{ "id": "poieti-platform.nursing-admission", "version": "1.0.0", "title": "入院護理評估表", "locale": "zh-TW", "pages": [ { "id": "basic-alerts", "title": "基本／警訊", "sections": [ { "id": "basic-information", "title": "基本資料", "fields": [ { "id": "basic.education", "label": "教育程度", "type": "single", "options": [ { "value": "illiterate", "label": "不識字" }, { "value": "elementary", "label": "小學" }, { "value": "junior_high", "label": "初中" }, { "value": "senior_high", "label": "高中" }, { "value": "college", "label": "專科" }, { "value": "university_or_above", "label": "大學以上" } ], "required": true }, { "id": "basic.languages", "label": "溝通語言", "type": "multi", "options": [ { "value": "mandarin", "label": "國語" }, { "value": "taiwanese_hokkien", "label": "閩南語" }, { "value": "hakka", "label": "客家語" }, { "value": "amis", "label": "原住民語－阿美" }, { "value": "atayal", "label": "原住民語－泰雅" }, { "value": "rukai", "label": "原住民語－魯凱" }, { "value": "yami", "label": "原住民語－雅美" }, { "value": "english", "label": "外國語－英語" }, { "value": "indonesian", "label": "外國語－印尼語" }, { "value": "japanese", "label": "外國語－日本" }, { "value": "thai", "label": "外國語－泰國語" }, { "value": "filipino", "label": "外國語－菲律賓語" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "basic.religions", "label": "宗教信仰", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "buddhism", "label": "佛教" }, { "value": "taoism", "label": "道教" }, { "value": "christianity", "label": "基督教" }, { "value": "catholicism", "label": "天主教" }, { "value": "islam", "label": "回教" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } } ] }, { "id": "alerts", "title": "警訊／照護問題", "fields": [ { "id": "alerts.antithromboticUse", "label": "抗血栓藥物使用", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "yes", "label": "有" }, { "value": "uncertain", "label": "不詳" } ], "required": true }, { "id": "alerts.drugAllergy", "label": "藥物過敏", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "unknown", "label": "不知道" }, { "value": "yes", "label": "有" } ], "required": true }, { "id": "alerts.drugAllergyNote", "label": "藥物過敏說明", "type": "textarea", "requiredWhen": { "fieldId": "alerts.drugAllergy", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "alerts.drugAllergy", "operator": "equals", "value": "yes" }, "validation": { "minLength": 1, "maxLength": 4000 } }, { "id": "alerts.drugAllergens", "label": "藥物過敏種類", "type": "multi", "options": [ { "value": "contrast_media", "label": "顯影劑過敏" }, { "value": "blood_transfusion", "label": "輸血過敏" }, { "value": "nsaid", "label": "NSAID" }, { "value": "sulfonamides", "label": "Sulfonamides" }, { "value": "penicillin", "label": "Penicillin" }, { "value": "g6pd", "label": "G6PD" }, { "value": "other", "label": "其他" } ], "requiredWhen": { "fieldId": "alerts.drugAllergy", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "alerts.drugAllergy", "operator": "equals", "value": "yes" }, "validation": { "minSelections": 1 } }, { "id": "alerts.otherDrugAllergen", "label": "其他藥物過敏", "type": "text", "requiredWhen": { "fieldId": "alerts.drugAllergens", "operator": "includes", "value": "other" }, "visibleWhen": { "fieldId": "alerts.drugAllergens", "operator": "includes", "value": "other" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "alerts.foodAllergy", "label": "食物過敏", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "unknown", "label": "不知道" }, { "value": "yes", "label": "有" } ], "required": true }, { "id": "alerts.foodAllergens", "label": "食物過敏種類", "type": "multi", "options": [ { "value": "seafood", "label": "海鮮類" }, { "value": "mushroom", "label": "菇類" }, { "value": "beef", "label": "牛肉" }, { "value": "other", "label": "其它" } ], "requiredWhen": { "fieldId": "alerts.foodAllergy", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "alerts.foodAllergy", "operator": "equals", "value": "yes" }, "validation": { "minSelections": 1 } }, { "id": "alerts.transfusionReaction", "label": "輸血反應", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "unknown", "label": "不知道" }, { "value": "yes", "label": "有" } ], "required": true }, { "id": "alerts.bloodType", "label": "血型", "type": "single", "options": [ { "value": "o_positive", "label": "O+" }, { "value": "a_positive", "label": "A+" }, { "value": "b_positive", "label": "B+" }, { "value": "ab_positive", "label": "AB+" }, { "value": "o_negative", "label": "O-" }, { "value": "a_negative", "label": "A-" }, { "value": "b_negative", "label": "B-" }, { "value": "ab_negative", "label": "AB-" }, { "value": "unknown", "label": "不知道" } ], "required": true, "description": "已知 ABO 血型但未提及 Rh 時，依本表填寫規則預設為 Rh 陽性：明確提及 Rh 時填對應的血型。" }, { "id": "alerts.recentForeignTravel", "label": "近 3 個月外國旅遊史", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "yes", "label": "有" } ], "required": true }, { "id": "alerts.travelLocation", "label": "旅遊地點", "type": "text", "requiredWhen": { "fieldId": "alerts.recentForeignTravel", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "alerts.recentForeignTravel", "operator": "equals", "value": "yes" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "alerts.treatmentRestrictions", "label": "禁做治療", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "left_hand", "label": "左手" }, { "value": "right_hand", "label": "右手" }, { "value": "left_foot", "label": "左腳" }, { "value": "right_foot", "label": "右腳" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "alerts.tubes", "label": "管路", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "ng", "label": "NG" }, { "value": "foley", "label": "Foley" }, { "value": "tracheostomy", "label": "氣切" }, { "value": "pigtail", "label": "pigtail" }, { "value": "port_a", "label": "port-A" }, { "value": "av_shunt", "label": "AV shunt" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "alerts.rapidTestDate", "label": "快篩日期", "type": "partial-date" }, { "id": "alerts.rapidTestResult", "label": "快篩結果", "type": "single", "options": [ { "value": "positive", "label": "Positive" }, { "value": "negative", "label": "Negative" } ] }, { "id": "alerts.pcrDate", "label": "PCR 日期", "type": "partial-date" }, { "id": "alerts.pcrResult", "label": "PCR 結果", "type": "single", "options": [ { "value": "positive", "label": "Positive" }, { "value": "negative", "label": "Negative" } ] }, { "id": "alerts.pcrCtValue", "label": "CT 