SMARTBEAR\ABCQuestionnaire - XML Representation

Smart Bear Implementation Guide - Local Development build (v0.3.2). See the Directory of published versions
: ABCQuestionnaire - XML Representation

Draft as of 2023-08-01


<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="ABCQuestionnaire"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkId for the item">LinkId</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the itemcan appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> ABCQuestionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">https://smart-bear.eu/fhir/Questionnaire/ABCQuestionnaire#0.3.2</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Integer" class="hierarchy"/> ABC_1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Walk around the house?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_1">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: white; background-color: inherit" title="Integer" class="hierarchy"/> ABC_2</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Walk up or down stairs?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_2">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_3" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Integer" class="hierarchy"/> ABC_3</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Bend over and pick up a slipper (or item) from the front of a closet floor</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_3">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: white; background-color: inherit" title="Integer" class="hierarchy"/> ABC_4</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Reach for a small can off a shelf at eye level?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_4">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_5" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Integer" class="hierarchy"/> ABC_5</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Stand on your tiptoes and reach for something above your head?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_5">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_6" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: white; background-color: inherit" title="Integer" class="hierarchy"/> ABC_6</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Stand on a chair and reach for something?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_6">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_7" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Integer" class="hierarchy"/> ABC_7</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Sweep the floor?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_7">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_8" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: white; background-color: inherit" title="Integer" class="hierarchy"/> ABC_8</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Walk outside the house to a car parked in the driveway?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_8">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_9" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Integer" class="hierarchy"/> ABC_9</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Get into or out of a car?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_9">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_10" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: white; background-color: inherit" title="Integer" class="hierarchy"/> ABC_10</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Walk across a parking lot to the mall (store)?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_10">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_11" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Integer" class="hierarchy"/> ABC_11</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Walk up or down a ramp?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_11">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_12" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: white; background-color: inherit" title="Integer" class="hierarchy"/> ABC_12</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Walk in a crowded mall where people rapidly walk past you?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_12">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_13" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Integer" class="hierarchy"/> ABC_13</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Are bumped into by people as you walk through the mall?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_13">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_14" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: white; background-color: inherit" title="Integer" class="hierarchy"/> ABC_14</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Step onto or off an escalator while you are holding onto a railing?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_14">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_15" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Integer" class="hierarchy"/> ABC_15</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Step onto or off an escalator while holding onto parcels such that you cannot hold onto the railing?</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_15">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.ABC_16" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-integer.png" alt="." style="background-color: white; background-color: inherit" title="Integer" class="hierarchy"/> ABC_16</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">How confident are you that you will not lose your balance or become unsteady when you... Walk outside on icy sidewalks?</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.ABC_16">11 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.score" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="String" class="hierarchy"/> score</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Score</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Option Sets</b></p><a name="opt-item.ABC_1"> </a><p><b>Answer options for ABC_1</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_2"> </a><p><b>Answer options for ABC_2</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_3"> </a><p><b>Answer options for ABC_3</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_4"> </a><p><b>Answer options for ABC_4</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_5"> </a><p><b>Answer options for ABC_5</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_6"> </a><p><b>Answer options for ABC_6</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_7"> </a><p><b>Answer options for ABC_7</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_8"> </a><p><b>Answer options for ABC_8</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_9"> </a><p><b>Answer options for ABC_9</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_10"> </a><p><b>Answer options for ABC_10</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_11"> </a><p><b>Answer options for ABC_11</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_12"> </a><p><b>Answer options for ABC_12</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_13"> </a><p><b>Answer options for ABC_13</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_14"> </a><p><b>Answer options for ABC_14</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_15"> </a><p><b>Answer options for ABC_15</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul><a name="opt-item.ABC_16"> </a><p><b>Answer options for ABC_16</b></p><ul><li style="font-size: 11px">0</li><li style="font-size: 11px">10</li><li style="font-size: 11px">20</li><li style="font-size: 11px">30</li><li style="font-size: 11px">40</li><li style="font-size: 11px">50</li><li style="font-size: 11px">60</li><li style="font-size: 11px">70</li><li style="font-size: 11px">80</li><li style="font-size: 11px">90</li><li style="font-size: 11px">100</li></ul></div>
  </text>
  <url value="https://smart-bear.eu/fhir/Questionnaire/ABCQuestionnaire"/>
  <version value="0.3.2"/>
  <name value="ABCQuestionnaire"/>
  <title value="Activities-Specific Balance Confidence Scale"/>
  <status value="draft"/>
  <date value="2023-08-01T11:22:15+02:00"/>
  <item>
    <linkId value="ABC_1"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Walk around the house?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_2"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Walk up or down stairs?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_3"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Bend over and pick up a slipper (or item) from the front of a closet floor"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_4"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Reach for a small can off a shelf at eye level?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_5"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Stand on your tiptoes and reach for something above your head?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_6"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Stand on a chair and reach for something?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_7"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Sweep the floor?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_8"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Walk outside the house to a car parked in the driveway?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_9"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Get into or out of a car?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_10"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Walk across a parking lot to the mall (store)?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_11"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Walk up or down a ramp?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_12"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Walk in a crowded mall where people rapidly walk past you?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_13"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Are bumped into by people as you walk through the mall?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_14"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Step onto or off an escalator while you are holding onto a railing?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_15"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Step onto or off an escalator while holding onto parcels such that you cannot hold onto the railing?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="ABC_16"/>
    <text
          value="How confident are you that you will not lose your balance or become unsteady when you... Walk outside on icy sidewalks?"/>
    <type value="integer"/>
    <required value="true"/>
    <answerOption>
      <valueInteger value="0"/>
    </answerOption>
    <answerOption>
      <valueInteger value="10"/>
    </answerOption>
    <answerOption>
      <valueInteger value="20"/>
    </answerOption>
    <answerOption>
      <valueInteger value="30"/>
    </answerOption>
    <answerOption>
      <valueInteger value="40"/>
    </answerOption>
    <answerOption>
      <valueInteger value="50"/>
    </answerOption>
    <answerOption>
      <valueInteger value="60"/>
    </answerOption>
    <answerOption>
      <valueInteger value="70"/>
    </answerOption>
    <answerOption>
      <valueInteger value="80"/>
    </answerOption>
    <answerOption>
      <valueInteger value="90"/>
    </answerOption>
    <answerOption>
      <valueInteger value="100"/>
    </answerOption>
  </item>
  <item>
    <linkId value="score"/>
    <text value="Score"/>
    <type value="string"/>
    <required value="true"/>
  </item>
</Questionnaire>