Generated Narrative: Questionnaire MEDB71PsychStatusQuestionnaire

Structure
LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. MEDB71PsychStatusNASA Medical Requirements Integration Document for preflight behavioral health assessment. Captures psychiatric/psychological assessment of behavioral readiness for flight and review of psychological services.Questionnairehttps://mitre.org/fhir/space-health/Questionnaire/medb-7-1-psych-status#0.5.12
... overviewMedical Requirements Overview0..1group
.... overview.mrid-numberMRID Number and Title0..1displayInitial Value: string = MEDB 7.1 Preflight Psychiatric/Psychological Status Check
.... overview.sponsorSponsor1..1choiceiconiconOptions: 1 option
Initial Value: Coding = NASA MRID Sponsor Organizations#bhp "Behavioral Health and Performance"
.... overview.disciplineDiscipline1..1choiceiconiconOptions: 1 option
Initial Value: Coding = NASA MRID Medical Disciplines#behavioral "Behavior and Performance"
.... overview.categoryCategory1..1stringiconiconInitial Value: string = Medical Requirements (MR)
.... overview.referencesReferences0..1textInitial Value: string = Medical Evaluation Documents (MED) Volume B, Section 7.1; ISS MORD
.... overview.purposePurpose/Objectives1..1textInitial Value: string = Psychiatric/Psychological assessment of behavioral readiness for flight. Review of individual and crew psychological services.
.... overview.measurement-parametersMeasurement Parameters0..1stringInitial Value: string = N/A
.... overview.deliverablesDeliverables0..1stringInitial Value: string = N/A
.... overview.flight-durationFlight Duration1..1stringInitial Value: string = >= 30 days
.... overview.number-of-flightsNumber of Flights1..1stringInitial Value: string = Each ISS long duration expedition
.... overview.crew-members-requiredNumber and Type of Crew Members Required1..1stringInitial Value: string = All ISS crewmembers
... preflight-trainingPreflight Training0..1group
.... preflight-training.naNo Preflight Training Required0..1display
... preflight-activitiesPreflight Activities0..1group
.... preflight-activities.descriptionActivity Description0..1textInitial Value: string = An assessment of crew flight readiness is conducted by BHP personnel. Preflight briefings between the crewmembers & BHP specialist are required to confirm behavioral readiness for flight & review of individual & crew psychological services. This will include a check of life events that would have an impact on the astronaut's fitness for launch. Behavioral Medicine Assessments to include Neurocognitive baseline and Behavioral health baseline needed for in flight monitoring to be completed between L-12 and launch.
.... preflight-activities.assessment1Behavioral Medicine Assessment 10..1group
..... preflight-activities.assessment1.durationDuration (minutes)1..1integerInitial Value: integer = 60
..... preflight-activities.assessment1.scheduleSchedule1..1stringInitial Value: string = L-12 m, L-240/180 d
..... preflight-activities.assessment1.dateAssessment Date0..1date
..... preflight-activities.assessment1.completedAssessment Completed1..1boolean
.... preflight-activities.assessment2Behavioral Medicine Assessment 20..1group
..... preflight-activities.assessment2.durationDuration (minutes)1..1integerInitial Value: integer = 60
..... preflight-activities.assessment2.scheduleSchedule1..1stringInitial Value: string = L-90/30 days