值", "type": "number", "requiredWhen": { "fieldId": "alerts.pcrResult", "operator": "equals", "value": "positive" }, "visibleWhen": { "fieldId": "alerts.pcrResult", "operator": "equals", "value": "positive" }, "validation": { "min": 0, "max": 50 } } ] } ] }, { "id": "health-family", "title": "健康／家庭", "sections": [ { "id": "family-health-history", "title": "家庭健康史", "fields": [ { "id": "health.familyHistoryStatus", "label": "家族病史", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "yes", "label": "有" }, { "value": "uncertain", "label": "不詳" } ], "required": true }, { "id": "health.familyHistory", "label": "各親屬家族病史", "type": "repeatable", "itemLabel": "親屬病史", "itemFields": [ { "id": "relation", "label": "發病親屬", "type": "single", "options": [ { "value": "father", "label": "父" }, { "value": "mother", "label": "母" }, { "value": "son", "label": "子" }, { "value": "daughter", "label": "女" }, { "value": "paternal_grandfather", "label": "祖父" }, { "value": "paternal_grandmother", "label": "祖母" }, { "value": "other", "label": "其他" } ], "required": true }, { "id": "diseases", "label": "疾病", "type": "multi", "options": [ { "value": "hypertension", "label": "高血壓" }, { "value": "heart_disease", "label": "心臟病" }, { "value": "diabetes", "label": "糖尿病" }, { "value": "liver_cancer", "label": "肝癌" }, { "value": "colorectal_cancer", "label": "大腸直腸癌" }, { "value": "asthma", "label": "氣喘" }, { "value": "blood_disease", "label": "血液病" }, { "value": "cancer", "label": "癌症" }, { "value": "cerebrovascular_disease", "label": "腦血管疾病" }, { "value": "mental_illness", "label": "精神疾病" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } } ], "minItems": 1, "requiredWhen": { "fieldId": "health.familyHistoryStatus", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "health.familyHistoryStatus", "operator": "equals", "value": "yes" } } ] }, { "id": "family-social", "title": "家庭與社會狀況", "fields": [ { "id": "health.maritalStatus", "label": "婚姻狀況", "type": "single", "options": [ { "value": "single", "label": "未婚" }, { "value": "married", "label": "已婚" }, { "value": "divorced", "label": "離婚" }, { "value": "separated", "label": "分居" }, { "value": "cohabiting", "label": "同居" }, { "value": "widowed", "label": "喪偶" } ], "required": true }, { "id": "health.livingStatus", "label": "居住狀況", "type": "single", "options": [ { "value": "spouse_only", "label": "僅有配偶同住" }, { "value": "with_family", "label": "與家人同住" }, { "value": "alone_family_support", "label": "獨居且有家屬協助" }, { "value": "alone_friend_support", "label": "獨居且有朋友協助" }, { "value": "alone_independent", "label": "獨居且無人協助但能自理" }, { "value": "alone_dependent", "label": "獨居且無人協助且無法自理" }, { "value": "care_facility", "label": "住護理之家或療養機構" }, { "value": "other", "label": "其它" } ], "required": true }, { "id": "health.familyInteraction", "label": "與家人互動關係", "type": "single", "options": [ { "value": "caring", "label": "互相關懷" }, { "value": "distant", "label": "疏離" }, { "value": "no_contact", "label": "不相往來" }, { "value": "other", "label": "其他" } ], "required": true }, { "id": "health.otherFamilyInteraction", "label": "其它互動關係", "type": "text", "requiredWhen": { "fieldId": "health.familyInteraction", "operator": "equals", "value": "other" }, "visibleWhen": { "fieldId": "health.familyInteraction", "operator": "equals", "value": "other" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "health.primaryCaregivers", "label": "住院期間主要照顧者", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "spouse", "label": "配偶" }, { "value": "parents", "label": "父母" }, { "value": "children", "label": "子女" }, { "value": "friends", "label": "朋友" }, { "value": "caregiver", "label": "看護" }, { "value": "foreign_caregiver", "label": "外傭" }, { "value": "other", "label": "其他" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "health.otherPrimaryCaregiver", "label": "其它主要照顧者", "type": "text", "requiredWhen": { "fieldId": "health.primaryCaregivers", "operator": "includes", "value": "other" }, "visibleWhen": { "fieldId": "health.primaryCaregivers", "operator": "includes", "value": "other" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "health.occupation", "label": "職業別", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "military", "label": "軍人" }, { "value": "civil_service", "label": "公" }, { "value": "education", "label": "教" }, { "value": "industrial", "label": "工" }, { "value": "commerce", "label": "商" }, { "value": "agriculture", "label": "農" }, { "value": "student", "label": "學生" }, { "value": "healthcare", "label": "醫護" }, { "value": "service", "label": "服務業" }, { "value": "other", "label": "其它" } ], "required": true }, { "id": "health.otherOccupation", "label": "其它職業", "type": "text", "requiredWhen": { "fieldId": "health.occupation", "operator": "equals", "value": "other" }, "visibleWhen": { "fieldId": "health.occupation", "operator": "equals", "value": "other" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "health.financialStatus", "label": "經濟狀況", "type": "single", "options": [ { "value": "affluent", "label": "富裕" }, { "value": "comfortable", "label": "小康" }, { "value": "barely_sustaining", "label": "勉強維持生活" }, { "value": "low_income", "label": "低收入戶" } ], "required": true } ] }, { "id": "health-behavior", "title": "健康行為", "fields": [ { "id": "health.smokingStatus", "label": "抽菸狀態", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "current", "label": "有" }, { "value": "quitting_under_six_months", "label": "持續戒菸中未達半年" }, { "value": "quit_six_months_or_more", "label": "已戒達半年以上" } ], "required": true }, { "id": "health.smokingAmount", "label": "抽菸量", "type": "number", "requiredWhen": { "fieldId": "health.smokingStatus", "operator": "notEquals", "value": "none" }, "visibleWhen": { "fieldId": "health.smokingStatus", "operator": "notEquals", "value": "none" }, "validation": { "min": 0, "max": 1000 } }, { "id": "health.smokingAmountUnit", "label": "抽菸量單位", "type": "single", "options": [ { "value": "packs_per_day", "label": "包／天" }, { "value": "cigarettes_per_day", "label": "支／天" } ], "requiredWhen": { "fieldId": "health.smokingStatus", "operator": "notEquals", "value": "none" }, "visibleWhen": { "fieldId": "health.smokingStatus", "operator": "notEquals", "value": "none" } }, { "id": "health.smokingYears", "label": "開始吸菸至今", "type": "number", "unit": "年", "requiredWhen": { "fieldId": "health.smokingStatus", "operator": "notEquals", "value": "none" }, "visibleWhen": { "fieldId": "health.smokingStatus", "operator": "notEquals", "value": "none" }, "validation": { "min": 