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186null,"DRUG"),e.createElement("th",null,"CYCLE DAYS GIVEN"),e.createElement("th",null,"DRUG PREPARATION"),e.createElement("th",null,"NO. OF VIALS/AMPS/TABS"),e.createElement("th",null,"NO. RELEASED BY NAVIGATOR"))),e.createElement("tbody",null,e.createElement("tr",null,e.createElement("td",null,"Ifosfamide"),e.createElement("td",null,e.createElement(n,{...l("ifosfamide1gmVialCycle"),disabled:!0})),e.createElement("td",null,"1 gm vial"),e.createElement("td",null,e.createElement(n,{type:"number",...l("ifosfamide1gmVial"),disabled:!0})),e.createElement("td",null,e.createElement(n,{type:"number",...l("ifosfamide1gmVialReleased"),disabled:!0}))),e.createElement("tr",null,e.createElement("td",null,"Doxorubicin"),e.createElement("td",null,e.createElement(n,{...l("doxorubicin50mgVialCycle"),disabled:!0})),e.createElement("td",null,"50 mg vial"),e.createElement("td",null,e.createElement(n,{type:"number",...l("doxorubicin50mgVial"),disabled:!0})),e.createElement("td",null,e.createElement(n,{type:"number",...l("doxorubicin50mgVialReleased"),disabled:!0})))))))};var Ln=e.memo(wn,(t,a)=>m(t.id,a.id)&&m(t.resetCount,a.resetCount)&&m(t.isOpen,a.isOpen)&&m(t.errors,a.errors));const Fn=({getFieldProps:t,isNavigator:a,isOpen:r})=>{const{getSubFieldProps:l}=v({getFieldProps:t,parent:"treatmentArmOS1"});return e.createElement(L,{title:"TREATMENT ARM, OSTEOSARCOMA 1 st Line, Tx1 - Pre-Op (MAP)",initialOpenValue:a?r:!0,headerComponent:e.createElement("p",{className:"sub-header"},e.createElement("b",null,"Days 1 and 28:\xA0Methotrexate")," 8g/m 2 \xA0IV followed by citrovorum factor rescue",` 187`,e.createElement("b",null,"Days 7-9 and 34-36:\xA0Cisplatin")," 120mg/m 2 \xA0by intra-arterial infusion for 72 hours",` 188`,e.createElement("b",null,"Days 9 and 36:\xA0Doxorubicin")," 60mg/m 2 \xA0IV starting 8 hours after the beginning of cisplatin.")},e.createElement(F,null,e.createElement("table",null,e.createElement("thead",null,e.createElement("tr",null,e.createElement("th",
188null,"DRUG"),e.createElement("th",null,"CYCLE DAYS GIVEN"),e.createElement("th",null,"DRUG PREPARATION"),e.createElement("th",null,"NO. OF VIALS/AMPS/TABS"),e.createElement("th",null,"NO. RELEASED BY NAVIGATOR"))),e.createElement("tbody",null,e.createElement("tr",null,e.createElement("td",null,"Methotrexate"),e.createElement("td",null,e.createElement(n,{...l("methotrexate1gVialCycle"),disabled:!0})),e.createElement("td",null,"1g vial"),e.createElement("td",null,e.createElement(n,{type:"number",...l("methotrexate1gVial"),disabled:!0})),e.createElement("td",null,e.createElement(n,{type:"number",...l("methotrexate1gVialReleased"),disabled:!0}))),e.createElement("tr",null,e.createElement("td",null,"Folinic"),e.createElement("td",null,e.createElement(n,{...l("folinic40mgVialCycle"),disabled:!0})),e.createElement("td",null,"40 mg vial"),e.createElement("td",null,e.createElement(n,{type:"number",...l("folinic40mgVial"),disabled:!0})),e.createElement("td",null,e.createElement(n,{type:"number",...l("folinic40mgVialReleased"),disabled:!0}))),e.createElement("tr",null,e.createElement("td",null,"Cisplatin"),e.createElement("td",null,e.createElement(n,{...l("cisplatin50mgVialCycle"),disabled:!0})),e.createElement("td",null,"50 mg vial"),e.createElement("td",null,e.createElement(n,{type:"number",...l("cisplatin50mgVial"),disabled:!0})),e.createElement("td",null,e.createElement(n,{type:"number",...l("cisplatin50mgVialReleased"),disabled:!0}))),e.createElement("tr",null,e.createElement("td",null,"Doxorubicin"),e.createElement("td",null,e.createElement(n,{...l("doxorubicin50mgVialCycle"),disabled:!0})),e.createElement("td",null,"50 mg vial"),e.createElement("td",null,e.createElement(n,{type:"number",...l("doxorubicin50mgVial"),disabled:!0})),e.createElement("td",null,e.createElement(n,{type:"number",...l("doxorubicin50mgVialReleased"),disabled:!0})))))))};var Gn=e.memo(Fn,(t,a)=>m(t.id,a.id)&&m(t.resetCount,a.resetCount)&&m(t.isOpen,a.isOpen)&&m(t.errors,a.errors));const Un=({getFieldProps:t,isNavigator:a,isOpen:r})=>{const{getSubFieldProps:l}=v({getFieldProps:t,parent:"treatmentArmOS2"});return e.createElement(L,{title:"TREATMENT ARM, OSTEOSARCOMA 1 st Line, Tx2 - Post-Op (MAP)",initialOpenValue:a?r:!0,headerComponent:e.createElement("p",{className:"sub-header"},e.createElement("b",null,"Days 1, 48, 96, and 144:\xA0Doxorubicin")," 45mg/m 2 /day for 2 consecutive days in a 4-hour IV infusion",` 189`,e.createElement("b",null,"Days 21, 69, and 117:\xA0Methotrexate")," 8g/m 2 \xA0IV followed by citrovorum factor rescue",` 190`,e.createElement("b",null,"Days 27, 75, and 123:\xA0Cisplatin")," 120mg/m 2 \xA0by intra-arterial infusion for 72 hours.")