..... preflight-activities.assessment2.dateAssessment Date0..1date
..... preflight-activities.assessment2.completedAssessment Completed1..1boolean
.... preflight-activities.flexibilityFlexibility0..1stringInitial Value: string = May be conducted over 2 days between L-90/30
.... preflight-activities.personnelPersonnel Required1..*choiceOptions: 2 options
.... preflight-activities.locationTest Location1..1choiceOptions: 2 options
.... preflight-activities.room-requirementsRoom Requirements0..1stringInitial Value: string = 8' x 10' private room free of distractions
.... preflight-activities.constraintsConstraints/Special Requirements0..1textInitial Value: string = Request that the L-90/30 event be scheduled as close as possible to the crewmember's final departure from the US prior to their Soyuz launch.
... assessment-resultsBehavioral Assessment Results0..1group
.... assessment-results.behavioral-readinessBehavioral Readiness for Flight1..1choiceOptions: 4 options
.... assessment-results.neurocognitive-baselineNeurocognitive Baseline Completed1..1boolean
.... assessment-results.behavioral-baselineBehavioral Health Baseline Completed1..1boolean
.... assessment-results.life-events-reviewLife Events Review Completed1..1boolean
.... assessment-results.life-events-impactLife Events with Potential Impact Identified0..1boolean
.... assessment-results.psych-services-reviewIndividual Psychological Services Reviewed1..1boolean
.... assessment-results.crew-services-reviewCrew Psychological Services Reviewed1..1boolean
.... assessment-results.aeromedical-concernsAeromedical Concerns Identified1..1boolean
.... assessment-results.aeromedical-concerns-detailsAeromedical Concerns Details0..1textEnable When: assessment-results.aeromedical-concerns =
... behavioral-metricsBehavioral State Metrics0..1group
.... behavioral-metrics.mood-levelMood Level (-3 to +3)0..1integer
.... behavioral-metrics.anxiety-levelAnxiety Level (0-10)0..1integer
.... behavioral-metrics.coping-capacityCoping Capacity Assessment0..1choiceOptions: 5 options
.... behavioral-metrics.sleep-qualitySleep Quality Assessment0..1choiceOptions: 4 options
.... behavioral-metrics.cognitive-readinessCognitive Readiness for Mission0..1choiceOptions: 4 options
.... behavioral-metrics.social-connectednessSocial Connectedness (with crew/family)0..1choiceOptions: 4 options
... inflight-activitiesIn-Flight Activities0..1group
.... inflight-activities.naNo In-Flight Activities0..1display
... postflight-activitiesPostflight Activities0..1group
.... postflight-activities.naNo Postflight Activities0..1display
... data-deliveryData Delivery0..1group
.... data-delivery.data-controlData Control0..1textInitial Value: string = Data are crew member controlled. The crewmember is the designated recipient of the data and sharing this information is at his/her discretion.
.... data-delivery.emr-entryEMR Entry Made1..1boolean
.... data-delivery.emr-entry-notesEMR Entry Notes0..1textInitial Value: string = Entries will be made in the EMR for each event showing completion of the MEDB requirement and stating if any aeromedical concerns were identified.
.... data-delivery.archiveData Archive System1..1choiceOptions: 1 option
... postflight-debriefPostflight Debrief0..1group
.... postflight-debrief.naNo Postflight Debrief Required0..1display

