This form structure is an organized set of data definitions for a copyrighted form

 General Details

Title:
Family Assessment Device (FAD)
Short Name:
FAD
Description:
The FAD is a 60 item self-report instrument with responses rated on a 4-point Likert scale from strongly agree to strongly disagree. There is a General Functioning scale and six subscales -- Problem Solving, Communication, Roles, Affective Responsiveness, Affective Involvement, and Behavior Control.
Disease:
Traumatic Brain Injury
Organization:
NINDS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-02-23
Version:
1.0
Date Created:
2016-02-03
Owner:
Number of Data Elements:
75
eForms:
N

 Documentation


 Groups & Attached Data Elements

Logically grouped data elements with defined frequency at which they repeat.

# Title Short Description Variable Name Required? Type
1 GUID   Global Unique ID which uniquely identifies a subject GUID Required CDE
2 Subject identifier number   An identification number assigned to the participant/subject within a given protocol or a study. SubjectIDNum Optional CDE
3 Age in years   Value for participant's subject age recorded in years. AgeYrs Recommended CDE
4 Vital status   Status of participant/subject as alive or dead VitStatus Recommended CDE
5 Visit date   Actual interview or visit date VisitDate Recommended CDE
6 Site name   The name of the site for the study SiteName Recommended CDE
7 Days since baseline   The number of days since baseline DaysSinceBaseline Optional CDE
8 Case control indicator   Indicator of whether subject is in the case or control arm of the study CaseContrlInd Optional CDE
9 General notes text   General notes GeneralNotesTxt Optional CDE

Additional Element Groups

Listed below are your additional element groups.

Form Administration (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 Context type  The context to which the questions were answered ContextType Recommended CDE
2 Context type other text  The free-text related to ContextType specifying other text ContextTypeOTH Recommended CDE
3 Data source  Source of the data provided on the case report form DataSource Recommended CDE
4 Data source other text  The free-text field related to Data source specifying other text. Source of the data provided on the case report form DataSourceOTH Recommended CDE