},e.createElement(F,null,e.createElement("table",null,e.createElement("thead",null,e.createElement("tr",null,e.createElement("th",
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204),(c||y)&&e.createElement($e,{className:"add-remove-controls"},c&&e.createElement(be,{className:"field-array-control",type:"add",onClick:()=>d({definitiveSurgery:"",date:null,typeOfSurgery:""})},"Add more"),y&&e.createElement(be,{className:"field-array-control",type:"remove",onClick:()=>E(s)},"Remove")))}))};var fm=e.memo(Dm);const Rm=({getFieldProps:t,cancerMassArray:a})=>{const{getSubFieldProps:r}=v({getFieldProps:t,parent:"masses"}),{fields:l,append:d,remove:E}=a;return e.createElement(e.Fragment,null,(l||[]).map((h,s)=>{const c=l.length-1===s,y=l.length>1;return e.createElement("div",{className:"row",key:h.keyId},e.createElement(P,{className:"by3",label:"Is primary complaint a mass",items:B,...r("mass",s),fullWidth:!0}),e.createElement(n,{fullWidth:!0,className:"by3",label:"Location",...r("location",s),defaultValue:h.location}),e.createElement(n,{fullWidth:!0,type:"number",className:"by3",label:"Widest diameter Size",...r("size",s),unitProps:{...r("unit",s),items:mt,defaultValue:h.unit},defaultValue:h.size}),(c||y)&&e.createElement($e,{className:"add-remove-controls"},c&&e.createElement(be,{className:"field-array-control",type:"add",onClick:()=>d({mass:"",location:"",size:0,unit:"cm"})},"Add more"),y&&e.createElement(be,{className:"field-array-control",type:"remove",onClick:()=>E(s)},"Remove")))}))};var Nm=e.memo(Rm);const Sm=t=>({diagnosisList:t.search.diagnosisList}),Tm=t=>Ee({searchDiagnosis:zl},t),Om=({searchDiagnosis:t,name:a,unit:r,label:l,className:d,getFieldProps:E,...h})=>{const{t:s}=se(),{data:c,inProgress:y}=h.diagnosisList,{getSubFieldProps:I}=v({getFieldProps:E,parent:"cancer"}),S=b.exports.useMemo(()=>c?c.map(w=>({id:w.code,value:w.name})):[],[c]);return e.createElement(ve,{label:l||s("diagnosis",{ns:"encounter"}),className:d||"",...I(a),loading:y,options:S,onSearch:t,unit:r,fullWidth:!0,disableClearable:!1,disabled:h.disabled})};var Vt=de(Sm,Tm)(Om);const Pm=({getFieldProps:t,watchedFields:a,cancerMassArray:r,cancerBiopsiesArray:l,cancerDefinitiveSurgeriesDoneArray:d})=>{const[E]=se("patient_profile"),h=Be("type"),{getSubFieldProps:s}=v({getFieldProps:t,parent:"cancer"}),{metastasis:c,pain:y}=a;return e.createElement("div",{className:"cancer"},e.createElement("p",{className:"section-text"},"Cancer"),e.createElement(Vt,{unit:a.icd.id||"ICD10",name:"icd",label:"Primary Cancer Site (ICD)",getFieldProps:t}),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("newlyDiagnosed"),items:B,label:E("newly_diagnosed")}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("notTreated"),items:B,label:"Not treated"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("completedFirstTreatment"),items:B,label:"Completed 1st treatment now recurrent"}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("incompleteTreatment"),items:B,label:"Incomplete treatment, now progressive"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("unknownTreatment"),items:B,label:"Unknown treatment"})),e.createElement("div",{className:"row anchor-top has-helper-text"},e.createElement(ve,{className:"by3-4",fullWidth:!0,...s("firstSymptom"),label:"1st Symptom/s",options:[],multiple:!0,freeSolo:!0,helperText:"You can enter multiple values here by typing and pressing `Enter`"}),e.createElement(H,{className:"by4",...s("dateSymptomStarted"),label:"Date symptom