doco Documentation for this format

Options Sets

Answer options for overview.sponsor

  • https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-sponsor-cs#bhp ("Behavioral Health and Performance")

Answer options for overview.discipline

  • https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-discipline-cs#behavioral ("Behavior and Performance")

Answer options for preflight-activities.personnel

  • https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-roles-cs#crewmember ("Crewmember")
  • https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-roles-cs#bhp-specialist ("BHP Specialist")

Answer options for preflight-activities.location

  • https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-facility-cs#jsc ("Johnson Space Center")
  • https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-facility-cs#russia-gctc ("Gagarin Cosmonaut Training Center")

Answer options for assessment-results.behavioral-readiness

  • http://snomed.info/sct#17621005 ("Normal")
  • http://snomed.info/sct#263654008 ("Abnormal")
  • Cleared with conditions
  • Not cleared

Answer options for behavioral-metrics.coping-capacity

  • Excellent
  • Good
  • Adequate
  • Marginal
  • Inadequate

Answer options for behavioral-metrics.sleep-quality

  • Excellent
  • Good
  • Fair
  • Poor

Answer options for behavioral-metrics.cognitive-readiness

  • Fully ready
  • Ready with minor concerns
  • Ready with monitoring
  • Not ready

Answer options for behavioral-metrics.social-connectedness

  • Strong
  • Adequate
  • Weak
  • Concerning

Answer options for data-delivery.archive

  • https://mitre.org/fhir/space-health/CodeSystem/nasa-data-archive-cs#emr ("Electronic Medical Record")
 <status value="active"/> <date value="2012-05-31"/> <publisher value="MITRE"/> <contact> <name value="MITRE"/> <telecom> <system value="url"/> <value value="https://www.mitre.org/"/> </telecom> </contact> <description value="NASA Medical Requirements Integration Document for preflight behavioral health assessment. Captures psychiatric/psychological assessment of behavioral readiness for flight and review of psychological services."/> <purpose value="Psychiatric/Psychological assessment of behavioral readiness for flight. Review of individual and crew psychological services."/> <copyright value="NASA Johnson Space Center - Medical Requirements Integration Documents (MRIDs) JSC28913"/> <item> <linkId value="overview"/> <text value="Medical Requirements Overview"/> <type value="group"/> <item> <linkId value="overview.mrid-number"/> <text value="MRID Number and Title"/> <type value="display"/> <initial> <valueString value="MEDB 7.1 Preflight Psychiatric/Psychological Status Check"/> </initial> </item> <item> <linkId value="overview.sponsor"/> <text value="Sponsor"/> <type value="choice"/> <required value="true"/> <readOnly value="true"/> <answerOption> <valueCoding> <system value="https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-sponsor-cs"/> <code value="bhp"/> <display value="Behavioral Health and Performance"/> </valueCoding> </answerOption> <initial> <valueCoding> <system value="https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-sponsor-cs"/> <code value="bhp"/> <display value="Behavioral Health and Performance"/> </valueCoding> </initial> </item> <item> <linkId value="overview.discipline"/> <text value="Discipline"/> <type value="choice"/> <required value="true"/> <readOnly value="true"/> <answerOption> <valueCoding> <system value="https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-discipline-cs"/> <code value="behavioral"/> <display value="Behavior and Performance"/> </valueCoding> </answerOption> <initial> <valueCoding> <system value="https://mitre.org/fhir/space-health/CodeSystem/nasa-mrid-discipline-cs"/> <code value="behavioral"/> <display value="Behavior and Performance"/> </valueCoding> </initial> </item> <item> <linkId value="overview.category"/> <text value="Category"/> <type value="string"/> <required value="true"/> <readOnly value="true"/> <initial> <valueString value="Medical Requirements (MR)"/> </initial> </item> <item> <linkId value="overview.references"/> <text value="References"/> <type value="text"/> <required value="false"/> <initial> <valueString value="Medical Evaluation Documents (MED) Volume B, Section 7.1; ISS MORD"/> </initial> </item> <item> <linkId value="overview.purpose"/> <text value="Purpose/Objectives"/> <type value="text"/> <required value="true"/> <initial> <valueString value="Psychiatric/Psychological assessment of behavioral readiness for flight. Review of individual and crew psychological services."