0, "max": 120 } }, { "id": "health.quitSmokingExperience", "label": "戒菸經驗", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "yes", "label": "有" } ], "requiredWhen": { "fieldId": "health.smokingStatus", "operator": "notEquals", "value": "none" }, "visibleWhen": { "fieldId": "health.smokingStatus", "operator": "notEquals", "value": "none" } }, { "id": "health.quitSmokingWillingness", "label": "戒菸意願", "type": "single", "options": [ { "value": "yes", "label": "是" }, { "value": "no", "label": "否" } ], "requiredWhen": { "fieldId": "health.smokingStatus", "operator": "notEquals", "value": "none" }, "visibleWhen": { "fieldId": "health.smokingStatus", "operator": "notEquals", "value": "none" } }, { "id": "health.alcoholUse", "label": "喝酒", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "quit", "label": "已戒" }, { "value": "occasional", "label": "偶爾（應酬）" }, { "value": "frequent", "label": "經常" }, { "value": "daily", "label": "每天" } ], "required": true }, { "id": "health.betelNutStatus", "label": "檳榔狀態", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "quit", "label": "已戒" }, { "value": "current", "label": "有" } ], "required": true }, { "id": "health.betelNutAmount", "label": "檳榔量", "type": "number", "unit": "包／天", "requiredWhen": { "fieldId": "health.betelNutStatus", "operator": "notEquals", "value": "none" }, "visibleWhen": { "fieldId": "health.betelNutStatus", "operator": "notEquals", "value": "none" }, "validation": { "min": 0, "max": 1000 } }, { "id": "health.betelNutYears", "label": "開始嚼檳榔至今", "type": "number", "unit": "年", "requiredWhen": { "fieldId": "health.betelNutStatus", "operator": "notEquals", "value": "none" }, "visibleWhen": { "fieldId": "health.betelNutStatus", "operator": "notEquals", "value": "none" }, "validation": { "min": 0, "max": 120 } } ] }, { "id": "medical-history", "title": "過去病史、就醫與用藥", "fields": [ { "id": "health.medicalHistory", "label": "過去病史", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "breast_cancer", "label": "乳癌" }, { "value": "blood_disease", "label": "血液病" }, { "value": "mental_illness", "label": "精神疾病" }, { "value": "hypertension", "label": "高血壓" }, { "value": "liver_cancer", "label": "肝癌", "description": "僅在對話明確提到肝癌、肝細胞癌或肝臟惡性腫瘤時選擇。B 型肝炎、C 型肝炎、一般肝病、肝硬化或使用保肝藥物均不代表肝癌。" }, { "value": "cancer", "label": "癌症" }, { "value": "heart_disease", "label": "心臟病" }, { "value": "colorectal_cancer", "label": "大腸直腸癌" }, { "value": "suicide", "label": "自殺" }, { "value": "diabetes", "label": "糖尿病" }, { "value": "asthma", "label": "氣喘" }, { "value": "cerebrovascular_disease", "label": "腦血管病變" }, { "value": "other", "label": "其它", "description": "明確提到但未列於其它選項的病史。" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "health.surgeryExperience", "label": "手術經驗", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "yes", "label": "有" } ], "required": true }, { "id": "health.surgeryNote", "label": "手術說明", "type": "text", "requiredWhen": { "fieldId": "health.surgeryExperience", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "health.surgeryExperience", "operator": "equals", "value": "yes" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "health.recentEmergencyOrAdmissionCount", "label": "近 3 個月急診或住院次數", "type": "single", "options": [ { "value": "none", "label": "沒有" }, { "value": "one", "label": "1 次" }, { "value": "two", "label": "2 次" }, { "value": "more_than_two", "label": ">2 次" } ], "required": true }, { "id": "health.currentMedications", "label": "現在用藥", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "antidepressant_or_antipsychotic", "label": "抗憂鬱／抗精神病藥" }, { "value": "cardiac", "label": "心臟用藥" }, { "value": "laxative_or_stool_softener", "label": "瀉藥／軟便劑" }, { "value": "antihypertensive", "label": "降血壓" }, { "value": "antiepileptic", "label": "抗癲癇藥" }, { "value": "anticoagulant", "label": "抗凝血劑" }, { "value": "anesthetic_analgesic", "label": "麻醉止痛藥" }, { "value": "glucose_lowering", "label": "降血糖" }, { "value": "anti_parkinson", "label": "抗帕金森氏症藥" }, { "value": "erythropoietin", "label": "紅血球生成素" }, { "value": "muscle_relaxant", "label": "肌肉鬆弛劑" }, { "value": "diuretic", "label": "利尿劑" }, { "value": "oral_anticancer", "label": "口服抗癌藥物", "description": "僅在對話明確確認正在使用口服抗癌藥物時選擇。" }, { "value": "sedative_hypnotic", "label": "鎮靜安眠藥" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } } ] } ] }, { "id": "nutrition-sleep", "title": "營養／睡眠", "sections": [ { "id": "nutrition-metabolism", "title": "營養代謝", "fields": [ { "id": "nutrition.heightCm", "label": "身高", "type": "number", "unit": "公分", "validation": { "min": 20, "max": 250 } }, { "id": "nutrition.weightKg", "label": "體重", "type": "number", "unit": "Kg", "validation": { "min": 0.5, "max": 500 } }, { "id": "nutrition.idealWeightKg", "label": "理想體重", "type": "computed", "unit": "Kg", "readOnly": true, "computed": { "kind": "formula", "description": "由身高计算；公式由产品端配置。", "dependsOn": [ "nutrition.heightCm" ] } }, { "id": "nutrition.measurementUnavailableReason", "label": "身高體重無法測量原因", "type": "text", "requiredWhen": { "any": [ { "fieldId": "nutrition.heightCm", "operator": "isPresent", "value": false }, { "fieldId": "nutrition.weightKg", "operator": "isPresent", "value": false } ] }, "visibleWhen": { "any": [ { "fieldId": "nutrition.heightCm", "operator": "isPresent", "value": false }, { "fieldId": "nutrition.weightKg", "operator": "isPresent", "value": false } ] }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "nutrition.relativeIdealWeight", "label": "相較理想體重", "type": "computed", "readOnly": true, "visibleWhen": { "all": [ { "fieldId": "nutrition.heightCm", "operator": "isPresent", "value": true }, { "fieldId": "nutrition.weightKg", "operator": "isPresent", "value": true } ] }, "computed": { "kind": "derived", "description": "依 BMI 自動分類：<18.5 過輕；18.5–<24 健康體重；24–<27 過重；>=27 肥胖。", "dependsOn": [ "nutrition.heightCm", "nutrition.weightKg" ] } }, { "id": "nutrition.edemaStatus", "label": "水腫情形", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "present", "label": "有" } ], "required": true }, { "id": "nutrition.edemaFindings", "label": "水腫部位與程度", "type": "repeatable", "itemLabel": "水腫部位", "itemFields": [ { "id": "site", "label": "部位", "type": "single", "options": [ { "value": "left_upper_limb", "label": "左上肢" }, { "value": "right_upper_limb", "label": "右上肢" }, { "value": "left_lower_limb", "label": "左下肢" }, { "value": "right_lower_limb", "label": "右下肢" }, { "value": "both_upper_limbs", "label": "雙上肢" }, { "value": "both_lower_limbs", "label": "雙下肢" }, { "value": "all_limbs", "label": "四肢" } ], "required": true }, { "id": "severity", "label": "程度", "type": "select", "options": [ { "value": "grade_1", "label": "1+" }, { "value": "grade_2", "label": "2+" }, { "value": "grade_3", "label": "3+" }, { "value": "grade_4", "label": "4+" } ], "required": true, "description": "目前產品定義為 1+、2+、3+、4+。" } ], "minItems": 1, "requiredWhen": { "fieldId": "nutrition.edemaStatus", "operator": "equals", "value": "present" }, "visibleWhen": { "fieldId": "nutrition.edemaStatus", "operator": "equals", "value": "present" } }, { "id": "nutrition.feedingRoutes", "label": "進食方式", "type": "multi", "options": [ { "value": "oral", "label": "由口進食" }, { "value": "ng_feeding", "label": "N-G Feeding" }, { "value": "gastrostomy", "label": "胃造" }, { "value": "enterostomy", "label": "腸造" }, { "value": "tpn_ppn", "label": "TPN/PPN" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "nutrition.feedingStatus", "label": "進食情況", "type": "multi", "options": [ { "value": "normal", "label": "正常", "exclusive": true }, { "value": "decreased_appetite", "label": "食慾減低" }, { "value": "dysphagia", "label": "吞嚥困難" }, { "value": "chewing_difficulty", "label": "咀嚼困難" }, { "value": "npo", "label": "禁食" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "nutrition.oralConditions", "label": "口腔狀況", "type": "multi", "options": [ { "value": "normal", "label": "正常", "exclusive": true }, { "value": "mucosal_damage", "label": "黏膜破損" }, { "value": "oral_odor", "label": "口腔異味" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "nutrition.dentures", "label": "假牙", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "upper", "label": "上" }, { "value": "lower", "label": "下" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "nutrition.upperDentureType", "label": "上假牙類型", "type": "single", "options": [ { "value": "fixed", "label": "固定" }, { "value": "removable", "label": "活動" } ], "requiredWhen": { "fieldId": "nutrition.dentures", "operator": "includes", "value": "upper" }, "visibleWhen": { "fieldId": "nutrition.dentures", "operator": "includes", "value": "upper" } }, { "id": "nutrition.lowerDentureType", "label": "下假牙類型", "type": "single", "options": [ { "value": "fixed", "label": "固定" }, { "value": "removable", "label": "活動" } ], "requiredWhen": { "fieldId": "nutrition.dentures", "operator": "includes", "value": "lower" }, "visibleWhen": { "fieldId": "nutrition.dentures", "operator": "includes", "value": "lower" } }, { "id": "nutrition.dietTypes", "label": "飲食種類", "type": "multi", "options": [ { "value": "regular", "label": "普通飲食" }, { "value": "tube_feeding", "label": "管灌" }, { "value": "vegetarian", "label": "素食" }, { "value": "special", "label": "特殊飲食" }, { "value": "other", "label": "其他" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "nutrition.vegetarianDietDetails", "label": "素食細項", "type": "multi", "options": [ { "value": "soft", "label": "軟質" }, { "value": "liquid", "label": "流質" }, { "value": "diabetic", "label": "糖尿病" }, { "value": "low_fat", "label": "低油" }, { "value": "low_salt", "label": "低鹽" } ], "requiredWhen": { "fieldId": "nutrition.dietTypes", "operator": "includes", "value": "vegetarian" }, "visibleWhen": { "fieldId": "nutrition.dietTypes", "operator": "includes", "value": "vegetarian" }, "validation": { "minSelections": 1 } }, { "id": "nutrition.specialDietDetails", "label": "特殊飲食細項", "type": "multi", "options": [ { "value": "soft", "label": "軟質" }, { "value": "liquid", "label": "流質" }, { "value": "diabetic", "label": "糖尿病" }, { "value": "low_fat", "label": "低油" }, { "value": "low_salt", "label": "低鹽" } ], "requiredWhen": { "fieldId": "nutrition.dietTypes", "operator": "includes", "value": "special" }, "visibleWhen": { "fieldId": "nutrition.dietTypes", "operator": "includes", "value": "special" }, "validation": { "minSelections": 1 } }, { "id": "nutrition.otherDiet", "label": "其它飲食", "type": "text", "requiredWhen": { "fieldId": "nutrition.dietTypes", "operator": "includes", "value": "other" }, "visibleWhen": { "fieldId": "nutrition.dietTypes", "operator": "includes", "value": "other" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "nutrition.foodRestriction", "label": "食物禁忌", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "yes", "label": "有" } ], "required": true }, { "id": "nutrition.foodRestrictionNote", "label": "食物禁忌說明", "type": "text", "requiredWhen": { "fieldId": "nutrition.foodRestriction", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "nutrition.foodRestriction", "operator": "equals", "value": "yes" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "nutrition.otherSymptoms", "label": "其它症狀", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "nausea", "label": "噁心" }, { "value": "vomiting", "label": "嘔吐" }, { "value": "hiccups", "label": "打嗝" }, { "value": "bloating", "label": "腹脹" } ], "required": true, "validation": { "minSelections": 1 } } ] }, { "id": "sleep-rest", "title": "休息睡眠", "fields": [ { "id": "sleep.conditions", "label": "休息睡眠狀況", "type": "multi", "options": [ { "value": "normal", "label": "正常", "exclusive": true }, { "value": "day_night_reversal", "label": "日夜顛倒" }, { "value": "insomnia", "label": "失眠" }, { "value": "fatigue", "label": "倦怠" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "sleep.usualHours", "label": "平時約入睡幾小時", "type": "number", "unit": "小時", "required": true, "validation": { "min": 0, "max": 24 } } ] } ] }, { "id": "activity-exercise", "title": "活動／運動", "sections": [ { "id": "activity-mobility", "title": "活動運動", "fields": [ { "id": "activity.mobility", "label": "活動能力", "type": "single", "options": [ { "value": "unable_to_walk", "label": "無法自行走動" }, { "value": "walks_with_person_assistance", "label": "可走動需他人協助" }, { "value": "independent", "label": "自己可走動" } ], "required": true }, { "id": "activity.needsMobilityAid", "label": "可走動需輔助協助", "type": "boolean", "required": true }, { "id": "activity.mobilityAids", "label": "行動輔具", "type": "multi", "options": [ { "value": "cane", "label": "拐杖" }, { "value": "walker", "label": "助行器" }, { "value": "wheelchair", "label": "輪椅" }, { "value": "prosthesis", "label": "義肢" }, { "value": "mobile_commode", "label": "活動便盆椅" }, { "value": "mobile_iv_stand", "label": "活動點滴架" }, { "value": "other", "label": "其他" } ], "requiredWhen": { "fieldId": "activity.needsMobilityAid", "operator": "equals", "value": true }, "visibleWhen": { "fieldId": "activity.needsMobilityAid", "operator": "equals", "value": true }, "validation": { "minSelections": 1 } }, { "id": "activity.otherMobilityAid", "label": "其它行動輔具", "type": "text", "requiredWhen": { "fieldId": "activity.mobilityAids", "operator": "includes", "value": "other" }, "visibleWhen": { "fieldId": "activity.mobilityAids", "operator": "includes", "value": "other" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "activity.leftUpperMuscleStrength", "label": "左上肢肌肉張力", "type": "select", "options": [ { "value": "0", "label": "0 分" }, { "value": "1", "label": "1 分" }, { "value": "2", "label": "2 分" }, { "value": "3", "label": "3 分" }, { "value": "4", "label": "4 分" }, { "value": "5", "label": "5 分" } ], "required": true }, { "id": "activity.rightUpperMuscleStrength", "label": "右上肢肌肉張力", "type": "select", "options": [ { "value": "0", "label": "0 分" }, { "value": "1", "label": "1 分" }, { "value": "2", "label": "2 分" }, { "value": "3", "label": "3 分" }, { "value": "4", "label": "4 分" }, { "value": "5", "label": "5 分" } ], "required": true }, { "id": "activity.leftLowerMuscleStrength", "label": "左下肢肌肉張力", "type": "select", "options": [ { "value": "0", "label": "0 分" }, { "value": "1", "label": "1 分" }, { "value": "2", "label": "2 分" }, { "value": "3", "label": "3 分" }, { "value": "4", "label": "4 分" }, { "value": "5", "label": "5 分" } ], "required": true }, { "id": "activity.rightLowerMuscleStrength", "label": "右下肢肌肉張力", "type": "select", "options": [ { "value": "0", "label": "0 分" }, { "value": "1", "label": "1 分" }, { "value": "2", "label": "2 分" }, { "value": "3", "label": "3 分" }, { "value": "4", "label": "4 分" }, { "value": "5", "label": "5 分" } ], "required": true }, { "id": "activity.limbAppearance", "label": "外觀－肢體", "type": "single", "options": [ { "value": "normal", "label": "正常" }, { "value": "abnormal", "label": "異常" } ], "required": true }, { "id": "activity.gait", "label": "步態", "type": "single", "options": [ { "value": "stable", "label": "穩定" }, { "value": "unstable", "label": "不穩定" } ], "required": true }, { "id": "activity.unstableGaitDetails", "label": "不穩定步態細項", "type": "multi", "options": [ { "value": "left_hemiplegia", "label": "偏癱（左側）" }, { "value": "right_hemiplegia", "label": "偏癱（右側）" }, { "value": "limp", "label": "跛行" }, { "value": "unable_to_assess", "label": "暫無法評估" }, { "value": "other", "label": "其他" } ], "requiredWhen": { "fieldId": "activity.gait", "operator": "equals", "value": "unstable" }, "visibleWhen": { "fieldId": "activity.gait", "operator": "equals", "value": "unstable" }, "validation": { "minSelections": 1 } }, { "id": "activity.otherGait", "label": "其它步態", "type": "text", "requiredWhen": { "fieldId": "activity.unstableGaitDetails", "operator": "includes", "value": "other" }, "visibleWhen": { "fieldId": "activity.unstableGaitDetails", "operator": "includes", "value": "other" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "activity.selfCareAbility", "label": "自我照顧能力", "type": "single", "options": [ { "value": "independent", "label": "日常生活獨立" }, { "value": "needs_help", "label": "需他人協助" } ], "required": true }, { "id": "activity.selfCareAssistance", "label": "需協助項目", "type": "multi", "options": [ { "value": "eating", "label": "進食" }, { "value": "dressing", "label": "穿衣" }, { "value": "bathing", "label": "沐浴" }, { "value": "toileting", "label": "如廁" }, { "value": "transfer", "label": "移位" }, { "value": "medication", "label": "服藥" }, { "value": "cooking", "label": "煮飯" }, { "value": "finances", "label": "處理財物" }, { "value": "shopping", "label": "購物" }, { "value": "going_out", "label": "外出" } ], "requiredWhen": { "fieldId": "activity.selfCareAbility", "operator": "equals", "value": "needs_help" }, "visibleWhen": { "fieldId": "activity.selfCareAbility", "operator": "equals", "value": "needs_help" }, "validation": { "minSelections": 1 } }, { "id": "activity.fallInPastYear", "label": "最近一年內曾發生跌倒", "type": "single", "options": [ { "value": "yes", "label": "是" }, { "value": "no", "label": "否" }, { "value": "uncertain", "label": "不詳" } ], "required": true } ] }, { "id": "respiratory-circulation", "title": "氣循環", "fields": [ { "id": "respiratory.chestSymmetry", "label": "胸廓對稱性", "type": "single", "options": [ { "value": "normal", "label": "正常" }, { "value": "abnormally_symmetric", "label": "不正常對稱" } ], "required": true }, { "id": "respiratory.patterns", "label": "呼吸型態", "type": "multi", "options": [ { "value": "normal", "label": "正常", "exclusive": true }, { "value": "labored", "label": "費力" }, { "value": "orthopnea", "label": "端坐喘息" }, { "value": "accessory_muscle_use", "label": "使用呼吸輔助肌" }, { "value": "ventilator_use", "label": "使用呼吸器" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "respiratory.coughFrequency", "label": "咳嗽", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "occasional", "label": "偶爾" }, { "value": "frequent", "label": "經常" } ], "required": true }, { "id": "respiratory.sputumClearance", "label": "咳痰能力", "type": "single", "options": [ { "value": "normal", "label": "正常" }, { "value": "needs_assistance", "label": "需協助咳痰" }, { "value": "suction", "label": "抽痰" } ], "required": true }, { "id": "respiratory.sputumStatus", "label": "痰液", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "yes", "label": "有" } ], "required": true }, { "id": "respiratory.sputumColor", "label": "痰液顏色", "type": "single", "options": [ { "value": "yellow", "label": "黃色" }, { "value": "white", "label": "白色" }, { "value": "red", "label": "紅色" }, { "value": "rust", "label": "鐵銹色" } ], "requiredWhen": { "fieldId": "respiratory.sputumStatus", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "respiratory.sputumStatus", "operator": "equals", "value": "yes" } }, { "id": "respiratory.sputumViscosity", "label": "痰液黏稠度", "type": "single", "options": [ { "value": "thin", "label": "稀" }, { "value": "thick", "label": "稠" } ], "requiredWhen": { "fieldId": "respiratory.sputumStatus", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "respiratory.sputumStatus", "operator": "equals", "value": "yes" } }, { "id": "respiratory.sputumAmount", "label": "痰液量", "type": "single", "options": [ { "value": "large", "label": "多" }, { "value": "medium", "label": "中" }, { "value": "small", "label": "少" } ], "requiredWhen": { "fieldId": "respiratory.sputumStatus", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "respiratory.sputumStatus", "operator": "equals", "value": "yes" } }, { "id": "respiratory.breathSounds", "label": "呼吸聲", "type": "multi", "options": [ { "value": "normal", "label": "正常", "exclusive": true }, { "value": "diminished", "label": "減弱" }, { "value": "rhonchi", "label": "囉音 rhonch I" }, { "value": "wheezing", "label": "喘鳴音 wheezing" }, { "value": "stridor", "label": "摩擦音 stridor" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "respiratory.oxygenTherapies", "label": "用氧情況", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "nasal_cannula", "label": "Nasal cannula" }, { "value": "mask", "label": "Mask" }, { "value": "ventilator", "label": "ventilator" }, { "value": "peep", "label": "PEEP" }, { "value": "fio2", "label": "FIO2" }, { "value": "tracheostomy", "label": "氣切" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "circulation.implantStatus", "label": "人工置入物", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "yes", "label": "有" } ], "required": true }, { "id": "circulation.implantTypes", "label": "人工置入物種類", "type": "multi", "options": [ { "value": "pacemaker", "label": "pacemaker" }, { "value": "metal_valve", "label": "金屬瓣膜置換" } ], "requiredWhen": { "fieldId": "circulation.implantStatus", "operator": "equals", "value": "yes" }, "visibleWhen": { "fieldId": "circulation.implantStatus", "operator": "equals", "value": "yes" }, "validation": { "minSelections": 1 } }, { "id": "circulation.peripheralCirculation", "label": "末梢循環", "type": "single", "options": [ { "value": "warm", "label": "溫暖" }, { "value": "cold", "label": "冰冷" }, { "value": "other", "label": "其它" } ], "required": true }, { "id": "circulation.symptoms", "label": "病徵", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "palpitations", "label": "心悸" }, { "value": "clubbing", "label": "杵狀指" }, { "value": "jugular_venous_distention", "label": "頸靜脈怒張" }, { "value": "epigastric_burning", "label": "上腹灼熱" }, { "value": "chest_tightness", "label": "胸悶" }, { "value": "dizziness", "label": "頭暈（含暈厥及眩暈）" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } } ] } ] }, { "id": "cognition-sensation", "title": "認知／感受", "sections": [ { "id": "cognition-perception", "title": "認知知覺", "fields": [ { "id": "cognition.leftVision", "label": "視力（左）", "type": "multi", "options": [ { "value": "clear", "label": "清晰", "exclusive": true }, { "value": "blind", "label": "失明" }, { "value": "presbyopia", "label": "老花眼" }, { "value": "myopia", "label": "近視" }, { "value": "diplopia", "label": "複視" }, { "value": "amblyopia", "label": "弱視" }, { "value": "hemianopia", "label": "偏盲" }, { "value": "cataract", "label": "白內障" }, { "value": "glaucoma", "label": "青光眼" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "cognition.rightVision", "label": "視力（右）", "type": "multi", "options": [ { "value": "clear", "label": "清晰", "exclusive": true }, { "value": "blind", "label": "失明" }, { "value": "presbyopia", "label": "老花眼" }, { "value": "myopia", "label": "近視" }, { "value": "diplopia", "label": "複視" }, { "value": "amblyopia", "label": "弱視" }, { "value": "hemianopia", "label": "偏盲" }, { "value": "cataract", "label": "白內障" }, { "value": "glaucoma", "label": "青光眼" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "cognition.leftHearing", "label": "聽力（左）", "type": "multi", "options": [ { "value": "clear", "label": "清晰", "exclusive": true }, { "value": "hard_of_hearing", "label": "重聽" }, { "value": "deaf", "label": "失聰" }, { "value": "tinnitus", "label": "耳鳴" }, { "value": "hearing_aid", "label": "助聽器" }, { "value": "cochlear_implant", "label": "電子耳" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "cognition.rightHearing", "label": "聽力（右）", "type": "multi", "options": [ { "value": "clear", "label": "清晰", "exclusive": true }, { "value": "hard_of_hearing", "label": "重聽" }, { "value": "deaf", "label": "失聰" }, { "value": "tinnitus", "label": "耳鳴" }, { "value": "hearing_aid", "label": "助聽器" }, { "value": "cochlear_implant", "label": "電子耳" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "cognition.orientation", "label": "意識－認知能力", "type": "single", "options": [ { "value": "fully_oriented", "label": "清醒且對人時地物認知正確" }, { "value": "sometimes_partially_disoriented", "label": "一天中某些時間失去部份定向感" }, { "value": "always_partially_disoriented", "label": "一天中所有時間失去部份定向感" }, { "value": "sometimes_fully_disoriented", "label": "一天中某些時間失去全部定向感" }, { "value": "always_fully_disoriented", "label": "一天中所有時間失去全部定向感" }, { "value": "coma", "label": "昏迷" } ], "required": true }, { "id": "cognition.behaviors", "label": "意識－行為型態", "type": "multi", "options": [ { "value": "appropriate", "label": "適當", "exclusive": true }, { "value": "wandering", "label": "四處游走" }, { "value": "restless", "label": "燥動不安" }, { "value": "confused", "label": "混亂" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "cognition.painStatus", "label": "疼痛狀態", "type": "single", "options": [ { "value": "none", "label": "無" }, { "value": "present", "label": "有" }, { "value": "unable_to_assess", "label": "無法評估" } ], "required": true }, { "id": "cognition.painFindings", "label": "疼痛部位與分數", "type": "repeatable", "itemLabel": "疼痛部位", "itemFields": [ { "id": "site", "label": "部位", "type": "single", "options": [ { "value": "head", "label": "頭部" }, { "value": "tooth", "label": "牙" }, { "value": "mouth", "label": "口腔" }, { "value": "eye", "label": "眼睛" }, { "value": "ear", "label": "耳朵" }, { "value": "neck", "label": "頸部" }, { "value": "back", "label": "背部" }, { "value": "chest", "label": "胸部" }, { "value": "abdomen", "label": "腹部" }, { "value": "waist", "label": "腰部" }, { "value": "upper_limb", "label": "上肢" }, { "value": "lower_limb", "label": "下肢" }, { "value": "other", "label": "其他" } ], "required": true }, { "id": "score", "label": "疼痛分數", "type": "select", "options": [ { "value": "0", "label": "0 分" }, { "value": "1", "label": "1 分" }, { "value": "2", "label": "2 