started",disableFuture:!0})),e.createElement(Nm,{cancerMassArray:r,getFieldProps:s}),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("skinNippleInfiltration"),items:B,label:"Skin/Nipple Infiltration"}),e.createElement(n,{type:"number",className:"by2 mass-size",...s("massSize"),label:"Mass size (cm)",unitProps:{...s("massLaterality"),items:Kt}})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by3",...s("lymphadenopathy"),items:B,label:"Is there lymphadenopathy"}),e.createElement(n,{className:"by3",...s("lymphadenopathyLocation"),label:"Location"}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by3",...s("lymphadenopathyBulky"),items:St,label:"Bulky"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("extralymphaticSites"),items:B,label:"Extralymphatic sites"}),e.createElement(n,{className:"by2",...s("extralymphaticSitesLocation"),label:"Location"}
204)),e.createElement("div",{className:"row anchor-top has-helper-text"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by3",...s("metastasis"),items:B,label:"Metastasis"}),e.createElement(ve,{className:"by2-3 with-toggle",fullWidth:!0,...s("metastasisSites"),label:"Sites",options:[],multiple:!0,freeSolo:!0,helperText:"You can enter multiple values here by typing and pressing `Enter`",disabled:c!=="Yes"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("pain"),items:B,label:"Pain"}),e.createElement(n,{className:"by2",...s("painSites"),label:"Location",disabled:y!=="Yes"})),e.createElement("div",{className:"row"},e.createElement(ve,{clearOnEscape:!0,className:"stage by3",options:Zt,...s("clinicalStage"),fullWidth:!0,freeSolo:!0,label:"Clinical Stage"}),e.createElement("div",{className:"nodes by2-3"},e.createElement(ve,{clearOnEscape:!0,options:el,...s("tTumor"),fullWidth:!0,label:"T",freeSolo:!0,className:"by3"}),e.createElement(ve,{clearOnEscape:!0,options:tl,...s("nLymphNodes"),fullWidth:!0,label:"N",freeSolo:!0,className:"by3"}),e.createElement(ve,{clearOnEscape:!0,options:ll,...s("mMetastasis"),fullWidth:!0,label:"M",freeSolo:!0,className:"by3"}))),e.createElement("div",{className:"row"},e.createElement("div",{className:"by3"}),e.createElement(gm,{className:"by2-3 reference-link-left"})),h===ae.CCMAP&&e.createElement("div",{className:"row"},e.createElement(n,{className:"by2",...s("otherStagingUsed"),label:"Other Staging Used"}),e.createElement(n,{className:"by2",...s("whatStage"),label:"What Stage"})),e.createElement("div",{className:"row"},e.createElement(Vt,{className:"by3-4",unit:a.historicalDiagnosis.id||"ICD10",name:"historicalDiagnosis",label:"Histological Diagnosis",getFieldProps:t}),e.createElement(le,{className:"by4",...s("grade"),items:xt,label:"Histological Grade"})),e.createElement(dm,null),e.createElement(Cm,{getFieldProps:s,cancerBiopsiesArray:l}),e.createElement(fm,{getFieldProps:s,cancerDefinitiveSurgeriesDoneArray:d}),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("lviPositive"),items:ie,label:"LVI+"}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("pniPositive"),items:ie,label:"PNI+"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("lnodes"),items:ie,label:"LNodes+/TotalLN"}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("surgicalMarginsPositive"),items:ie,label:"Surgical Margins+"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("tumorInvades"),items:ie,label:"Tumor invades"}),e.createElement(n,{className:"by2",...s("serosa"),label:"Serosa"})),e.createElement("div",{className:"row"},e.createElement(n,{className:"by2",...s("muscularisPropria"),label:"Muscularis propria"}),e.createElement(n,{className:"by2",...s("mucosa"),label:"Mucosa"})),e.createElement("div",{className:"row"},e.createElement(n,{className:"by3",...s("submucosa"),label:"Submucosa"}),e.createElement(n,{className:"by3",...s("mesentery"),label:"Mesentery"}),e.createElement(n,{className:"by3",...s("mesorectum"),label:"Mesorectum"})),e.createElement("div",{className:"row"},e.createElement(n,{className:"by3",...s("pericolic"),label:"Pericolic"}),e.createElement(n,{className:"by3",...s("visceralPeritoneum"),label:"Visceral peritoneum"}),e.createElement(n,{className:"by3",...s("adherentToOrgan"),label:"Adherent to other organ"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("pleuralEffusion"),items:St,label:"Pleural effusion"}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("ascitis"),items:B,label:"Ascitis"})),h===ae.HBCMAP&&e.createElement(e.Fragment,null,e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("boneMarrowAspirationBiopsy"),items:ie,label:"Bone marrow aspiration biopsy done?"}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("boneMarrowAspirationBiopsyCancerCells"),items:B,label:"If yes, with cancer