Family Assessment Device (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 Family Assessment Device (FAD) - Difficult plan activities misunderstand indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family has difficulty planning activities because they misunderstand each other, as part of the Family Assessment Device (FAD) FADDiffPlanActMisunrstndInd Recommended CDE
2 Family Assessment Device (FAD) - Resolve most everyday problem indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family resolves most of the everyday problems in the house, as part of the Family Assessment Device (FAD) FADResolvMstEverydayPrblmInd Recommended CDE
3 Family Assessment Device (FAD) - Everyone know family member upset indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family will know why a certain family member is upset, as part of the Family Assessment Device (FAD) FADEveryoneKnowFamUpsetInd Recommended CDE
4 Family Assessment Device (FAD) - Check on family member indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family has to check up on each other when someone asks to do someone to do something, as part of the Family Assessment Device (FAD) FADCheckOnFamMembrInd Recommended CDE
5 Family Assessment Device (FAD) - Too involve trouble indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family become too involved when someone is in trouble. FADTooInvolveTroubleInd Recommended CDE
6 Family Assessment Device (FAD) - Crisis support each other indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family turns to each other for support in times of crisis, as part of the Family Assessment Device (FAD) FADCrisisSupportEachOtherInd Recommended CDE
7 Family Assessment Device (FAD) - Lost during emergency indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family does not know what to do when an emergency comes up, as part of the Family Assessment Device (FAD) FADLostDuringEmergncyInd Recommended CDE
8 Family Assessment Device (FAD) - Run out necessity indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family runs out of things they need. FADRunOutNecessityInd Recommended CDE
9 Family Assessment Device (FAD) - Reluctant show affection indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family is reluctant to show affection towards each other, as part of the Family Assessment Device (FAD) FADReluctantShowAffectionInd Recommended CDE
10 Family Assessment Device (FAD) - Family member meet responsibility indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family makes sure that each member meets their respective responsibilities, as part of the Family Assessment Device (FAD) FADFamMembrMeetRespnsiblityInd Recommended CDE
11 Family Assessment Device (FAD) - Cannot talk sadness indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family cannot talk to each other about the sadness they feel, as part of the Family Assessment Device (FAD) FADCantTalkSadnessInd Recommended CDE
12 Family Assessment Device (FAD) - Act decision regard problem indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family acts on their decisions regarding problems, as part of the Family Assessment Device (FAD) FADActDecisionRegardProblemInd Recommended CDE
13 Family Assessment Device (FAD) - Attention only when interest indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members are only attentive when they are interested, as part of the Family Assessment Device (FAD) FADAttentionOnlyWhnInterestInd Recommended CDE
14 Family Assessment Device (FAD) - Misread family member word indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family can't tell how someone is feeling from what they are saying, as part of the Family Assessment Device (FAD) FADMisreadMemberWordInd Recommended CDE
15 Family Assessment Device (FAD) - Spread out family task indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family don't spread their tasks around enough, as part of the Family Assessment Device (FAD) FADSpreadOutFamTaskInd Recommended CDE
16 Family Assessment Device (FAD) - Individually accept indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family accept each individual family member for who they are, as part of the Family Assessment Device (FAD) FADIndividuallyAcceptInd Recommended CDE
17 Family Assessment Device (FAD) - Break rule easily indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family can get away easily when breaking the rules, as part of the Family Assessment Device (FAD) FADBreakRuleEasilyInd Recommended CDE
18 Family Assessment Device (FAD) - People blunt instead hint indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family come right out and say things instead of hinting at each other, as part of the Family Assessment Device (FAD) FADPeopleBluntInsteadHintInd Recommended CDE
19 Family Assessment Device (FAD) - No emotional response indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members don't respond emotionally, as part of the Family Assessment Device (FAD) FADNoEmotionalRespnsInd Recommended CDE
20 Family Assessment Device (FAD) - Emergency aware indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family knows what to do in an emergency, as part of the Family Assessment Device (FAD) FADEmergencyAwareInd Recommended CDE
21 Family Assessment Device (FAD) - Avoid discuss fear concern indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members avoid discussing each others' fears and concerns, as part of the Family Assessment Device (FAD) FADAvoidDiscussFearConcernINd Recommended CDE
22 Family Assessment Device (FAD) - Difficult talk about tender feeling indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family has difficulty talking about each others tender feelings, as part of the Family Assessment Device (FAD) FADDiffcltTlkAboutTendrFeelInd Recommended CDE
23 Family Assessment Device (FAD) - Trouble meet financial obligation indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family has trouble meeting the family's financial obligations, as part of the Family Assessment Device (FAD) FADTroublMeetFinanclObligtnInd Recommended CDE
24 Family Assessment Device (FAD) - Discuss problem indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family tries to discuss how to solve problems, as part of the Family Assessment Device (FAD) FADDiscussProblemInd Recommended CDE
25 Family Assessment Device (FAD) - Too self center indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members are too self-centered, as part of the Family Assessment Device (FAD) FADTooSelfCenterInd Recommended CDE
26 Family Assessment Device (FAD) - Express feeling each other indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family can express feelings to each other, as part of the Family Assessment Device (FAD) FADExpressFeelingEachOtherInd Recommended CDE
27 Family Assessment Device (FAD) - No clear expectation toilet habit indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family has no clear expectations for each other about toilet habits, as part of the Family Assessment Device (FAD) FADNoClearExpctnToiletHabitInd Recommended CDE
28 Family Assessment Device (FAD) - Show love indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family can't show love for each other, as part of the Family Assessment Device (FAD) FADShowLoveInd Recommended CDE
29 Family Assessment Device (FAD) - Go directly people indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family goes directly to people to talk rather than through go-betweens, as part of the Family Assessment Device (FAD) FADGoDirectlyPeopleInd Recommended CDE
30 Family Assessment Device (FAD) - Particular duty responsibility indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members each have a particular set of duties and responsibilities, as part of the Family Assessment Device (FAD) FADParticlrDutyRespnsbilityInd Recommended CDE
31 Family Assessment Device (FAD) - Family bad feeling indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family has lots of bad feelings among each other, as part of the Family Assessment Device (FAD) FADFamBadFeelingInd Recommended CDE
