Form Structure: Family Assessment Device (FAD)
This form structure is an organized set of data definitions for a copyrighted form
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
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 |
Keywords