204cells?"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("peripheralBloodSmear"),items:ie,label:"Peripheral Blood Smear done?"}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("peripheralBloodSmearCancerCells"),items:B,label:"If yes, with cancer cells?"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("spinalTap"),items:ie,label:"Spinal Tap done?"}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("spinalTapCancerCells"),items:B,label:"If yes, with cancer cells?"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("serumElectrophoresis"),items:ie,label:"Serum Electrophoresis done?"}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("serumElectrophoresisCancerCells"),items:B,label:"If yes, with significant M proteins?"}))),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by2",...s("pericardialEffusion"),items:B,label:"Pericardial effusion"}),e.createElement(n,{className:"by2",...s("other"),label:"Other"})),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by4",...s("lvi"),items:B,label:"LVI"}),e.createElement(n,{type:"number",className:"by4",...s("axlnPositive"),label:"Total Axln+"}),e.createElement(n,{type:"number",className:"by4",...s("axlnTaken"),label:"Total Axln+ taken"}),e.createElement(P,{allowDeselect:!0,fullWidth:!0,className:"by4",...s("palpableAxln"),items:B,label:"Palpable Axln"})))};var Vm=e.memo(Pm,(t,a)=>m(t.watchedFields,a.watchedFields)&&m(t.errors,a.errors)&&m(t.resetCounter,a.resetCounter)&&m(t.getFieldProps,a.getFieldProps)&&m(t.cancerMassArray,a.cancerMassArray)&&m(t.cancerBiopsiesArray,a.cancerBiopsiesArray)&&m(t.cancerDefinitiveSurgeriesDoneArray,a.cancerDefinitiveSurgeriesDoneArray));const vm=({getFieldProps:t,watchedFields:a})=>{const{getSubFieldProps:r}=v({getFieldProps:t,parent:"coMorbidities"}),l=[{label:"Hypertension",key1:"hypertension",key2:"hypertensionMedication",key3:"hypertensionControlled"},{label:"Diabetes",key1:"diabetes",key2:"diabetesMedication",key3:"diabetesControlled"},{label:"Heart Disease",key1:"heartDisease",key2:"heartDiseaseMedication",key3:"heartDiseaseControlled"},{label:"Allergy, specify",key1:"allergy",key2:"allergyMedication",key3:"allergyControlled"},{label:"Others, specify",key1:"others",key2:"othersMedication",key3:"othersControlled"}],d=[{label:"CO-MORBIDITIES"},{label:""},{label:"IF YES, ON WHAT MEDICATION"},{label:"CONTROLLED?"}],E={allergy:"allergySpecify",others:"othersSpecify"},h=b.exports.useMemo(()=>l.map((s,c)=>e.createElement(Ce,{key:c},e.createElement(ee,{component:"th",scope:"row"},Object.keys(E).includes(s.key1)?e.createElement(n,{fullWidth:!0,...r(E[s.key1]),label:`${s.key1==="allergy"?"Allergy, specify type":"Others"}`,disabled:a[s.key1]!=="Yes"}):e.createElement("span",{className:"co-morbidities-label"},s.label)),e.createElement(ee,{align:"center"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,...r(s.key1),items:B})),e.createElement(ee,{align:"center"},e.createElement(n,{fullWidth:!0,...r(s.key2),disabled:a[s.key1]!