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December 5, 2013 19:50
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| --- | |
| finish_on_last_page: false | |
| name: Lung Information Needs Questionnaire | |
| redirect_url: /accounts/profile/ | |
| show_progress: true | |
| slug: linq | |
| step_navigation: true | |
| steps_are_sequential: true | |
| success_message: Questionnaire complete. | |
| --- | |
| # Introduction | |
| ~~~{#patient_age .integer } | |
| What is the patient's age (in years) | |
| ~~~ | |
| ~~~{#patient_gender .likert } | |
| The patient is: | |
| >>> | |
| 1=Female | |
| 0=Male | |
| ~~~ | |
| ~~~{#patient_diagnosis .pulldown } | |
| What is the patient's primary respiratory diagnosis? | |
| >>> | |
| 1=COPD | |
| 2=Asthma | |
| ~~~ | |
| ~~~{#which_country_are_you_based .short-text } | |
| In which country are you based? | |
| ~~~ | |
| ~~~{#linq_agree_data_can_be_used .likert } | |
| I agree that data submitted may be analysed as part of the research of the PRPP. | |
| >>> | |
| 1=Yes | |
| 0=No | |
| ~~~ | |
| # Information needs | |
| ~~~{#linq_name .likert } | |
| Do you know the name of your lung disease? | |
| >>> | |
| 1=Yes | |
| 0=No | |
| ~~~ | |
| ~~~{#linq_how .likert } | |
| Has a doctor or nurse told you how this disease affects your lungs? | |
| >>> | |
| 1=Yes | |
| 0=No | |
| ~~~ | |
| ~~~{#linq_future .likert } | |
| Has a doctor or nurse told you what is likely to happen in the future? | |
| >>> | |
| 1=Yes | |
| 0=No | |
| ~~~ | |
| ~~~{#linq_nextfewyears .likert-list } | |
| Which of the following statements best describes what will happen to you over the next few years? | |
| >>> | |
| 1=Now that my disease is being treated, I will probably get better | |
| 2=Now that my disease is being treated, I will probably stay the same | |
| 3=I will get worse | |
| 4=I have no idea | |
| ~~~ | |
| ~~~{#linq_medicinereason .likert } | |
| Has a doctor or nurse explained the reason for taking your inhalers or medicines? | |
| >>> | |
| 1=Yes | |
| 0=No | |
| ~~~ | |
| ~~~{#linq_medsasinstructed .likert } | |
| Do you try to take your inhalers or medicines exactly as you have been instructed by a doctor or nurse? | |
| >>> | |
| 1=Yes | |
| 0=No | |
| ~~~ | |
| ~~~{#linq_medinfosatisfied .likert-list } | |
| Are you satisfied with the information doctors and nurses have given you about your inhalers or medicines? | |
| >>> | |
| 0=I understand everything I need to know | |
| 1=I understand what I have been told but I would like to know more | |
| 2=I am slightly confused about my medicines | |
| 3=I am very confused about my medicines | |
| ~~~ | |
| ~~~{#linq_whatodosymptomsworse .likert-list } | |
| What sentence best describes what you have been told to do if your breathing gets worse (e.g., take two puffs instead of one)? | |
| >>> | |
| 0=I have been told what to do and the doctor/nurse has given me written instructions | |
| 1=I have been told but it is not written on paper | |
| 2=I haven't been told but I know what to do | |
| 3=I haven't been told and I don’t know what to do | |
| ~~~ | |
| ~~~{#linq_whenabulance .likert-list } | |
| Have you been told when you should call an ambulance if your breathing worsens? | |
| >>> | |
| 0=I have been told what to do and the doctor/nurse has given me written instructions | |
| 1=I have been told but it isn't written on paper | |
| 2=I haven't been told but I know what to do | |
| 3=I haven't been told and I am uncertain when an ambulance should be called | |
| ~~~ | |
| ~~~{#linq_smoker .likert } | |
| What best describes you? | |
| >>> | |
| 0=Never smoked (skip the next 2 questions) | |
| 1=Used to smoke but don't now (skip the next 2 questions) | |
| 2=Still smoking | |
| ~~~ | |
| ~~~{#linq_quitsmoking .likert } | |
| Has a doctor or nurse advised you to give up smoking? | |
| >>> | |
| 0=Yes | |
| 1=No | |
