CDE Detailed Report

Disease: Sport Related Concussion
Subdomain Name: Family and Environment
CRF: Family Burden of Injury Interview (FBII)

Displaying 1 - 41 of 41
CDE ID CDE Name Variable Name Definition Short Description Question Text Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C54013 Family Burden of Injury Interview (FBII) -Any family routine changed or affected indicator FBIIAnyFmlyRoutnChngAffctInd Indicator if any family routine changed or affected , as part of Family Burden of Injury Interview (FHII) Indicator if any family routine changed or affected , as part of Family Burden of Injury Interview (FHII) Have any family routines been affected or changed as a result of your child's injury? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54024 Family Burden of Injury Interview (FBII) -Difficult to talk to others about your childs injury indicator FBIIDffTlkOthrsAbtYrChldInjInd Indicator for difficulty to talk to others about your child's injury , as part of Family Burden of Injury Interview (FHII) Indicator for difficulty to talk to others about your child's injury , as part of Family Burden of Injury Interview (FHII) Is it difficult in any way for you to talk to other family members or persons outside the family about your child's injury or what has happened since? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54003 Family Burden of Injury Interview (FBII) -Difficulty in discplining child behavior indicator FBIIDffctDscplChldBehInd Indicator for difficulty in discplining child behavior , as part of Family Burden of Injury Interview (FHII) Indicator for difficulty in discplining child behavior , as part of Family Burden of Injury Interview (FHII) Have you or your spouse/partner had difficulties in disciplining or managing your child's behavior since the accident? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54035 Family Burden of Injury Interview (FBII) -Composite score FBIICompositeScore Composite score , as part of Family Burden of Injury Interview (FHII) Composite score , as part of Family Burden of Injury Interview (FHII) Numeric Values

Composite score derived from factor analysis that represents the mean of the Child, Spouse, and Extended Family and Friends scales. For caregivers without spouses, the average of the other two scales was used as the composite score.

Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Free-Form Entry

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C54014 Family Burden of Injury Interview (FBII) -Any long term goals affected indicator FBIIAnyLngTrmGoalAffctedInd Indicator for any long term goals affected , as part of Family Burden of Injury Interview (FHII) Indicator for any long term goals affected , as part of Family Burden of Injury Interview (FHII) Have any long-term goals been affected by your child' s injury, i.e., career, financial, or educational goals? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54025 Family Burden of Injury Interview (FBII) -Have difficulty finding time for your activities indicator FBIIHvDffFndTmeYrActvtInd Indicator for having difficulty finding time for your activities , as part of Family Burden of Injury Interview (FHII) Indicator for having difficulty finding time for your activities , as part of Family Burden of Injury Interview (FHII) Are you having difficulty finding time for your own activities? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54004 Family Burden of Injury Interview (FBII) -Noticed change in behavior of your other children indicator FBIINotcChngBehYrOthrChldrnInd Indicator for noticed change in behavior of your other children , as part of Family Burden of Injury Interview (FHII) Indicator for noticed change in behavior of your other children , as part of Family Burden of Injury Interview (FHII) Have you noticed any changes in the behavior of your other children? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54036 Family Burden of Injury Interview (FBII) -Any burden score FBIIAnyBurdenScore Any burden score , as part of Family Burden of Injury Interview (FHII) Any burden score , as part of Family Burden of Injury Interview (FHII) Numeric Values

Additional scores: ANY BURDEN = any stress levels scored as 1-4 for each subscale, re-coded to ïâ?â½noïâ?â½ if not ïâ?â½due to injury or consequencesïâ?â½. Note: a ïâ?â½yes, have problemïâ?â½, but ïâ?â½no, 0 stressïâ?â½ is not considered any burden.

Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Free-Form Entry

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C54015 Family Burden of Injury Interview (FBII) -Difficult to accept and deal with your childs injury indicator FBIIDffctAccptDealYrChldInjInd Indicator for difficulty to accept and deal with your child's injury , as part of Family Burden of Injury Interview (FHII) Indicator for difficulty to accept and deal with your child's injury , as part of Family Burden of Injury Interview (FHII) Has it been difficult for you to accept and deal with your child's injury? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54026 Family Burden of Injury Interview (FBII) -Spouse/partner have difficulty finding time for their activities indicator FBIISpsPrtnDffFndTmeThrActvInd Indicator for spouse/partner having difficulty finding time for their activities , as part of Family Burden of Injury Interview (FHII) Indicator for spouse/partner having difficulty finding time for their activities , as part of Family Burden of Injury Interview (FHII) Is your spouse/partner having difficulty finding time for his/her own activities? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54005 Family Burden of Injury Interview (FBII) -Difficulty in discplining your other child behavior indicator FBIIDffctDscplOthrYrChldBehInd Indicator for difficulty in discplining your other child behavior , as part of Family Burden of Injury Interview (FHII) Indicator for difficulty in discplining your other child behavior , as part of Family Burden of Injury Interview (FHII) Have you or your spouse/partner had difficulties in disciplining or managing your other children's behavior since the accident? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54037 Family Burden of Injury Interview (FBII) -Hi stress score FBIIHiStressScore Hi stress score , as part of Family Burden of Injury Interview (FHII) Hi stress score , as part of Family Burden of Injury Interview (FHII) Numeric Values