=="Yes"})),e.createElement(ee,{align:"center"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,...r(s.key3),items:B})))),[l,a,r,E]);return e.createElement(e.Fragment,null,e.createElement("p",{className:"section-text"},"Co-morbidities"),e.createElement(we,{className:"co-morbidities",headers:d,rows:h}))};var xm=e.memo(vm,(t,a)=>m(t.watchedFields,a.watchedFields)&&m(t.errors,a.errors)&&m(t.resetCounter,a.resetCounter)&&m(t.getFieldProps,a.getFieldProps));const Mm=({getFieldProps:t,watchedFields:a})=>{const{getSubFieldProps:r}=v({getFieldProps:t,parent:"demographics"});return e.createElement("div",{className:"demographics"},e.createElement("p",{className:"section-text"},"Demographics"),e.createElement("div",{className:"row"},e.createElement(le,{className:"by2",fullWidth:!0,label:"Longest job held",...r("longestJobHeld"),items:Mt}),a.longestJobHeld==="15"&&e.createElement(n,{className:"by2",fullWidth:!0,...r("longestJobHeldOtherSpecify"),label:"If other, specify"})),e.createElement("div",{className:"row"},e.createElement(n,{className:"by2",type:"number",fullWidth:!0,...r("averageMonthlyFamilyIncome"),label:"Average monthly family\xA0income (pesos)"})),e.createElement("span",{className:"dmg-text-info"},"Means of health expenditure (check all that applies)"),e.createElement("div",{className:"dmg-checkbox-container"},e.createElement(k,{fullWidth:!0,label:"Out of own pocket",...r("meansOfHealthExpOutOfOwnPocket")}),e.createElement(k,{fullWidth:!0,label:"Family Support",...r("meansOfHealthExpFamilySupport")}),e.createElement(k,{fullWidth:!0,label:"PhilHealth",...r("meansOfHealthExpPhilhealth")}),e.createElement(k,{fullWidth:!0,label:"Private Insurance / HMO",...r("meansOfHealthExpPrivateInsuranceHmo")}),e.createElement(k,{fullWidth:!0,label:"DSWD",...r("meansOfHealthExpDswd")}),e.createElement(k,{fullWidth:!0,label:"PCSO",...r("meansOfHealthExpPcso")}),e.createElement(k,{fullWidth:!0,label:"LGU",...r("meansOfHealthExpLgu")}),e.createElement("div",{className:"has-specify"},e.createElement(k,{label:"Others",...r("meansOfHealthExpOthers")}),e.createElement(n,{fullWidth:!0,...r("meansOfHealthExpOthersSpecify"),label:"Specify",disabled:!a.meansOfHealthExpOthers}))))};var 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qt=({width:t,height:a,imageURL:r,diagramData:l,onSubmit:d,label:E,instruction:h,disabled:s=!1,buttonLabel:c,buttonClass:y=""})=>{const{open:I,close:S,modalRef:w,isOpen:i}=yl({title:E,component:()=>e.createElement(Uu,null,e.createElement("span",{className:"instruction"},h),e.createElement(Ql,{width:t,height:a,imageURL:r,diagramData:l,onCancel:()=>S(),onSubmit:A=>{d(A),S()}})),options:{disableCloseButton:!0},index:1,size:"md"});return e.createElement("div",{className:`${c?"diagram-button":"row-reverse"} ${y}`},i&&w,e.createElement($,{label:`${c||"Add Diagram"}`,color:"secondary",onClick:I,disabled:s}))},Uu=Me.div` 255 width: 100%; 256 .instruction { 257 display: block; 258 color: #757575; 259 font-size: 14px; 260 margin-bottom: 16px; 261 } 262`;var Bu="/app/assets/cmap_esas_diagram.fa418f20.jpg";const Yu=({getFieldProps:t,setValue:a,watchedFields:r})=>{const{getSubFieldProps:l}=v({getFieldProps:t,parent:"indicateEsasScore"});return e.createElement(e.Fragment,null,e.createElement("p",{className:"spc-subheader"},"B. Indicate ESAS-r Score of Patient, at 1st visit:"),e.createElement("div",{className:"row"},e.createElement(H,{className:"by2",...l("firstVisitDate"),label:"Date",disableFuture:!0,helperText:"(Can have multiple follow-up visits and scored accordingly)"})),e.createElement("br",null),e.createElement("br",null),e.createElement("span",{className:"spc-text-info bold"},"Edmonton Symtom Assessment System Revised (ESAS -r)"),e.createElement("span",{className:"spc-text-info"},"Please circle the number that best describes how you feel NOW:"),e.createElement("br",null),e.createElement(qt,{width:480,height:600,imageURL:Bu,diagramData:r.diagram?JSON.parse(r.diagram):{splines:[],texts:[]},onSubmit:d=>a(l("diagram").name,JSON.stringify(d)),label:"Diagram",instruction:"Please mark on these pictures where it is that you hurt"}),e.createElement("br",null),e.createElement("div",{className:"row"},e.createElement("span",{className:"rate-label by3"},` 263`,e.createElement("b",null,"No 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sleepy)"),e.createElement("span",{className:"rate-label by3"}),e.createElement("span",{className:"rate-label by3 right-aligned"},e.createElement("b",null,"Worst Possible"),` 268`,"Drowsiness")),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,...l("drowsiness"),items:Pe(1,10)})),e.createElement("div",{className:"row"},e.createElement("span",{className:"rate-label by3"},` 