ID
14645
Description
https://www.hope-clara.de/ The HOPE Hospice and Palliative Care Recording standard documentation is used for documentation of palliative care and as an instrument for quality assurance in pallatiave wards, hospices and oncological wards as well as in ambulatory services and palliative teams.
Link
Keywords
Versions (1)
- 4/25/16 4/25/16 -
Copyright Holder
CC BY-NC 3.0
Uploaded on
April 25, 2016
DOI
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License
Creative Commons BY-NC 3.0
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Palliative and Hospice Care Baseline Form
Palliative and Hospice Care Baseline Form
- StudyEvent: ODM
Description
Basic Medical Information
Description
specialized ambulatory palliative care request
Data type
integer
Description
Agreement and submitted form
Data type
integer
Alias
- UMLS CUI [1,1]
- C0680240
- UMLS CUI [1,2]
- C1515023
Description
Care level
Data type
integer
Alias
- UMLS CUI [1]
- C1547668
Description
if there is no ICD available, please specify in the following item
Data type
integer
Alias
- UMLS CUI [1]
- C0332137
- UMLS CUI [2]
- C0011900
- UMLS CUI [3]
- C0870733
Description
Main diagnosis and other diagnoses/problems
Data type
text
Alias
- UMLS CUI [1]
- C0332137
- UMLS CUI [2]
- C0011900
Description
Date of diagnosis
Data type
date
Alias
- UMLS CUI [1]
- C2316983
Description
If other location, please specify in the following item
Data type
integer
Alias
- UMLS CUI [1]
- C0027627
Description
Other location of metastases
Data type
text
Alias
- UMLS CUI [1,1]
- C0027627
- UMLS CUI [1,2]
- C0450429
- UMLS CUI [1,3]
- C0205394
Description
If other, please specify in the following item
Data type
integer
Alias
- UMLS CUI [1,1]
- C0039798
- UMLS CUI [1,2]
- C0025070
- UMLS CUI [1,3]
- C0205156
Description
ECOG status
Data type
integer
Alias
- UMLS CUI [1]
- C1520224
Description
Barthel Index
Data type
integer
Measurement units
- points
Alias
- UMLS CUI [1]
- C0451019
Description
Medical Issues
Description
Date of collection of the patient's medical issues
Data type
date
Alias
- UMLS CUI [1,1]
- C1516698
- UMLS CUI [1,2]
- C0011008
- UMLS CUI [2,1]
- C0033213
- UMLS CUI [2,2]
- C0205476
Description
Pain
Data type
integer
Alias
- UMLS CUI [1]
- C0030193
Description
Nausea
Data type
integer
Alias
- UMLS CUI [1]
- C0027497
Description
Emesis
Data type
integer
Alias
- UMLS CUI [1]
- C0042963
Description
Dyspnea
Data type
integer
Alias
- UMLS CUI [1]
- C0013404
Description
Constipation
Data type
integer
Alias
- UMLS CUI [1]
- C0009806
Description
Weakness
Data type
integer
Alias
- UMLS CUI [1]
- C3714552
Description
Loss of appetite
Data type
integer
Alias
- UMLS CUI [1]
- C1971624
Description
Fatigue
Data type
integer
Alias
- UMLS CUI [1]
- C0015672
Description
Care issues due to lesions/pressure ulcers
Data type
integer
Alias
- UMLS CUI [1,1]
- C0017313
- UMLS CUI [1,2]
- C0033213
- UMLS CUI [2]
- C0221198
- UMLS CUI [3]
- C0011127
Description
Need for assistance for activities of daily living
Data type
integer
Alias
- UMLS CUI [1,1]
- C0476651
- UMLS CUI [1,2]
- C0001288
Description
Depressed mood
Data type
integer
Alias
- UMLS CUI [1]
- C0344315
Description
Anxiety
Data type
integer
Alias
- UMLS CUI [1]
- C0003467
Description
Stress
Data type
integer
Alias
- UMLS CUI [1]
- C0038435
Description
Disorientation, confusion
Data type
integer
Alias
- UMLS CUI [1]
- C0233407
- UMLS CUI [2]
- C0009676
Description
Issues organizing care
Data type
integer
Alias
- UMLS CUI [1,1]
- C0033213
- UMLS CUI [1,2]
- C1822380
Description
Overstrain of family or environment
Data type
integer
Description
Other issues
Data type
text
Alias
- UMLS CUI [1,1]
- C0033213
- UMLS CUI [1,2]
- C0205394
Description
Severity of other issue
Data type
integer
Alias
- UMLS CUI [1]
- C0441982
Description
Comments
Data type
text
Alias
- UMLS CUI [1]
- C0947611
Description
Reason for visit, treatment goal
Data type
text
Alias
- UMLS CUI [1]
- C1704447
- UMLS CUI [2]
- C0679840
Description
Medication until today
Description
Non-opioids
Data type
boolean
Alias
- UMLS CUI [1]
- C3863698
Description
