answer options for social_life </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.uncomfortable"> </a><p><b>Answer options for uncomfortable </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.expectation"> </a><p><b>Answer options for expectation </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.enough_money"> </a><p><b>Answer options for enough_money </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.much_longer"> </a><p><b>Answer options for much_longer </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.lost_control"> </a><p><b>Answer options for lost_control </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.leave_care"> </a><p><b>Answer options for leave_care </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.uncertain"> </a><p><b>Answer options for uncertain </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.do_more"> </a><p><b>Answer options for do_more </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.better_job"> </a><p><b>Answer options for better_job </b></p><ul><li style="font-size: 11px">null#0 (&quot;Never&quot;)</li><li style="font-size: 11px">null#1 (&quot;Rarely&quot;)</li><li style="font-size: 11px">null#2 (&quot;Sometimes&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite Frequently&quot;)</li><li style="font-size: 11px">null#4 (&quot;Nearly Always&quot;)</li></ul><a name="opt-item.overall_burden"> </a><p><b>Answer options for overall_burden </b></p><ul><li style="font-size: 11px">null#0 (&quot;Not at all&quot;)</li><li style="font-size: 11px">null#1 (&quot;A little bit&quot;)</li><li style="font-size: 11px">null#2 (&quot;Moderately&quot;)</li><li style="font-size: 11px">null#3 (&quot;Quite a bit&quot;)</li><li style="font-size: 11px">null#4 (&quot;Extremely&quot;)</li></ul></div>
        </text>
        <url value="https://globalalliantinc.com/fhir/questionnaires/ZBI-22"/>
        <version value="0.1.0"/>
        <name value="ZBI-22"/>
        <title value="ZBI-22"/>
        <status value="draft"/>
        <date value="2025-06-11T22:07:39-04:00"/>
        <publisher value="MITRE"/>
        <contact>
          <name value="MITRE"/>
          <telecom>
            <system value="url"/>
            <value value="http://www.mitre.org"/>
          </telecom>
        </contact>
        <contact>
          <name value="May Terry"/>
          <telecom>
            <system value="email"/>
            <value value="mayT@mitre.org"/>
            <use value="work"/>
          </telecom>
        </contact>
        <description value="Zarit Burden Interview (ZBI) "/>
        <purpose
                 value="The ZBI-22 uses a scale of 0-4 to gauge the  degree of burden Primary Caregivers experience related to the demands of providing daily care  to a dependent adult."/>
        <lastReviewDate value="2024-04-11"/>
        <item>
          <linkId value="first_name"/>
          <text value="What is the patient's first name?"/>
          <type value="string"/>
          <required value="true"/>
          <repeats value="false"/>
          <maxLength value="100"/>
        </item>
        <item>
          <linkId value="last_name"/>
          <text value="What is the patient's last name?"/>
          <type value="string"/>
          <required value="true"/>
          <repeats value="false"/>
          <maxLength value="100"/>
        </item>
        <item>
          <linkId value="date_of_birth"/>
          <text value="What is this patient's date of birth?"/>
          <type value="date"/>
          <required value="true"/>
          <repeats value="false"/>
        </item>
        <item>
          <extension url="http://hl7.org/fhir/StructureDefinition/regex">
            <valueString
                         value="^[1-9](?![SLOIBZ])[A-Z](?![SLOIBZ])[0-9A-Z][0-9](?![SLOIBZ])[A-Z](?![SLOIBZ])[0-9A-Z][0-9](?![SLOIBZ])[A-Z]{2}[0-9]{2}$"/>
          </extension>
          <linkId value="mbi"/>
          <text
                value="What is this patient's Medicare Beneficiary Identifier (MBI)?"/>
          <type value="string"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
        </item>
        <item>
          <linkId value="pcg_first_name"/>
          <text value="What is the primary caregiver's first name?"/>
          <type value="string"/>
          <required value="true"/>
          <repeats value="false"/>
          <maxLength value="100"/>
        </item>
        <item>
          <linkId value="pcg_last_name"/>
          <text value="What is the primary caregiver's last name?"/>
          <type value="string"/>
          <required value="true"/>
          <repeats value="false"/>
          <maxLength value="100"/>
        </item>
        <item>
          <linkId value="assessment_date"/>
          <text value="Please report the date this assessment was complete."/>
          <type value="date"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="ask_more"/>
          <text
                value="Do you feel that your relative asks for more help than he/she needs?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="enough_time"/>
          <text
                value="Do you feel that because of the time you spend with your relative that you don’t have enough time for yourself?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="stressed"/>
          <text
                value="Do you feel stressed between caring for your relative and trying to meet other responsibilities for your family or work?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="embarrassed"/>
          <text
                value="Do you feel embarrassed over your relative’s behavior?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="angry"/>
          <text value="Do you feel angry when you are around your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="affects_relationships"/>
          <text
                value="Do you feel that your relative currently affects your relationship with other family members or friends in a negative way?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="afraid_future"/>
          <text
                value="Are you afraid what the future holds for your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
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            <valueCodeableConcept>
              <coding>
                <system
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                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="dependent"/>
          <text value="Do you feel your relative is dependent upon you?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="strained"/>
          <text
                value="Do you feel strained when you are around your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
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                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="health_suffered"/>
          <text
                value="Do you feel your health has suffered because of your involvement with your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
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                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="privacy"/>
          <text
                value="Do you feel that you don’t have as much privacy as you would like, because of your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="social_life"/>
          <text
                value="Do you feel that your social life has suffered because you are caring for your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="uncomfortable"/>
          <text
                value="Do you feel uncomfortable about having friends over, because of your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="expectation"/>
          <text
                value="Do you feel that your relative seems to expect you to take care of him/her, as if you were the only one he/she could depend on?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="enough_money"/>
          <text
                value="Do you feel that you don’t have enough money to care for your relative, in addition to the rest of your expenses?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/questionnaire-item-control"/>
                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="much_longer"/>
          <text
                value="Do you feel that you will be unable to take care of your relative much longer?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
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                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="lost_control"/>
          <text
                value="Do you feel you have lost control of your life since your relative’s illness?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
                <system
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                <code value="drop-down"/>
                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="leave_care"/>
          <text
                value="Do you wish you could just leave the care of your relative to someone else?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
            <valueCodeableConcept>
              <coding>
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                <display value="Drop down"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <linkId value="uncertain"/>
          <text
                value="Do you feel uncertain about what to do about your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
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                <display value="Drop down"/>
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          </extension>
          <linkId value="do_more"/>
          <text
                value="Do you feel you should be doing more for your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
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          </extension>
          <linkId value="better_job"/>
          <text
                value="Do you feel you could do a better job in caring for your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Never"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="Rarely"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Sometimes"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite Frequently"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Nearly Always"/>
            </valueCoding>
          </answerOption>
        </item>
        <item>
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                <display value="Drop down"/>
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          </extension>
          <linkId value="overall_burden"/>
          <text
                value="Overall, how burdened do you feel in caring for your relative?"/>
          <type value="choice"/>
          <required value="true"/>
          <repeats value="false"/>
          <readOnly value="false"/>
          <answerOption>
            <valueCoding>
              <code value="0"/>
              <display value="Not at all"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="1"/>
              <display value="A little bit"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="2"/>
              <display value="Moderately"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="3"/>
              <display value="Quite a bit"/>
            </valueCoding>
          </answerOption>
          <answerOption>
            <valueCoding>
              <code value="4"/>
              <display value="Extremely"/>
            </valueCoding>
          </answerOption>
        </item>
      </Questionnaire>
    </resource>
    <search>
      <mode value="match"/>
    </search>
  </entry>
</Bundle>