304 lines
7.3 KiB
JavaScript
304 lines
7.3 KiB
JavaScript
export default {
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steps: {
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page0: {
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elements: [
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'h4',
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'day_time_symptoms',
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'night_symptoms_copy',
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'during_or_after_exersise_symptoms',
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'extra_albuterol_use',
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],
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},
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page1: {
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elements: [
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'h4_1',
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'upper_respiratory_symptoms',
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'upper_respiratory_symptoms_copy',
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],
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},
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page2: {
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elements: [
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'h4_2',
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'lung_function_test',
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'container',
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],
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},
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page3: {
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elements: [
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'h4_3',
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'alergy_symptoms_month',
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],
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},
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},
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schema: {
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h4: {
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type: 'static',
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tag: 'h4',
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content: 'COUGH OR WHEEZE SYMPTOMS',
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},
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day_time_symptoms: {
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type: 'checkboxgroup',
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items: [
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{
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value: 'less_than_twice_weekly',
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label: 'Less than twice weekly',
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},
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{
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value: 'more_than_twice_weekly',
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label: 'More than twice weekly',
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},
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{
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value: 'daily',
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label: 'Daily',
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},
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{
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value: 'continuous',
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label: 'Continuous',
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},
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],
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label: 'DAYTIME SYMPTOMS',
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},
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night_symptoms_copy: {
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type: 'checkboxgroup',
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items: [
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{
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value: 'less_than_twice_weekly',
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label: 'Less than twice weekly',
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},
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{
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value: 'more_than_twice_weekly',
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label: 'More than twice weekly',
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},
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{
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value: 'nightly',
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label: 'Nightly',
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},
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],
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label: 'NIGHT SYMPTOMS\n',
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},
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during_or_after_exersise_symptoms: {
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type: 'checkboxgroup',
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items: [
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{
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value: 'exercise_symptoms_may_occur',
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label: 'Exercise symptoms may occur',
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},
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{
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value: 'less_than_once_weekly',
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label: 'Less than once weekly',
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},
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{
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value: 'frequent_exercise_symptoms',
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label: 'Frequent exercise symptoms',
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},
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{
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value: 'significant_limitation_activity',
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label: 'Significant limitation activity',
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},
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],
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label: 'DURING OR AFTER EXERCISE',
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},
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extra_albuterol_use: {
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type: 'checkboxgroup',
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items: [
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{
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value: 'occasional_use',
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label: 'Occasional use',
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},
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{
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value: 'periods_of_daily_use',
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label: 'Periods of daily use',
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},
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{
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value: 'daily_use',
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label: 'Daily use',
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},
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{
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value: 'frequent_daily_need',
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label: 'Frequent daily need',
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},
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{
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value: '_',
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label: null,
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},
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],
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label: 'EXTRA ALBUTEROL USE',
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},
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h4_1: {
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type: 'static',
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tag: 'h4',
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content: 'ALLERGY - LIKE SYMPTOMS',
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},
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upper_respiratory_symptoms: {
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type: 'checkboxgroup',
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items: [
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{
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value: 'sneezing',
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label: 'Sneezing',
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},
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{
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value: 'sniffing_drippy_nose',
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label: 'Sniffing drippy nose',
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},
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{
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value: 'itchy_eyes_nose',
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label: 'Itchy eyes/nose',
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},
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{
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value: 'dark_circles_under_eyes',
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label: 'Dark circles under eyes',
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},
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{
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value: 'sinus_infection',
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label: 'Sinus infection',
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},
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{
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value: 'mouth_breathing_snoring',
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label: 'mouth breathing/snoring',
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},
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{
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value: 'congestion',
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label: 'Congestion',
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},
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{
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value: 'dry_skin',
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label: 'Dry Skin',
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},
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],
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label: 'UPPER RESPIRATORY SYMPTOMS',
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},
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upper_respiratory_symptoms_copy: {
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type: 'checkboxgroup',
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items: [
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{
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value: 'smoke',
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label: 'Smoke',
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},
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{
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value: 'fireplace_woodstove',
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label: 'Fireplace/woodstove',
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},
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{
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value: 'animals',
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label: 'Animals',
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},
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{
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value: 'feather',
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label: 'Feather (pillows, stuffed animals)',
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},
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{
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value: 'carpeting',
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label: 'Carpeting',
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},
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{
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value: 'bedroom_carpeting',
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label: 'Bedroom carpeting',
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},
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{
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value: 'forced_air_heat',
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label: 'Forced air heat',
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},
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{
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value: 'mold_in_lower level',
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label: 'Mold in lower level',
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},
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],
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label: 'EXPOSURES',
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},
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h4_2: {
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type: 'static',
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tag: 'h4',
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content: 'Has the patient ever had a breathing/lung function test?',
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},
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lung_function_test: {
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type: 'radiogroup',
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items: [
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{
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value: 'yes',
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label: 'Yes',
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},
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{
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value: 'no',
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label: 'No',
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},
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],
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},
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container: {
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type: 'group',
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schema: {
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text: {
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type: 'text',
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label: 'When?',
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},
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},
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conditions: [
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[
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'lung_function_test',
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'in',
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[
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'yes',
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],
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],
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],
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},
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h4_3: {
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type: 'static',
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tag: 'h4',
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content: 'Please select symptoms month',
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},
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alergy_symptoms_month: {
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type: 'checkboxgroup',
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items: [
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{
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value: '1',
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label: 'January',
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},
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{
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value: '2',
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label: 'February',
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},
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{
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value: '3',
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label: 'March',
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},
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{
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value: '4',
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label: 'April',
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},
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{
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value: '5',
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label: 'May',
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},
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{
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value: '6',
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label: 'June',
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},
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{
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value: '7',
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label: 'July',
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},
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{
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value: '8',
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label: 'August',
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},
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{
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value: '9',
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label: 'September',
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},
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{
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value: '10',
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label: 'October',
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},
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{
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value: '11',
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label: 'November',
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},
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{
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value: '12',
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label: 'December',
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},
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],
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},
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},
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}
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