export default { steps: { page0: { elements: [ 'h1', 'h2', 'anxiety_level', ], buttons: { previous: false, }, }, page1: { elements: [ 'h3', 'h4', 'anxiety_duration', ], }, page2: { elements: [ 'h5', 'h6', 'anxiety_triggers', ], }, page3: { elements: [ 'h7', 'h8', 'diagnosed_anxiety', ], }, page4: { elements: [ 'h9', 'h10', 'anxiety_symptoms', ], }, page5: { elements: [ 'h11', 'h12', 'anxiety_medication', ], }, page6: { elements: [ 'h13', 'h14', 'anxiety_supplements', ], }, page7: { elements: [ 'h15', 'h16', 'stress_level', ], }, page8: { elements: [ 'h17', 'h18', 'seeing_therapist', ], }, page9: { elements: [ 'h19', 'h20', 'other_conditions', ], }, page10: { elements: [ 'h21', 'h22', 'adverse_reactions', ], }, page11: { elements: [ 'h23', 'h24', 'history_mental_health', ], }, page12: { elements: [ 'h25', 'h26', 'pregnant', ], }, }, schema: { h1: { type: 'static', tag: 'h2', content: 'Anxiety Assessment', align: 'left', }, h2: { type: 'static', tag: 'h4', content: 'How would you rate your current level of anxiety?', }, anxiety_level: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Mild', label: 'Mild', }, { value: 'Moderate', label: 'Moderate', }, { value: 'Severe', label: 'Severe', }, ], }, h3: { type: 'static', tag: 'h4', content: 'How long have you experienced symptoms of anxiety?', }, h4: { type: 'static', tag: 'h5', content: 'Select one:', }, anxiety_duration: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Weeks', label: 'Weeks', }, { value: 'Months', label: 'Months', }, { value: 'Years', label: 'Years', }, ], }, h5: { type: 'static', tag: 'h4', content: 'What are the main triggers or situations that cause your anxiety?', }, h6: { type: 'static', tag: 'h5', content: 'Check all that apply:', }, anxiety_triggers: { type: 'checkboxgroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Social situations', label: 'Social situations', }, { value: 'Work-related stress', label: 'Work-related stress', }, { value: 'Family or relationship issues', label: 'Family or relationship issues', }, { value: 'Health concerns', label: 'Health concerns', }, { value: 'Financial problems', label: 'Financial problems', }, { value: 'Other', label: 'Other', }, ], }, h7: { type: 'static', tag: 'h4', content: 'Have you been diagnosed with an anxiety disorder?', }, h8: { type: 'static', tag: 'h5', content: '(e.g., generalized anxiety disorder, panic disorder, social anxiety)', }, diagnosed_anxiety: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], }, h9: { type: 'static', tag: 'h4', content: 'If yes, please specify the condition.', }, specified_condition: { type: 'text', inputType: 'text', rules: [ 'required', ], conditions: [ [ 'diagnosed_anxiety', 'in', [ 'Yes', ], ], ], }, h10: { type: 'static', tag: 'h4', content: 'Do you experience the following symptoms?', }, h11: { type: 'static', tag: 'h5', content: 'Check all that apply:', }, anxiety_symptoms: { type: 'checkboxgroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Restlessness or nervousness', label: 'Restlessness or nervousness', }, { value: 'Trouble concentrating', label: 'Trouble concentrating', }, { value: 'Rapid heart rate', label: 'Rapid heart rate', }, { value: 'Sweating', label: 'Sweating', }, { value: 'Difficulty breathing', label: 'Difficulty breathing', }, { value: 'Irritability', label: 'Irritability', }, { value: 'Insomnia or sleep disturbances', label: 'Insomnia or sleep disturbances', }, { value: 'Muscle tension', label: 'Muscle tension', }, { value: 'Nausea or digestive issues', label: 'Nausea or digestive issues', }, { value: 'Other', label: 'Other', }, ], }, h12: { type: 'static', tag: 'h4', content: 'Are you currently taking any medications for anxiety?', }, anxiety_medication: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], }, medication_details: { type: 'text', inputType: 'text', rules: [ 'required', ], conditions: [ [ 'anxiety_medication', 'in', [ 'Yes', ], ], ], }, h13: { type: 'static', tag: 'h4', content: 'Have you used natural supplements or other therapies for anxiety?', }, anxiety_supplements: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], }, supplement_details: { type: 'text', inputType: 'text', rules: [ 'required', ], conditions: [ [ 'anxiety_supplements', 'in', [ 'Yes', ], ], ], }, h14: { type: 'static', tag: 'h4', content: 'How would you rate your current stress levels?', }, stress_level: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Low', label: 'Low', }, { value: 'Moderate', label: 'Moderate', }, { value: 'High', label: 'High', }, { value: 'Very High', label: 'Very High', }, ], }, h15: { type: 'static', tag: 'h4', content: 'Are you currently seeing a therapist or mental health professional for your anxiety?', }, seeing_therapist: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], }, h16: { type: 'static', tag: 'h4', content: 'Do you have any of the following conditions that may affect your anxiety treatment?', }, other_conditions: { type: 'checkboxgroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Heart disease', label: 'Heart disease', }, { value: 'Hypertension', label: 'Hypertension', }, { value: 'Asthma or respiratory conditions', label: 'Asthma or respiratory conditions', }, { value: 'Thyroid disorders', label: 'Thyroid disorders', }, { value: 'Autoimmune conditions', label: 'Autoimmune conditions', }, { value: 'Chronic pain', label: 'Chronic pain', }, { value: 'Other', label: 'Other', }, ], }, h17: { type: 'static', tag: 'h4', content: 'Have you experienced any adverse reactions to medications or treatments for anxiety in the past?', }, adverse_reactions: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], }, reaction_details: { type: 'text', inputType: 'text', rules: [ 'required', ], conditions: [ [ 'adverse_reactions', 'in', [ 'Yes', ], ], ], }, h18: { type: 'static', tag: 'h4', content: 'Do you have a history of depression, PTSD, or other mental health conditions in addition to anxiety?', }, history_mental_health: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], }, mental_health_details: { type: 'text', inputType: 'text', rules: [ 'required', ], conditions: [ [ 'history_mental_health', 'in', [ 'Yes', ], ], ], }, h19: { type: 'static', tag: 'h4', content: 'Are you Pregnant? (Female Specific)', }, pregnant: { type: 'radiogroup', rules: [ 'required', ], view: 'blocks', items: [ { value: 'Yes', label: 'Yes', }, { value: 'No', label: 'No', }, ], }, }, };