分" }, { "value": "3", "label": "3 分" }, { "value": "4", "label": "4 分" }, { "value": "5", "label": "5 分" }, { "value": "6", "label": "6 分" }, { "value": "7", "label": "7 分" }, { "value": "8", "label": "8 分" }, { "value": "9", "label": "9 分" }, { "value": "10", "label": "10 分" } ], "required": true }, { "id": "otherSite", "label": "其它疼痛部位", "type": "text", "requiredWhen": { "fieldId": "site", "operator": "equals", "value": "other" }, "visibleWhen": { "fieldId": "site", "operator": "equals", "value": "other" }, "validation": { "minLength": 1, "maxLength": 500 } } ], "minItems": 1, "requiredWhen": { "fieldId": "cognition.painStatus", "operator": "equals", "value": "present" }, "visibleWhen": { "fieldId": "cognition.painStatus", "operator": "equals", "value": "present" } }, { "id": "cognition.speech", "label": "語言表達", "type": "single", "options": [ { "value": "normal", "label": "正常" }, { "value": "unclear_articulation", "label": "口齒欠清" }, { "value": "speech_disorder", "label": "語言障礙" }, { "value": "aphasia", "label": "失語症" }, { "value": "other", "label": "其它" } ], "required": true }, { "id": "cognition.skinAppearance", "label": "皮膚外觀", "type": "single", "options": [ { "value": "normal", "label": "正常" }, { "value": "abnormal", "label": "異常" }, { "value": "other", "label": "其它" } ], "required": true }, { "id": "cognition.skinFindings", "label": "皮膚問題與部位", "type": "repeatable", "itemLabel": "皮膚問題", "itemFields": [ { "id": "type", "label": "皮膚問題類型", "type": "single", "options": [ { "value": "pallor", "label": "蒼白" }, { "value": "rash", "label": "紅疹" }, { "value": "blister", "label": "水泡" }, { "value": "swelling", "label": "紅腫" }, { "value": "ulcer", "label": "潰瘍" }, { "value": "jaundice", "label": "黃疸" }, { "value": "wound", "label": "傷口" }, { "value": "peeling", "label": "脫皮" }, { "value": "cracking", "label": "乾裂" } ], "required": true }, { "id": "sites", "label": "發生部位", "type": "multi", "options": [ { "value": "face", "label": "臉部" }, { "value": "eyelid", "label": "眼瞼" }, { "value": "mouth", "label": "口腔" }, { "value": "neck", "label": "頸部" }, { "value": "back", "label": "背部" }, { "value": "chest", "label": "胸部" }, { "value": "abdomen", "label": "腹部" }, { "value": "waist", "label": "腰部" }, { "value": "upper_limb", "label": "上肢" }, { "value": "lower_limb", "label": "下肢" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } } ], "minItems": 1, "requiredWhen": { "fieldId": "cognition.skinAppearance", "operator": "equals", "value": "abnormal" }, "visibleWhen": { "fieldId": "cognition.skinAppearance", "operator": "equals", "value": "abnormal" } } ] } ] }, { "id": "reproduction-elimination", "title": "生殖／排泄", "sections": [ { "id": "elimination", "title": "生理評估－排泄", "fields": [ { "id": "elimination.stoolConditions", "label": "大便狀況", "type": "multi", "options": [ { "value": "normal", "label": "正常", "exclusive": true }, { "value": "incontinence", "label": "失禁" }, { "value": "constipation", "label": "便秘" }, { "value": "diarrhea", "label": "腹瀉" }, { "value": "colostomy", "label": "人工肛門" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "elimination.stoolColor", "label": "大便顏色", "type": "single", "options": [ { "value": "normal", "label": "正常" }, { "value": "bloody", "label": "血便" }, { "value": "black", "label": "黑便" }, { "value": "clay", "label": "黏土色" }, { "value": "gray_white", "label": "灰白便" }, { "value": "other", "label": "其它" } ], "required": true }, { "id": "elimination.urinationConditions", "label": "小便狀況", "type": "multi", "options": [ { "value": "normal", "label": "正常", "exclusive": true }, { "value": "incontinence", "label": "失禁" }, { "value": "nocturia", "label": "夜尿" }, { "value": "frequency", "label": "頻尿" }, { "value": "difficulty", "label": "排尿困難" }, { "value": "dysuria", "label": "解尿疼痛" }, { "value": "oliguria", "label": "尿少" }, { "value": "renal_stoma", "label": "人工造瘻－腎" }, { "value": "bladder_stoma", "label": "人工造瘻－膀胱" }, { "value": "indwelling_catheter", "label": "導尿－存留導尿" }, { "value": "intermittent_catheter", "label": "導尿－間歇導尿" }, { "value": "other", "label": "其它" } ], "required": true, "validation": { "minSelections": 1 } }, { "id": "elimination.urineColor", "label": "尿液顏色", "type": "single", "options": [ { "value": "normal", "label": "正常" }, { "value": "tea", "label": "茶色" }, { "value": "cloudy", "label": "混濁" }, { "value": "bloody", "label": "血尿" }, { "value": "other", "label": "其它" } ], "required": true }, { "id": "elimination.otherSymptoms", "label": "其它症狀", "type": "multi", "options": [ { "value": "hematemesis", "label": "吐血" }, { "value": "profuse_sweating", "label": "大量出汗" }, { "value": "ascites", "label": "腹水" } ], "validation": { "minSelections": 0 } } ] }, { "id": "reproduction", "title": "性生殖", "fields": [ { "id": "reproduction.maleGenitalAppearance", "label": "生殖器外觀（男）", "type": "multi", "options": [ { "value": "normal", "label": "正常", "exclusive": true }, { "value": "abnormal_discharge", "label": "異常分泌物" }, { "value": "enlarged_prostate", "label": "攝護腺腫大" }, { "value": "other", "label": "其它" } ], "requiredWhen": { "source": "context", "fieldId": "patientSex", "operator": "equals", "value": "male" }, "visibleWhen": { "source": "context", "fieldId": "patientSex", "operator": "equals", "value": "male" }, "validation": { "minSelections": 1 } } ] }, { "id": "information-providers", "title": "資料提供者", "fields": [ { "id": "contacts.decisionMakerName", "label": "醫療措施決策者姓名", "type": "text", "required": true, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "contacts.decisionMakerPhone", "label": "醫療措施決策者電話", "type": "text", "required": true, "validation": { "minLength": 6, "maxLength": 20, "pattern": "^[0-9+()\\-\\s]{6,20}$" } }, { "id": "contacts.decisionMakerRelation", "label": "醫療措施決策者稱謂／關係", "type": "text", "required": true, "description": "請以繁體中文填寫與病人的稱謂／關係，例如：本人、女兒、兒子、配偶、母親、父親；不要使用英文稱謂。", "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "contacts.informationProviderName", "label": "資料提供者姓名", "type": "text", "required": true, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "contacts.informationProviderPhone", "label": "資料提供者電話", "type": "text", "required": true, "validation": { "minLength": 6, "maxLength": 