32 Family Assessment Device (FAD) - Hit people rule indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family has rules about hitting people, as part of the Family Assessment Device (FAD) FADHitPeopleRuleInd Recommended CDE
33 Family Assessment Device (FAD) - Involve only interest indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family only get involved with each other when something interests them, as part of the Family Assessment Device (FAD) FADInvolveOnlyInterestInd Recommended CDE
34 Family Assessment Device (FAD) - Little time explore personal interest indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members have little time to explore personal interests, as part of the Family Assessment Device (FAD) FADLittlTiExplrPrsnlInterstInd Recommended CDE
35 Family Assessment Device (FAD) - Say different meaning text  Indicator reflecting the participant/subject's agreement with the statement that his or her family members often don't say what they mean, as part of the Family Assessment Device (FAD) FADSayDiffMeaningInd Recommended CDE
36 Family Assessment Device (FAD) - Feel accept individual indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members feel accepted for who they are, as part of the Family Assessment Device (FAD) FADFeelAcceptIndividualInd Recommended CDE
37 Family Assessment Device (FAD) - Show interest achieve something personally indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members only show interest in each other when they are able to get something out of it personally, as part of the Family Assessment Device (FAD) FADShwIntrstAchvSmthngPrsnlInd Recommended CDE
38 Family Assessment Device (FAD) - Resolve most emotional upset indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family resolves most the emotional upsets that arise, as part of the Family Assessment Device (FAD) FADResolvMostEmotionalUpsetInd Recommended CDE
39 Family Assessment Device (FAD) - Tenderness take second place indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family takes tenderness second place to other things in the family, as part of the Family Assessment Device (FAD) FADTendrnessTakeSecondPlaceInd Recommended CDE
40 Family Assessment Device (FAD) - Discuss household job indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family discusses each member's responsibility regarding household jobs, as part of the Family Assessment Device (FAD) FADDiscussHouseholdJobInd Recommended CDE
41 Family Assessment Device (FAD) - Make decision hard indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family has a hard time making decisions, as part of the Family Assessment Device (FAD) FADMakeDecisionHardInd Recommended CDE
42 Family Assessment Device (FAD) - Show interest get something indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family shows interest in each other only when they can get something out of it, as part of the Family Assessment Device (FAD) FADShowInterestGetSomethingInd Recommended CDE
43 Family Assessment Device (FAD) - Frank with each other indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family is frank, direct or straightforward, with each other, as part of the Family Assessment Device (FAD) FADFrankWithEachOtherInd Recommended CDE
44 Family Assessment Device (FAD) - No rule standard indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family has no rules or standards, as part of the Family Assessment Device (FAD) FADNoRuleStandardInd Recommended CDE
45 Family Assessment Device (FAD) - Need reminder task indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members need reminding when asked to perform a task, as part of the Family Assessment Device (FAD) FADNeedReminderTaskInd Recommended CDE
46 Family Assessment Device (FAD) - Make decision solve problem indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family is able to make decisions about how to solve problems, as part of the Family Assessment Device (FAD) FADMakeDecisionSolveProblemInd Recommended CDE
47 Family Assessment Device (FAD) - Unexpect break rule indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family doesn't know what to expect when rules are broken, as part of the Family Assessment Device (FAD) FADUnexpectBreakRuleInd Recommended CDE
48 Family Assessment Device (FAD) - Anything goes indicator  Indicator reflecting the participant/subject's agreement with the statement that in his or her family, anything goes, as part of the Family Assessment Device (FAD) FADAnythingGoesInd Recommended CDE
49 Family Assessment Device (FAD) - Express tenderness indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family expresses tenderness to each other, as part of the Family Assessment Device (FAD) FADExpressTendernessInd Recommended CDE
50 Family Assessment Device (FAD) - Confront problem involve feeling indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family confront problems that involves feelings with each other, as part of the Family Assessment Device (FAD) FADConfrntPrblmInvolvFeelngInd Recommended CDE
51 Family Assessment Device (FAD) - Don't get along well indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family doesn't get along with each other well, as part of the Family Assessment Device (FAD) FADDontGetAlongWellInd Recommended CDE
52 Family Assessment Device (FAD) - No communication angry indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family does not talk to each other when angry, as part of the Family Assessment Device (FAD) FADNoCommunicationAngryInd Recommended CDE
53 Family Assessment Device (FAD) - Generally dissatisfy family duty indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members are generally dissatisfied when assigned family duties, as part of the Family Assessment Device (FAD) FADGenrllyDissatisfyFamDutyInd Recommended CDE
54 Family Assessment Device (FAD) - Intrude each other life indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family members often intrude on each others lives, even though they mean well, as part of the Family Assessment Device (FAD) FADIntrudeEachOtherLifeInd Recommended CDE
55 Family Assessment Device (FAD) - Dangerous situation rule indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family have rules about dangerous situations, as part of the Family Assessment Device (FAD) FADDangerousSituationRuleInd Recommended CDE
56 Family Assessment Device (FAD) - Confide each other indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family confides in each other, as part of the Family Assessment Device (FAD) FADConfideEachOtherInd Recommended CDE
57 Family Assessment Device (FAD) - Cry openly indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family cries openly in front of each other, as part of the Family Assessment Device (FAD) FADCryOpenlyInd Recommended CDE
58 Family Assessment Device (FAD) - No reasonable transport indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family has no reasonable transport, as part of the Family Assessment Device (FAD) FADNoReasonbleTransportInd Recommended CDE
59 Family Assessment Device (FAD) - Tell member no like indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family tells each other that they don't like what someone has done, as part of the Family Assessment Device (FAD) FADTellMemberNoLikeInd Recommended CDE
60 Family Assessment Device (FAD) - Think different solve problem indicator  Indicator reflecting the participant/subject's agreement with the statement that his or her family thinks differently to solve problems, as part of the Family Assessment Device (FAD) FADThinkDiffSolvProbInd Recommended CDE

FAD Scoring (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 FAD-GF Subscale value  Value of General Function Scale total score FADGFSubscaleVal Optional CDE
2 FAD Total score value  Value of sum of all scores FADTotalScoreVal Optional CDE

 Change History

 Administrative Change History