/> </initial> </item> <item> <linkId value="overview.measurement-parameters"/> <text value="Measurement Parameters"/> <type value="string"/> <required value="false"/> <initial> <valueString value="N/A"/> </initial> </item> <item> <linkId value="overview.deliverables"/> <text value="Deliverables"/> <type value="string"/> <required value="false"/> <initial> <valueString value="N/A"/> </initial> </item> <item> <linkId value="overview.flight-duration"/> <text value="Flight Duration"/> <type value="string"/> <required value="true"/> <initial> <valueString value=">= 30 days"/> </initial> </item> <item> <linkId value="overview.number-of-flights"/> <text value="Number of Flights"/> <type value="string"/> <required value="true"/> <initial> <valueString value="Each ISS long duration expedition"/> </initial> </item> <item> <linkId value="overview.crew-members-required"/> <text value="Number and Type of Crew Members Required"/> <type value="string"/> <required value="true"/> <initial> <valueString value="All ISS crewmembers"/> </initial> </item> </item> <item> <linkId value="preflight-training"/> <text value="Preflight Training"/> <type value="group"/> <item> <linkId value="preflight-training.na"/> <text value="No Preflight Training Required"/> <type value="display"/> </item> </item> <item> <linkId value="preflight-activities"/> <text value="Preflight Activities"/> <type value="group"/> <item> <linkId value="preflight-activities.description"/> <text value="Activity Description"/> <type value="text"/> <required value="false"/> <initial> <valueString value="An assessment of crew flight readiness is conducted by BHP personnel. Preflight briefings between the crewmembers & BHP specialist are required to confirm behavioral readiness for flight & review of individual & crew psychological services. This will include a check of life events that would have an impact on the astronaut's fitness for launch. Behavioral Medicine Assessments to include Neurocognitive baseline and Behavioral health baseline needed for in flight monitoring to be completed between L-12 and launch."/> </initial> </item> <item> <linkId value="preflight-activities.assessment1"/> <text value="Behavioral Medicine Assessment 1"/> <type value="group"/> <item> <linkId value="preflight-activities.assessment1.duration"/> <text value="Duration (minutes)"/> <type value="integer"/> <required value="true"/> <initial> <valueInteger value="60"/> </initial> </item> <item> <linkId value="preflight-activities.assessment1.schedule"/> <text value="Schedule"/> <type value="string"/> <required value="true"/> <initial> <valueString value="L-12 m, L-240/180 d"/> </initial> </item> <item> <linkId value="preflight-activities.assessment1.date"/> <text value="Assessment Date"/> <type value="date"/> <required value="false"/> </item> <item> <linkId value="preflight-activities.assessment1.completed"/> <text value="Assessment Completed"/> <type value="boolean"/> <required value="true"/> </item> </item> <item> <linkId value="preflight-activities.assessment2"/> <text value="Behavioral Medicine Assessment 2"/> <type value="group"/> <item> <linkId value="preflight-activities.assessment2.duration"/> <text value="Duration (minutes)"/> <type value="integer"/> <required value="true"/> <initial> <valueInteger value="60"/> </initial> </item> <item> <linkId value="preflight-activities.assessment2.schedule"/> <text value="Schedule"/> <type value="string"/> <required value="true"/> <initial> <valueString value="L-90/30 days"/> </initial> </item> <item> <linkId value="preflight-activities.assessment2.date"/> <text value="Assessment Date"/> <type value="date"/> <required value="false"/> </item> <item> <linkId value="preflight-activities.assessment2.completed"/> <text value="Assessment Completed"/> <type value="boolean"/> <required value="true"/> </item> </item> <item> <linkId value="preflight-activities.flexibility"/> <text value="Flexibility"/> <type value="string"/> <required value="false"/> <initial> <valueString value="May be conducted over 2 days between L-90/30"/> </initial> </item> <item> <linkId value="preflight-activities.personnel"/> <text value="Personnel Required"/> <type value="choice"/> <required value="true"/> <repeats value="true"/> <answerOption> <valueCoding> <system value="https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-roles-cs"/> <code