Additional scores: ANY HI STRESS = any high stress scores per subscale and overall (stress of 3 or 4), again, if not due to injury, then not counted.

Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Free-Form Entry

81 108
C54016 Family Burden of Injury Interview (FBII) -Concerned about spouse/partner reaction to your childs injury indicator FBIIConSpsPrtnRctnYrChldInjInd Indicator for concern about spouse/partner's reaction to your child's injury , as part of Family Burden of Injury Interview (FHII) Indicator for concern about spouse/partner's reaction to your child's injury , as part of Family Burden of Injury Interview (FHII) If you have a spouse/partner, are you concerned about their reaction to your child's injury? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54027 Family Burden of Injury Interview (FBII) -Difficult finding time to be together with spouse/partner indicator FBIIDffFndTmeTghrSpsPrtnInd Indicator for difficulty in finding time to be together with spouse/partner, as part of Family Burden of Injury Interview (FHII) Indicator for difficulty in finding time to be together with spouse/partner, as part of Family Burden of Injury Interview (FHII) Are you having difficulty finding time to be together and doing things together with your spouse/partner? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54006 Family Burden of Injury Interview (FBII) - Concerned about your other children react or accept indicator FBIIConYrOthrChldrnReactAccInd Indicator for concern about your other children reaction or acceptance , as part of Family Burden of Injury Interview (FHII) Indicator for concern about your other children reaction or acceptance , as part of Family Burden of Injury Interview (FHII) If you have any other children, are you concerned about how they are reacting to or accepting your child's injury? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54017 Family Burden of Injury Interview (FBII) -Difficult for spouse/partner to accept your childs injury indicator FBIIDffSpsPrtnAccYrChldInjInd Indicator for difficulty for spouse/partner to accept your child's injury , as part of Family Burden of Injury Interview (FHII) Indicator for difficulty for spouse/partner to accept your child's injury , as part of Family Burden of Injury Interview (FHII) Has it been difficult for you spouse/partner to accept and deal with your child' s injury? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54028 Family Burden of Injury Interview (FBII) -Difficult finding time to do things with your other children indicator FBIIDffFndTmeDoThgOthrChldnInd Indicator for difficulty finding time to do things with your other children , as part of Family Burden of Injury Interview (FHII) Indicator for difficulty finding time to do things with your other children , as part of Family Burden of Injury Interview (FHII) Are you having difficulty finding time to do things with your other children? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54007 Family Burden of Injury Interview (BHII) -Concerned about your childs recovery or possible problems in future indicator FBIIConYrChldRcvryPssPrbFutInd Indicator for concern about your child's recovery or possible problems in future , as part of Family Burden of Injury Interview (FHII) Indicator for concern about your child's recovery or possible problems in future , as part of Family Burden of Injury Interview (FHII) Are you concerned about your child's recovery or possible problems in the future? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54018 Family Burden of Injury Interview (FBII) -Concerned your child being accepted by peers indicator FBIIConYrChldBngAccptPeersInd Indicator for concern about your child being accepted by peers , as part of Family Burden of Injury Interview (FHII) Indicator for concern about your child being accepted by peers , as part of Family Burden of Injury Interview (FHII) Are you concerned about how your child is being accepted by his/her peers? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C53953 Language form administration ISO code LangFormAdministratISOCode Code (ISO 639-2) for the language that was used for CRF/instrument/scale/etc. administration Code (ISO 639-2) for the language that was used for CRF/instrument/scale/etc. administration What is the ISO 639 code for the language the form/instrument has been administrated? chi;cze;dan;dut;eng;fin;fre;ger;gre;heb;hin;hun;ira;ita;jpn;nor;Other, specify;por;rus;sgn;spa;vie Chinese;Czech;Danish;Dutch;English;Finnish;French;German;Greek;Hebrew;Hindi;Hungarian;Iranian languages;Italian;Japanese;Norwegian;Other specify;Portuguese;Russian;Sign language;Spanish;Vietnamese Alphanumeric

Data Sharing Instructions: The language data should be coded using the ISO 639-2 codes ( (https://www.loc.gov/standards/iso639-2/php/code_list.php) prior to aggregation or sharing. Enter ISO 639-2 code for the language used to administer the CRF/instrument/scale/test/etc. If the language is not specified, the default value is 'eng'- English.