| ~~~ | |
| ~~~{#linq_helpquitsmoking .likert } | |
| Has a doctor or nurse offered to help you to give up smoking (e.g., given you nicotine gum or patches or referral to a Smoking Cessation clinic)? | |
| >>> | |
| 0=Yes | |
| 1=No | |
| ~~~ | |
| ~~~{#linq_toldexercise .likert } | |
| Have you been told by a doctor or nurse to try to do some physical activity (e.g., walking, brisk walking and other forms of exercise)? | |
| >>> | |
| 0=Yes | |
| 1=No | |
| ~~~ | |
| ~~~{#linq_explainexercise .likert-list } | |
| Has a doctor or nurse told you how much physical activity (e.g., walking, brisk walking and other forms of exercise) you should do? | |
| >>> | |
| 0=Yes and I know what to do | |
| 1=Yes but I am unsure what to do | |
| 2=Yes but I am unable to do it | |
| 3=No | |
| ~~~ | |
| ~~~{#linq_howmuchactivity .likert-list } | |
| How much physical activity do you do? | |
| >>> | |
| 0=I push myself as much as I can | |
| 1=I make an effort | |
| 2=As little as possible | |
| ~~~ | |
| ~~~{#linq_eating .likert-list } | |
| What have doctors or nurses told you about your diet or eating? | |
| >>> | |
| 1=Nothing | |
| 2=Lose or gain weight | |
| 3=Eat healthy food | |
| 4=Eat several small meals per day "(e.g., 6 small meals per day instead of 3 large ones) | |
| ~~~ | |
| ~~~{#linq_comments .long-text } | |
| Have you any questions or comments about your lung disease? "If so, write them in the space below" | |
| ~~~ | |
| # Your score | |
| ~~~{#total_score_linq_scoreslinqscore .instruction } | |
| ## The total score on the LINQ is: {{linq_total}} | |
| {% if linq > 5 %} | |
| This patient may require significant clarifications in numerous areas. | |
| {% endif %} | |
| <hr> | |
| ### Disease knowledge score: {{linq_disease}} | |
| {% if linq_disease == 0 %} | |
| The patient is fully informed | |
| {% elif linq_disease == 1 %} | |
| The patient is reasonably well informed but could do with additional advice | |
| {% else %} | |
| <div class="text"> | |
| The patient would benefit from more information about their disease | |
| </div> | |
| {%endif%} | |
| ### Self management score: {{linq_selfmanagement}} | |
| {% if not answers.linq_whenabulance == "1" %} | |
| <div class="text-warning">The patient may require clarification on when to call an ambulance</div> | |
| {%endif%} | |
| ### Medicines score: {{linq_medicine}} | |
| {% if linq_medicine > 0 %} | |
| <div class="text">The patient may benefit from advice regarding their medication</div> | |
| {% else %} | |
| The patient is fully informed. | |
| {%endif%} | |
| ### Exercise score: {{linq_exercise}} | |
| {% if linq_exercise > 0 %} | |
| <div class="text">The patient may benefit from advice regarding exercise</div> | |
| {% else %} | |
| The patient is fully informed. | |
| {%endif%} | |
| {% if answers.linq_smoker == 2 %} | |
| ### Smoking status: | |
| <div class="text-warning">The patient still smokes</div> | |
| {%endif%} | |
| ~~~ | |
| ~~~{#nept_slisk_day } | |
| >>> | |
| linq_total <- sum(linq_name linq_how linq_future linq_nextfewyears linq_medicinereason linq_medsasinstructed linq_medinfosatisfied linq_whatodosymptomsworse linq_whenabulance linq_smoker linq_quitsmoking linq_helpquitsmoking linq_toldexercise linq_explainexercise linq_howmuchactivity linq_eating) | |
| ~~~ | |
| ~~~{#jal_kun_griw } | |
| >>> | |
| linq_exercise <- sum(linq_toldexercise linq_explainexercise linq_howmuchactivity) | |
| ~~~ | |
| ~~~{#brang_plan_swar } | |
| >>> | |
| linq_medicine <- sum(linq_medicinereason linq_medsasinstructed linq_medinfosatisfied) | |
| ~~~ | |
| ~~~{#nuct_slent_mig } | |
| >>> | |
| linq_selfmanagement <- sum(linq_whatodosymptomsworse linq_whenabulance) | |
| ~~~ | |
| ~~~{#gress_fik_slaz } | |
| >>> | |
| linq_disease <- sum(linq_name linq_how linq_future linq_nextfewyears) | |
| ~~~ |
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