value="crewmember"/> <display value="Crewmember"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-roles-cs"/> <code value="bhp-specialist"/> <display value="BHP Specialist"/> </valueCoding> </answerOption> </item> <item> <linkId value="preflight-activities.location"/> <text value="Test Location"/> <type value="choice"/> <required value="true"/> <answerOption> <valueCoding> <system value="https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-facility-cs"/> <code value="jsc"/> <display value="Johnson Space Center"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="https://mitre.org/fhir/space-health/CodeSystem/nasa-medical-facility-cs"/> <code value="russia-gctc"/> <display value="Gagarin Cosmonaut Training Center"/> </valueCoding> </answerOption> </item> <item> <linkId value="preflight-activities.room-requirements"/> <text value="Room Requirements"/> <type value="string"/> <required value="false"/> <initial> <valueString value="8' x 10' private room free of distractions"/> </initial> </item> <item> <linkId value="preflight-activities.constraints"/> <text value="Constraints/Special Requirements"/> <type value="text"/> <required value="false"/> <initial> <valueString value="Request that the L-90/30 event be scheduled as close as possible to the crewmember's final departure from the US prior to their Soyuz launch."/> </initial> </item> </item> <item> <linkId value="assessment-results"/> <text value="Behavioral Assessment Results"/> <type value="group"/> <item> <linkId value="assessment-results.behavioral-readiness"/> <code> <system value="http://loinc.org"/> <code value="44249-1"/> <display value="Mental status Narrative"/> </code> <text value="Behavioral Readiness for Flight"/> <type value="choice"/> <required value="true"/> <answerOption> <valueCoding> <system value="http://snomed.info/sct"/> <code value="17621005"/> <display value="Normal"/> </valueCoding> </answerOption> <answerOption> <valueCoding> <system value="http://snomed.info/sct"/> <code value="263654008"/> <display value="Abnormal"/> </valueCoding> </answerOption> <answerOption> <valueString value="Cleared with conditions"/> </answerOption> <answerOption> <valueString value="Not cleared"/> </answerOption> </item> <item> <linkId value="assessment-results.neurocognitive-baseline"/> <text value="Neurocognitive Baseline Completed"/> <type value="boolean"/> <required value="true"/> </item> <item> <linkId value="assessment-results.behavioral-baseline"/> <text value="Behavioral Health Baseline Completed"/> <type value="boolean"/> <required value="true"/> </item> <item> <linkId value="assessment-results.life-events-review"/> <text value="Life Events Review Completed"/> <type value="boolean"/> <required value="true"/> </item> <item> <linkId value="assessment-results.life-events-impact"/> <text value="Life Events with Potential Impact Identified"/> <type value="boolean"/> <required value="false"/> </item> <item> <linkId value="assessment-results.psych-services-review"/> <text value="Individual Psychological Services Reviewed"/> <type value="boolean"/> <required value="true"/> </item> <item> <linkId value="assessment-results.crew-services-review"/> <text value="Crew Psychological Services Reviewed"/> <type value="boolean"/> <required value="true"/> </item> <item> <linkId value="assessment-results.aeromedical-concerns"/> <text value="Aeromedical Concerns Identified"/> <type value="boolean"/> <required value="true"/> </item> <item> <linkId value="assessment-results.aeromedical-concerns-details"/> <text value="Aeromedical Concerns Details"/> <type value="text"/> <enableWhen> <question value="assessment-results.aeromedical-concerns"/> <operator value="="/> <answerBoolean value="true"/> </enableWhen> <required value="false"/> </item> </item> <item> <linkId value="behavioral-metrics"/> <text value="Behavioral State Metrics"/> <type value="group"/> <item> <linkId value="behavioral-metrics.mood-level"/> <code> <system value="http://hl7.org/fhir/uv/aerospace/CodeSystem/aerospace-behavioral-state-cs"/> <code value="mood-level"/> <display value="Mood level"/> </code> <text value="Mood Level (-3 to +3)"/> <type value="integer"/> <required value="false"/> </item> <item> <linkId value="behavioral-metrics.anxiety-level"/> <code> <system value="http://hl7.org/fhir/uv/aerospace/CodeSystem/aerospace-behavioral-state-cs"/> <code value="anxiety-level"/> <display value="Anxiety level"/> </code> <text value="Anxiety Level (0-10)"/> <type