20, "pattern": "^[0-9+()\\-\\s]{6,20}$" } }, { "id": "contacts.informationProviderRelation", "label": "資料提供者與病人關係", "type": "text", "required": true, "description": "請以繁體中文填寫與病人的稱謂／關係，例如：本人、女兒、兒子、配偶、母親、父親；不要使用英文稱謂。", "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "contacts.contactName", "label": "聯絡人姓名", "type": "text", "required": true, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "contacts.contactPhone", "label": "聯絡人電話", "type": "text", "required": true, "validation": { "minLength": 6, "maxLength": 20, "pattern": "^[0-9+()\\-\\s]{6,20}$" } }, { "id": "contacts.contactPhone2", "label": "聯絡人電話 2", "type": "text", "validation": { "minLength": 6, "maxLength": 20, "pattern": "^[0-9+()\\-\\s]{6,20}$" } }, { "id": "contacts.contactRelation", "label": "聯絡人稱謂／關係", "type": "text", "required": true, "description": "請以繁體中文填寫與病人的稱謂／關係，例如：本人、女兒、兒子、配偶、母親、父親；不要使用英文稱謂。", "validation": { "minLength": 1, "maxLength": 500 } } ] } ] }, { "id": "admission-reason", "title": "住院原因", "sections": [ { "id": "admission", "title": "住院原因", "fields": [ { "id": "admission.wardDate", "label": "入住病房日期", "type": "date", "required": true }, { "id": "admission.wardTime", "label": "入住病房時間", "type": "time", "required": true }, { "id": "admission.reason", "label": "住院原因", "type": "textarea", "required": true, "description": "根据整段访谈整理本次住院相关的症状、病程及检查／手术安排，不必等受访者直接说出住院原因。", "validation": { "minLength": 1, "maxLength": 8000 } } ] } ] }, { "id": "family-relationships", "title": "家庭關係", "sections": [ { "id": "family-members", "title": "家庭成員", "fields": [ { "id": "family.members", "label": "家庭成員", "type": "repeatable", "itemLabel": "家庭成員", "itemFields": [ { "id": "memberId", "label": "成員 ID", "type": "computed", "readOnly": true, "computed": { "kind": "derived", "description": "新增成員時由系統產生唯一 ID。" } }, { "id": "role", "label": "成員身份", "type": "single", "options": [ { "value": "self", "label": "本人" }, { "value": "spouse", "label": "配偶" }, { "value": "father", "label": "爸爸" }, { "value": "mother", "label": "媽媽" }, { "value": "paternal_grandfather", "label": "祖父" }, { "value": "paternal_grandmother", "label": "祖母" }, { "value": "maternal_grandfather", "label": "外祖父" }, { "value": "maternal_grandmother", "label": "外祖母" }, { "value": "older_brother", "label": "哥哥" }, { "value": "older_sister", "label": "姐姐" }, { "value": "younger_brother", "label": "弟弟" }, { "value": "younger_sister", "label": "妹妹" }, { "value": "son", "label": "兒子" }, { "value": "daughter_in_law", "label": "媳婦" }, { "value": "daughter", "label": "女兒" }, { "value": "son_in_law", "label": "女婿" }, { "value": "fetus", "label": "懷孕胞胎" }, { "value": "grandson", "label": "孫子" }, { "value": "grandson_spouse", "label": "孫媳婦" }, { "value": "granddaughter", "label": "孫女" }, { "value": "granddaughter_spouse", "label": "孫女婿" }, { "value": "maternal_grandson", "label": "外孫" }, { "value": "maternal_grandson_spouse", "label": "外孫媳婦" }, { "value": "maternal_granddaughter", "label": "外孫女" }, { "value": "maternal_granddaughter_spouse", "label": "外孫女婿" }, { "value": "stepfather", "label": "繼父", "description": "病患的繼父。" }, { "value": "stepmother", "label": "繼母", "description": "病患的繼母。" }, { "value": "adoptive_father", "label": "養父", "aliases": [ "收養父親" ], "description": "病患的養父或收養父親。" }, { "value": "adoptive_mother", "label": "養母", "aliases": [ "收養母親" ], "description": "病患的養母或收養母親。" }, { "value": "adopted_son", "label": "養子", "aliases": [ "繼子" ], "description": "病患的養子或繼子；本產品將兩者歸為同一類。" }, { "value": "adopted_daughter", "label": "養女", "aliases": [ "繼女" ], "description": "病患的養女或繼女；本產品將兩者歸為同一類。" }, { "value": "other", "label": "其他" } ], "required": true }, { "id": "otherRole", "label": "其他成員身份", "type": "text", "requiredWhen": { "fieldId": "role", "operator": "equals", "value": "other" }, "visibleWhen": { "fieldId": "role", "operator": "equals", "value": "other" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "aliveStatus", "label": "存歿狀態", "type": "single", "options": [ { "value": "alive", "label": "存活" }, { "value": "deceased", "label": "死亡" } ], "description": "僅適用於非患者本人的家庭成員；role=self 時必須省略。", "visibleWhen": { "fieldId": "role", "operator": "notEquals", "value": "self" } }, { "id": "isDecisionMaker", "label": "家庭決策者", "type": "single", "options": [ { "value": "yes", "label": "是" }, { "value": "no", "label": "否" } ] }, { "id": "livesTogether", "label": "同住", "type": "single", "options": [ { "value": "yes", "label": "是" }, { "value": "no", "label": "否" } ] }, { "id": "birthOrder", "label": "排行", "type": "number", "validation": { "min": 1, "max": 30, "integer": true } }, { "id": "age", "label": "年齡", "type": "number", "unit": "歲", "validation": { "min": 0, "max": 130, "integer": true } }, { "id": "sex", "label": "性別", "type": "single", "options": [ { "value": "male", "label": "男性" }, { "value": "female", "label": "女性" }, { "value": "unknown", "label": "性別不明" } ] }, { "id": "multipleBirth", "label": "胞胎", "type": "single", "options": [ { "value": "yes", "label": "是" }, { "value": "no", "label": "否" } ] }, { "id": "maritalStatus", "label": "婚姻", "type": "single", "options": [ { "value": "single", "label": "未婚" }, { "value": "married", "label": "已婚" }, { "value": "divorced", "label": "離婚" }, { "value": "separated", "label": "分居" }, { "value": "cohabiting", "label": "同居" }, { "value": "widowed", "label": "喪偶" } ] }, { "id": "familyHistory", "label": "家族病史", "type": "multi", "options": [ { "value": "none", "label": "無", "exclusive": true }, { "value": "hypertension", "label": "高血壓" }, { "value": "heart_disease", "label": "心臟病" }, { "value": "diabetes", "label": "糖尿病" }, { "value": "liver_cancer", "label": "肝癌" }, { "value": "colorectal_cancer", "label": "大腸直腸癌" }, { "value": "asthma", "label": "氣喘" }, { "value": "blood_disease", "label": "血液病" }, { "value": "cancer", "label": "癌症" }, { "value": "cerebrovascular_disease", "label": "腦血管疾病" }, { "value": "mental_illness", "label": "精神疾病" }, { "value": "other", "label": "其它" } ], "validation": { "minSelections": 0 } }, { "id": "otherMedicalHistory", "label": "其他病史", "type": "text", "requiredWhen": { "fieldId": "familyHistory", "operator": "includes", "value": "other" }, "visibleWhen": { "fieldId": "familyHistory", "operator": "includes", "value": "other" }, "validation": { "minLength": 1, "maxLength": 500 } }, { "id": "note", "label": "備註", "type": "textarea", "validation": { "minLength": 1, "maxLength": 4000 } } ], "minItems": 0, "required": false } ] } ] } ] }