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Social History
Mathew Thorpe edited this page Aug 30, 2021
·
1 revision
| Variable / Field Name | Section Header | Field Type | Field Label | Choices or Calculations |
|---|---|---|---|---|
| social_status_before | radio | a) Before you got COVID-19 what was your occupation/working status (paid or unpaid work)? | 1, Working Full-time ; 2, Working Part-time ; 3, Full time carer (children or other) ; 4, Unemployed ; 5, Unable to work due to chronic illness ; 6, Student ; 7, Retired ; 8, Medically retired ; 9, Prefer not to say | |
| social_employ_pre_mar20 | radio | b.i) What was/ is your employment status? Before March 2020 | 1, FT employment ; 2, PT employment ; 3, Off sick ; 4, Caring for children ; 5, Caring for an adult ; 6, FT education ; 7, PT education ; 8, Unemployed ; 9, Retired | |
| social_employ_pre_covid | radio | b.ii) What was/ is your employment status? Before you were admitted to hospital with COVID | 1, FT employment ; 2, PT employment ; 3, Off sick ; 4, Caring for children ; 5, Caring for an adult ; 6, FT education ; 7, PT education ; 8, Unemployed ; 9, Retired ; 10, Furloughed ; 11, Laid off due to outbreak | |
| social_employ_post_covid | radio | b.iii) What was/ is your employment status? Since you were discharged from hospital after COVID | 1, FT employment ; 2, PT employment ; 3, Off sick ; 4, Caring for children ; 5, Caring for an adult ; 6, FT education ; 7, PT education ; 8, Unemployed ; 9, Retired ; 10, Furloughed ; 11, Laid off due to outbreak | |
| social_shift_work | radio | c) Prior to COVID did your work involve shift work? | 0, Never ; 1, Rarely ; 2, Sometimes ; 3, Usually ; 4, Always ; 5, Don't know / prefer not to say | |
| social_shift_night | radio | d) Prior to COVID did your work involve night shift? | 0, Never ; 1, Rarely ; 2, Sometimes ; 3, Usually ; 4, Always ; 5, Don't know / prefer not to say | |
| social_affect_work | yesno | e) Has your illness affected your ability to do your usual work? | 1, Yes ; 0, No | |
| social_exp_bereave | yesno | f) Have you experienced a close bereavement due to COVID19 | 1, Yes ; 0, No | |
| social_bereav_relation | text | f) Relationship in the bereavement |
Contents
Case Report Form Definitions
- Forms
- Timepoints
- PHOSP ID
- eConsent Tier 1
- eConsent Tier 2
- Informed Consent Form
- Split Tier Consent
- Eligibility Checklist
- CRF1A Part 1
- CRF1A Part 2
- CRF1A Part 3
- CRF1B
- CRF2A
- CRF2B
- CRF3A
- CRF3B
- CRF3C
- CRF4A
- CRF4B
- CRF Emergency Visit
- Adverse Event Log
- Withdrawals
- CRF Early Termination
- CRF Tier 2 Withdrawal
- Medications Log
- Activity Monitor Log
- Mental Health Assessment
- Nutrition
- Social History
- EQ-5D-5L
- GAD-7
- PHQ-9
- MRC Dyspnoea
- SARC-F
- GPPAQ
- Dyspnoea-12
- FACIT Fatigue
- PCL-5
- BPI
- NEADL
- MoCA
- Rockwood Clinical Frailty
- PSQI
- MEQ
- LCQ
- PFTs
- Walk Tests
- Tier 2 Core Test Checklist
- Tier 2 Research Samples
- Tier 2 Notification - Blood
- Tier 2 Notification - Oral Wash
- Tier 2 Notification - Sputum
- Tier 2 Notification - Urine
- QRISK3
- BIA
- DXA
- Muscle Strength
- SPPB
- Pre-PSQ
- PSQ
- Lab Log - Routine Blood
- Lab Log - Urine
- Lab Log - Immuno
- Lab Log - Additional Tests
- PCR Swab Tests