269`,e.createElement("b",null,"No Nausea")),e.createElement("span",{className:"rate-label by3"}),e.createElement("span",{className:"rate-label by3 right-aligned"},e.createElement("b",null,"Worst Possible"),` 270`,"Nausea")),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,...l("nausea"),items:Pe(1,10)})),e.createElement("div",{className:"row"},e.createElement("span",{className:"rate-label by3"},` 271`,e.createElement("b",null,"No Lack of Appetite")),e.createElement("span",{className:"rate-label by3"}),e.createElement("span",{className:"rate-label by3 right-aligned"},e.createElement("b",null,"Worst Possible"),` 272`,"Lack of Appetite")),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,...l("lackOfAppetite"),items:Pe(1,10)})),e.createElement("div",{className:"row"},e.createElement("span",{className:"rate-label by3"},` 273`,e.createElement("b",null,"No Shortness of Breath")),e.createElement("span",{className:"rate-label by3"}),e.createElement("span",{className:"rate-label by3 right-aligned"},e.createElement("b",null,"Worst Possible"),` 274`,"Shortness of Breath")),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,...l("shortnessOfBreath"),items:Pe(1,10)})),e.createElement("div",{className:"row"},e.createElement("span",{className:"rate-label by3"},e.createElement("b",null,"No Depression"),` 275`,"(Depression = feeling sad)"),e.createElement("span",{className:"rate-label by3"}),e.createElement("span",{className:"rate-label by3 right-aligned"},e.createElement("b",null,"Worst Possible"),` 276`,"Depression")),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,...l("depression"),items:Pe(1,10)})),e.createElement("div",{className:"row"},e.createElement("span",{className:"rate-label by3"},e.createElement("b",null,"No Anxiety"),` 277`,"(Anxiety = feeling nervous)"),e.createElement("span",{className:"rate-label by3"}),e.createElement("span",{className:"rate-label by3 right-aligned"},e.createElement("b",null,"Worst Possible"),` 278`,"Anxiety")),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,...l("anxiety"),items:Pe(1,10)})),e.createElement("div",{className:"row"},e.createElement("span",{className:"rate-label by3"},e.createElement("b",null,"Best Wellbeing"),` 279`,"(Wellbeing = how you feel overall)"),e.createElement("span",{className:"rate-label by3"}),e.createElement("span",{className:"rate-label by3 right-aligned"},e.createElement("b",null,"Worst Possible"),` 280`,"Wellbeing")),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,...l("wellbeing"),items:Pe(1,10)})),e.createElement("div",{className:"row"},e.createElement("span",{className:"rate-label by3"},e.createElement(n,{className:"no-margin",fullWidth:!0,...l("otherProblem"),label:"No"}),` 281`,"Other Problem (For example constipation)"),e.createElement("span",{className:"rate-label by3"}),e.createElement("span",{className:"rate-label by3 right-aligned"},e.createElement("b",null,"Worst Possible"),` 282`,e.createElement(n,{className:"no-margin",fullWidth:!0,...l("otherProblemSpecify"),label:"Specify"}))),e.createElement("div",{className:"row"},e.createElement(P,{allowDeselect:!0,fullWidth:!0,...l("otherProblem"),items:Pe(1,10)})),e.createElement("div",{className:"row"},e.createElement(H,{className:"by2",...l("scoreDate"),label:"Date",disableFuture:!0}),e.createElement(gl,{className:"by2",...l("scoreTime"),label:"Time"})),e.createElement("span",{className:"spc-text-info bold"},"Body Diagram on Reverse"),e.createElement("span",{className:"spc-text-info"},e.createElement("b",null,"Completed by")," (Check one)"),e.createElement("div",{className:"spc-checkbox-container"},e.createElement(k,{fullWidth:!0,label:"Patient",...l("bdorCompletedByPatient")}),e.createElement(k,{fullWidth:!0,label:"Family Caregiver",...l("bdorCompletedByFamilyCaregiver")}),e.createElement(k,{fullWidth:!0,label:"Health Care Professional Caregiver",...l("bdorCompletedByProfessionalCaregiver")}),e.createElement(k,{fullWidth:!0,label:"Caregiver-assisted",...l("bdorCompletedByCaregiverAssisted")})))};var Wu=e.memo(Yu,(t,a)=>m(t.getFieldProps,a.getFieldProps)&&m(t.setValue,a.setValue)&&m(t.watchedFields,a.watchedFields));const