ISO 639-2 language codes (http://www.loc.gov/standards/iso639-2/php/code_list.php) Adult;Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54029 Family Burden of Injury Interview (FBII) -Child subscale score FBIIChildSubscaleScore Child subscale score , as part of Family Burden of Injury Interview (FHII) Child subscale score , as part of Family Burden of Injury Interview (FHII) Numeric Values Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Free-Form Entry

0 20
C54008 Family Burden of Injury Interview (FBII) -Day to day life changed for family indicator FBIIDyDyLfChngFamlytInd Indicator for day to day life change for family , as part of Family Burden of Injury Interview (FHII) Indicator for day to day life change for family , as part of Family Burden of Injury Interview (FHII) Has day to day life changed for you and your family since we last saw you? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54019 Family Burden of Injury Interview (FBII) - Disagree with spouse/partner on taking care of problem with family indicator FBIIDisAgSpsPrtnTkCrePrbFmyInd Indicator for disagreeing with spouse/partner on taking care of problem with family, as part of Family Burden of Injury Interview (FHII) Indicator for disagreeing with spouse/partner on taking care of problem with family, as part of Family Burden of Injury Interview (FHII) If you have a spouse/partner, do you disagree about how to take care of problems with your child and family that have resulted from the injury? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C53954 Language form administration ISO code other text LangFormAdministratISOCodeOTH The free-text field related to 'Language form administration ISO code' specifying other text The free-text field related to 'Language form administration ISO code' specifying other tex Other, specify Alphanumeric

Other text for form administration language ISO 639-2 code. Should be used only if 1) the ISO code is not available under LangCRFAdministratISOCode permissible values or 2) the ISO code is not available at all. If the language is not specified, the default value is 'eng'- English.

ISO 639-2 language codes (http: //www.loc.gov/standards/iso639-2/php/code_list.php) Adult;Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points 4000

Free-Form Entry

C54030 Family Burden of Injury Interview (FBII) -Spouse subscale score FBIISpouseSubscaleScore Spouse subscale score , as part of Family Burden of Injury Interview (FHII) Spouse subscale score , as part of Family Burden of Injury Interview (FHII) Numeric Values Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Free-Form Entry

0 24
C54009 Family Burden of Injury Interview (FBII) -Either parent miss work or school indicator FBIIEthrPrntMssWrkSchlInd Indicator for if either parent missed work or school , as part of Family Burden of Injury Interview (FHII) Indicator for if either parent missed work or school , as part of Family Burden of Injury Interview (FHII) Is either parent missing work or school? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54020 Family Burden of Injury Interview (FBII) -Difficult to talk about your childs injury indicator FBIIDffTlkYrChldInjInd Indicator for difficulty to talk about your child's injury, as part of Family Burden of Injury Interview (FHII) Indicator for difficulty to talk about your child's injury, as part of Family Burden of Injury Interview (FHII) Has it been difficult in any way for you and your spouse/partner to talk about your child's injury? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C53999 Family Burden of Injury Interview (FBII) -Injury presence indicator FBIIInjuryPrsncInd Injury presence indicator , as part of Family Burden of Injury Interview (FHII) (FHII) Injury presence indicator , as part of Family Burden of Injury Interview (FHII) No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54031 Family Burden of Injury Interview (FBII) -Others subscale score FBIIOthersSubscaleScore Others subscale score , as part of Family Burden of Injury Interview (FHII) Others subscale score , as part of Family Burden of Injury Interview (FHII) Numeric Values Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Free-Form Entry

