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{
"survey": {
"sections": [
{
"name": "人口学信息",
"questions": [
{ "id": 1, "type": "text", "question": "您的姓名是?" },
{ "id": 2, "type": "choice", "question": "您的性别是?", "choices": ["男", "女"] },
{ "id": 3, "type": "number", "question": "您的年龄是?" },
{ "id": 4, "type": "text", "question": "您的民族是?" },
{ "id": 5, "type": "text", "question": "您的身份证号是?" },
{ "id": 6, "type": "text", "question": "您的户籍地址是?" },
{ "id": 7, "type": "text", "question": "您的现居住地址是?" },
{ "id": 8, "type": "phone", "question": "您的联系电话是?" },
{ "id": 9, "type": "email", "question": "您的电子邮箱是?", "optional": true }
]
},
{
"name": "疾病状况监测",
"questions": [
{ "id": 10, "type": "choice", "question": "自上次随访以来,您的症状有无变化?", "choices": ["改善", "恶化", "不变"] },
{ "id": 11, "type": "boolean", "question": "是否出现了新的症状?", "followup": { "type": "text", "question": "请描述新的症状。" } },
{ "id": 12, "type": "choice", "question": "对当前治疗方案的满意度?", "choices": ["高", "中", "低"] },
{ "id": 13, "type": "boolean", "question": "是否遵循医嘱?", "followup": { "type": "text", "question": "如果没有遵循,请说明原因。" } },
{ "id": 14, "type": "boolean", "question": "是否有治疗相关的副作用?", "followup": { "type": "text", "question": "请描述副作用。" } }
]
},
{
"name": "生活方式",
"questions": [
{ "id": 15, "type": "choice", "question": "您的吸烟情况?", "choices": ["不吸烟", "吸烟", "已戒烟"], "followup": { "if": "吸烟", "type": "number", "question": "您吸烟多少年?每天多少支?" } },
{ "id": 16, "type": "choice", "question": "您的饮酒情况?", "choices": ["不饮酒", "少量饮酒", "经常大量饮酒"] },
{ "id": 17, "type": "choice", "question": "您的运动习惯?", "choices": ["经常运动", "缺乏运动"] },
{ "id": 18, "type": "choice", "question": "您的膳食习惯?", "choices": ["偏咸", "偏淡", "适中"], "followup": { "type": "choice", "question": "荤素偏好?", "choices": ["偏荤", "偏素", "均衡"] } }
]
},
{
"name": "家族史",
"questions": [
{ "id": 19, "type": "choice", "question": "是否有脑卒中家族史?", "choices": ["无", "有"] },
{ "id": 20, "type": "choice", "question": "是否有冠心病家族史?", "choices": ["无", "有"] },
{ "id": 21, "type": "choice", "question": "是否有高血压家族史?", "choices": ["无", "有"] },
{ "id": 22, "type": "choice", "question": "是否有糖尿病家族史?", "choices": ["无", "有"] }
]
},
{
"name": "既往病史及控制情况",
"questions": [
{ "id": 23, "type": "boolean", "question": "是否有脑血管病史?", "followup": { "type": "text", "question": "请描述病情及治疗。" } },
{ "id": 24, "type": "boolean", "question": "是否有心脏病史?", "followup": { "type": "text", "question": "请描述病情及治疗。" } },
{ "id": 25, "type": "boolean", "question": "是否有高血压病史?", "followup": { "type": "text", "question": "请描述病情及治疗。" } },
{ "id": 26, "type": "boolean", "question": "是否有糖尿病病史?", "followup": { "type": "text", "question": "请描述病情及治疗。" } }
]
},
{
"name": "体格检查",
"questions": [
{ "id": 27, "type": "date", "question": "体检时间?" },
{ "id": 28, "type": "number", "question": "身高(cm)?" },
{ "id": 29, "type": "number", "question": "体重(kg)?" },
{ "id": 30, "type": "number", "question": "腰围(cm)?" },
{ "id": 31, "type": "number", "question": "血压?" }
]
}
]
}
}
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