Hu=({getFieldProps:t,watchedFields:a})=>{const{getSubFieldProps:r}=v({getFieldProps:t,parent:"palliativeCareNeeds"});return e.createElement(e.Fragment,null,e.createElement("p",{className:"spc-subheader"},"C. Palliative Care Needs of Patient"),e.createElement("div",{className:"row"},e.createElement(H,{className:"by2",...r("careDate"),label:"Date",disableFuture:!0,helperText:"(Can have multiple follow-up visits and assessed accordingly)"})),e.createElement("br",null),e.createElement("br",null),e.createElement("span",{className:"spc-text-info bold"},"1. Symptomatic Care as per ESAS-r positive symptoms above:"),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("symptomaticCareTiredness"),label:"Tiredness",items:B})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("symptomaticCareDrowsiness"),label:"Drowsiness",items:B})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("symptomaticCareNausea"),label:"Nausea",items:B})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("symptomaticCareShortnessOfBreath"),label:"Shortness of breath",items:B})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("symptomaticCareOthers"),label:"Others",items:B}),e.createElement(n,{className:"by2",fullWidth:!0,...r("symptomaticCareOthersSpecify"),label:"Specify",disabled:a.symptomaticCareOthers!=="Yes"})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("symptomaticCareQualityOfLifeImproved"),label:"Is patient\u2019s quality of life improved with these care by 25% or more?",items:ke})),e.createElement("br",null),e.createElement("span",{className:"spc-text-info bold"},"2. Nutritional (eg, Lack of appetite)"),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("nutritional"),items:B})),e.createElement("div",{className:"row"},e.createElement(n,{className:"by2",fullWidth:!0,...r("nutritionalSpecify"),label:"Specify",disabled:a.nutritional!=="Yes"})),e.createElement("span",{className:
282"spc-text-info"},"Where is care being given mainly in:"),e.createElement("div",{className:"spc-checkbox-container"},e.createElement(k,{fullWidth:!0,label:"Home",...r("nutritionalLocationHome"),disabled:a.nutritional!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Hospital",...r("nutritionalLocationHospital"),disabled:a.nutritional!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Community Clinic",...r("nutritionalLocationCommunityClinic"),disabled:a.nutritional!=="Yes"})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("nutritionalQualityOfLifeImproved"),label:"Is patient\u2019s quality of life improved with these care by 25% or more?",items:ke,disabled:a.nutritional!=="Yes"})),e.createElement("br",null),e.createElement("span",{className:"spc-text-info bold"},"3. Nursing"),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("nursing"),items:B})),e.createElement("div",{className:"row"},e.createElement(n,{className:"by2",fullWidth:!0,...r("nursingSpecify"),label:"Specify",disabled:a.nursing!=="Yes"})),e.createElement("span",{className:"spc-text-info"},"Where is care being given mainly in:"),e.createElement("div",{className:"spc-checkbox-container"},e.createElement(k,{fullWidth:!0,label:"Home",...r("nursingLocationHome"),disabled:a.nursing!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Hospital",...r("nursingLocationHospital"),disabled:a.nursing!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Community Clinic",...r("nursingLocationCommunityClinic"),disabled:a.nursing!=="Yes"})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("nursingQualityOfLifeImproved"),label:"Is patient\u2019s quality of life improved with these care by 25% or more?",items:ke,disabled:a.nursing!=="Yes"})),e.createElement("br",null),e.createElement("span",{className:"spc-text-info bold"},"4. Rehabilitation"),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("rehabilitation"),items:B})),e.createElement("div",{className:"row"},e.createElement(n,{className:"by2",fullWidth:!0,...r("rehabilitationSpecify"),label:"Specify",disabled:a.rehabilitation!