0 16
C54010 Family Burden of Injury Interview (FBII) -Job school schedules affected in any way indicator FBIIJbSchlSchdlAffctAnyWyInd Indicator if job or school schedules are affected in any way , as part of Family Burden of Injury Interview (FHII) Indicator if job or school schedules are affected in any way , as part of Family Burden of Injury Interview (FHII) Have job or school schedules been affected in any way? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54021 Family Burden of Injury Interview (FBII) -Concerned about other person reaction to your childs injury indicator FBIIConOthrPrsRctnYrChldInjInd Indicator for concern about other person reaction to your child's injury, as part of Family Burden of Injury Interview (FHII) Indicator for concern about other person reaction to your child's injury, as part of Family Burden of Injury Interview (FHII) Are you concerned about how other family members of persons outside the family are reacting to your child's injury? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54000 Family Burden of Injury Interview (FBII) -Any change in childs reaction indicator FBIIAnyChngChldReactnInd Indicator for any change in child's reaction, as part of Family Burden of Injury Interview (FHII) Indicator for any change in child's reaction, as part of Family Burden of Injury Interview (FHII) Has there been any change in how your child reacts or relates to you or your spouse/partner? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54032 Family Burden of Injury Interview (FBII) -Siblings subscale score FBIISiblingsSubscaleScore Siblings subscale score , as part of Family Burden of Injury Interview (FHII) Siblings subscale score , as part of Family Burden of Injury Interview (FHII) Numeric Values Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

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C54011 Family Burden of Injury Interview (FBII) -Difficult to take care of your other children indicator FBIIDffctTkeCreYrOthrChldrnInd Indicator for difficulty to take care of your other children , as part of Family Burden of Injury Interview (FHII) Indicator for difficulty to take care of your other children , as part of Family Burden of Injury Interview (FHII) If you have any other children, has your child's injury made it difficult for you to take care of them? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54022 Family Burden of Injury Interview (FBII) -Disagree with others to best care for your child and family indicator FBIIDisAgOthrBstCreChldFmyInd Indicator for disagreeing with others to best care for your child and family , as part of Family Burden of Injury Interview (FHII) Indicator for disagreeing with others to best care for your child and family , as part of Family Burden of Injury Interview (FHII) Do you disagree with other family members or persons outside the family about how to best care for your child and family? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54001 Family Burden of Injury Interview (FBII) -Question description text FBIIQuestionDescrpnTxt Question description text , as part of Family Burden of Injury Interview (FHII) Question description text , as part of Family Burden of Injury Interview (FHII) Alphanumeric

The parents described the specific problem in more detail

Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points 4000

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C54033 Family Burden of Injury Interview (FBII) -Routines subscale score FBIIRoutineSubscaleScore Routine subscale score , as part of Family Burden of Injury Interview (FHII) Routine subscale score , as part of Family Burden of Injury Interview (FHII) Numeric Values Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

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C54012 Family Burden of Injury Interview (FBII) -Difficulty keeping up with daily chores indicator FBIIDffctTKeepUpDailyChoresInd Indicator for difficulty in keeping up with daily chores , as part of Family Burden of Injury Interview (FHII) Indicator for difficulty in keeping up with daily chores , as part of Family Burden of Injury Interview (FHII) Are you having difficulty keeping up with daily chores, such as shopping or household tasks? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54023 Family Burden of Injury Interview (FBII) -Concerned what other persons think about you disciplining your child indicator FBIIConWhtOthPsnThkDscYrChdInd Indicator for concern about what other persons think about you disciplining your child, as part of Family Burden of Injury Interview (FHII) Indicator for concern about what other persons think about you disciplining your child, as part of Family Burden of Injury Interview (FHII) Are you concerned about what other persons think about how you are disciplining your child ,or the kinds of things you allow you child to do or not do? No;Yes No;Yes Alphanumeric Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54002 Family Burden of Injury Interview (FBII) -Rate the level of stress scale FBIIRateLevelStressScl Rate the level of stress scale , as part of Family Burden of Injury Interview (FHII) Rate the level of stress scale , as part of Family Burden of Injury Interview (FHII) 0;1;2;3;4 0;1;2;3;4 Numeric Values Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

Single Pre-Defined Value Selected

C54034 Family Burden of Injury Interview (FBII) -Total score FBIITotalScore Total score , as part of Family Burden of Injury Interview (FHII) Total score , as part of Family Burden of Injury Interview (FHII) Numeric Values

Total score averaging all five subscales

Copyright 1999 Lippincott Williams & Wilkins, Inc. Burgess, Erika Swift MA; Drotar, Dennis PhD; Taylor, Gerry H. PhD; Wade, Shari PhD; Stancin, Terry PhD; Yeates, Keith Owen PhDThe Family Burden of Injury Interview: Reliability and Validity Studies.Journa Pediatric Exploratory 1.00 2017-02-10 00:00:00.0 Family Burden of Injury Interview (FBII) Family and Environment Outcomes and End Points

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