value="integer"/> <required value="false"/> </item> <item> <linkId value="behavioral-metrics.coping-capacity"/> <code> <system value="http://hl7.org/fhir/uv/aerospace/CodeSystem/aerospace-behavioral-state-cs"/> <code value="coping-capacity"/> <display value="Coping capacity"/> </code> <text value="Coping Capacity Assessment"/> <type value="choice"/> <required value="false"/> <answerOption> <valueString value="Excellent"/> </answerOption> <answerOption> <valueString value="Good"/> </answerOption> <answerOption> <valueString value="Adequate"/> </answerOption> <answerOption> <valueString value="Marginal"/> </answerOption> <answerOption> <valueString value="Inadequate"/> </answerOption> </item> <item> <linkId value="behavioral-metrics.sleep-quality"/> <code> <system value="http://hl7.org/fhir/uv/aerospace/CodeSystem/aerospace-behavioral-state-cs"/> <code value="sleep-quality"/> <display value="Sleep quality"/> </code> <text value="Sleep Quality Assessment"/> <type value="choice"/> <required value="false"/> <answerOption> <valueString value="Excellent"/> </answerOption> <answerOption> <valueString value="Good"/> </answerOption> <answerOption> <valueString value="Fair"/> </answerOption> <answerOption> <valueString value="Poor"/> </answerOption> </item> <item> <linkId value="behavioral-metrics.cognitive-readiness"/> <code> <system value="http://hl7.org/fhir/uv/aerospace/CodeSystem/aerospace-behavioral-state-cs"/> <code value="cognitive-readiness"/> <display value="Cognitive readiness"/> </code> <text value="Cognitive Readiness for Mission"/> <type value="choice"/> <required value="false"/> <answerOption> <valueString value="Fully ready"/> </answerOption> <answerOption> <valueString value="Ready with minor concerns"/> </answerOption> <answerOption> <valueString value="Ready with monitoring"/> </answerOption> <answerOption> <valueString value="Not ready"/> </answerOption> </item> <item> <linkId value="behavioral-metrics.social-connectedness"/> <code> <system value="http://hl7.org/fhir/uv/aerospace/CodeSystem/aerospace-behavioral-state-cs"/> <code value="social-connectedness"/> <display value="Social connectedness"/> </code> <text value="Social Connectedness (with crew/family)"/> <type value="choice"/> <required value="false"/> <answerOption> <valueString value="Strong"/> </answerOption> <answerOption> <valueString value="Adequate"/> </answerOption> <answerOption> <valueString value="Weak"/> </answerOption> <answerOption> <valueString value="Concerning"/> </answerOption> </item> </item> <item> <linkId value="inflight-activities"/> <text value="In-Flight Activities"/> <type value="group"/> <item> <linkId value="inflight-activities.na"/> <text value="No In-Flight Activities"/> <type value="display"/> </item> </item> <item> <linkId value="postflight-activities"/> <text value="Postflight Activities"/> <type value="group"/> <item> <linkId value="postflight-activities.na"/> <text value="No Postflight Activities"/> <type value="display"/> </item> </item> <item> <linkId value="data-delivery"/> <text value="Data Delivery"/> <type value="group"/> <item> <linkId value="data-delivery.data-control"/> <text value="Data Control"/> <type value="text"/> <required value="false"/> <initial> <valueString value="Data are crew member controlled. The crewmember is the designated recipient of the data and sharing this information is at his/her discretion."/> </initial> </item> <item> <linkId value="data-delivery.emr-entry"/> <text value="EMR Entry Made"/> <type value="boolean"/> <required value="true"/> </item> <item> <linkId value="data-delivery.emr-entry-notes"/> <text value="EMR Entry Notes"/> <type value="text"/> <required value="false"/> <initial> <valueString value="Entries will be made in the EMR for each event showing completion of the MEDB requirement and stating if any aeromedical concerns were identified."/> </initial> </item> <item> <linkId value="data-delivery.archive"/> <text value="Data Archive System"/> <type value="choice"/> <required value="true"/> <answerOption> <valueCoding> <system value="https://mitre.org/fhir/space-health/CodeSystem/nasa-data-archive-cs"/> <code value="emr"/> <display value="Electronic Medical Record"/> </valueCoding> </answerOption> </item> </item> <item> <linkId value="postflight-debrief"/> <text value="Postflight Debrief"/> <type value="group"/> <item> <linkId value="postflight-debrief.na"/> <text value="No Postflight Debrief Required"/> <type value="display"/> </item> </item> </Questionnaire>