=="Yes"})),e.createElement("span",{className:"spc-text-info"},"Where is care being given mainly in:"),e.createElement("div",{className:"spc-checkbox-container"},e.createElement(k,{fullWidth:!0,label:"Home",...r("rehabilitationLocationHome"),disabled:a.rehabilitation!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Hospital",...r("rehabilitationLocationHospital"),disabled:a.rehabilitation!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Community Clinic",...r("rehabilitationLocationCommunityClinic"),disabled:a.rehabilitation!=="Yes"})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("rehabilitationQualityOfLifeImproved"),label:"Is patient\u2019s quality of life improved with these care by 25% or more?",items:ke,disabled:a.rehabilitation!=="Yes"})),e.createElement("br",null),e.createElement("span",{className:"spc-text-info bold"},"5. Psychosocial (e.g., depression, anxiety, well-beingness)"),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("psychosocial"),items:B})),e.createElement("div",{className:"row"},e.createElement(n,{className:"by2",fullWidth:!0,...r("psychosocialSpecify"),label:"Specify",disabled:a.psychosocial!=="Yes"})),e.createElement("span",{className:"spc-text-info"},"Where is care being given mainly in:"),e.createElement("div",{className:"spc-checkbox-container"},e.createElement(k,{fullWidth:!0,label:"Home",...r("psychosocialLocationHome"),disabled:a.psychosocial!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Hospital",...r("psychosocialLocationHospital"),disabled:a.psychosocial!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Community Clinic",...r("psychosocialLocationCommunityClinic"),disabled:a.psychosocial!=="Yes"})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("psych
282osocialQualityOfLifeImproved"),label:"Is patient\u2019s quality of life improved with these care by 25% or more?",items:ke,disabled:a.psychosocial!=="Yes"})),e.createElement("br",null),e.createElement("span",{className:"spc-text-info bold"},"6. Spiritual"),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("spiritual"),items:B})),e.createElement("div",{className:"row"},e.createElement(n,{className:"by2",fullWidth:!0,...r("spiritualSpecify"),label:"Specify",disabled:a.spiritual!=="Yes"})),e.createElement("span",{className:"spc-text-info"},"Where is care being given mainly in:"),e.createElement("div",{className:"spc-checkbox-container"},e.createElement(k,{fullWidth:!0,label:"Home",...r("spiritualLocationHome"),disabled:a.spiritual!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Hospital",...r("spiritualLocationHospital"),disabled:a.spiritual!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Community Clinic",...r("spiritualLocationCommunityClinic"),disabled:a.spiritual!=="Yes"})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("spiritualQualityOfLifeImproved"),label:"Is patient\u2019s quality of life improved with these care by 25% or more?",items:ke,disabled:a.spiritual!=="Yes"})),e.createElement("br",null),e.createElement("span",{className:"spc-text-info bold"},"7. Cultural/ Ethical"),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("cultural"),items:B})),e.createElement("div",{className:"row"},e.createElement(n,{className:"by2",fullWidth:!0,...r("culturalSpecify"),label:"Specify",disabled:a.cultural!=="Yes"})),e.createElement("span",{className:"spc-text-info"},"Where is care being given mainly in:"),e.createElement("div",{className:"spc-checkbox-container"},e.createElement(k,{fullWidth:!0,label:"Home",...r("culturalLocationHome"),disabled:a.cultural!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Hospital",...r("culturalLocationHospital"),disabled:a.cultural!=="Yes"}),e.createElement(k,{fullWidth:!0,label:"Community Clinic",...r("culturalLocationCommunityClinic"),disabled:a.cultural!=="Yes"})),e.createElement("div",{className:"row"},e.createElement(P,{className:"by2",allowDeselect:!0,fullWidth:!0,...r("culturalQualityOfLifeImproved"),label:"Is patient\u2019s quality of life improved with these care by 25% or more?",items:ke,disabled:a.cultural!=="Yes"})),e.createElement("br",null),e.createElement("span",{className:"spc-text-info bold"},"8. 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