Opioids WHO level 2
Data type
boolean
Alias
- UMLS CUI [1]
- C0242402
Description
Opioids WHO level 3
Data type
boolean
Alias
- UMLS CUI [1]
- C0242402
Description
Adjuvant analgesics
Data type
boolean
Alias
- UMLS CUI [1]
- C1510809
Description
Corticosteroids
Data type
boolean
Alias
- UMLS CUI [1]
- C0001617
Description
Antidepressants
Data type
boolean
Alias
- UMLS CUI [1]
- C0003289
Description
Antiemetics
Data type
boolean
Alias
- UMLS CUI [1]
- C0003297
Description
Neuroleptics
Data type
boolean
Alias
- UMLS CUI [1]
- C0040615
Description
Sedatives / Anxiolytics
Data type
boolean
Alias
- UMLS CUI [1]
- C0036557
- UMLS CUI [2]
- C0040616
Description
Stomach protector
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0038351
- UMLS CUI [1,2]
- C0033613
Description
Laxatives
Data type
boolean
Alias
- UMLS CUI [1]
- C0282090
Description
Antibiotics
Data type
boolean
Alias
- UMLS CUI [1]
- C0003232
Description
Diuretics
Data type
boolean
Alias
- UMLS CUI [1]
- C0012798
Description
Cardiaca/Antihypertensive Agents
Data type
boolean
Alias
- UMLS CUI [1]
- C0007209
- UMLS CUI [2]
- C0003364
Description
Other medication
Data type
boolean
Alias
- UMLS CUI [1]
- C1115771
Description
Other medication
Data type
text
Alias
- UMLS CUI [1]
- C1115771
Description
Procedures, Assistances
Description
Medication
Data type
integer
Alias
- UMLS CUI [1]
- C0013227
Description
Palliative sedation
Data type
integer
Alias
- UMLS CUI [1,1]
- C0344106
- UMLS CUI [1,2]
- C1285530
Description
Feeding
Data type
integer
Alias
- UMLS CUI [1]
- C2987508
Description
Transfusions
Data type
boolean
Alias
- UMLS CUI [1]
- C1879316
Description
Pumping system
Data type
integer
Description
Puncture or drainages
Data type
integer
Alias
- UMLS CUI [1]
- C0034117
- UMLS CUI [2]
- C0013103
Description
Application or change of
Data type
integer
Alias
- UMLS CUI [1]
- C0185125
- UMLS CUI [2]
- C0392747
Description
Radiotherapy
Data type
integer
Alias
- UMLS CUI [1]
- C1522449
Description
Care
Data type
integer
Alias
- UMLS CUI [1]
- C1947933
Description
Maintenance of catheters
Data type
integer
Alias
- UMLS CUI [1,1]
- C0024501
- UMLS CUI [1,2]
- C0085590
Description
Tumortherapy
Data type
integer
Alias
- UMLS CUI [1]
- C0920425
Description
Physiotherapy
Data type
integer
Alias
- UMLS CUI [1]
- C0949766
Description
Psychotherapy
Data type
integer
Alias
- UMLS CUI [1]
- C0033968
Description
Surgical procedure
Data type
boolean
Alias
- UMLS CUI [1]
- C0543467
Description
Diagnostic procedures
Data type
boolean
Alias
- UMLS CUI [1]
- C0430022
Description
Counseling
Data type
integer
Alias
- UMLS CUI [1]
- C0010210
Description
Organization of following treatment
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0039798
- UMLS CUI [1,2]
- C0332282
- UMLS CUI [1,3]
- C1300196
Description
assistance for (grieving) relatives
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0018896
- UMLS CUI [1,2]
- C0080103
- UMLS CUI [1,3]
- C0018235
Description
pastoral care
Data type
integer
Alias
- UMLS CUI [1]
- C0030643
Description
Other procedures
Data type
text
Alias
- UMLS CUI [1]
- C0393107
Description
Assessment of assistance
Description
Which issue was solved especially well?
Data type
text
Alias
- UMLS CUI [1]
- C0033213
Description
Which issue could not be solved sufficiently?
Data type
text
Alias
- UMLS CUI [1]
- C0033213
Description
if other, please specify in the following item
Data type
integer
Alias
- UMLS CUI [1]
- C3273494
Description
Other, who filled out the form
Data type
text
Alias
- UMLS CUI [1]
- C3273494
Description
Patient discharge
Description
Date of discharge/change in assistance/death
Data type
date
Alias
- UMLS CUI [1]
- C2361123
- UMLS CUI [2,1]
- C0011008
- UMLS CUI [2,2]
- C0443172
- UMLS CUI [2,3]
- C0025070
- UMLS CUI [3]
- C1148348
Description
if other please specify in the following item
Data type
integer
Alias
- UMLS CUI [1,1]
- C0087111
- UMLS CUI [1,2]
- C0444930
Description
Other end of therapy
Data type
text
Alias
- UMLS CUI [1,1]
- C0087111
- UMLS CUI [1,2]
- C0444930
- UMLS CUI [1,3]
- C0205394
Description
if other please specify
Data type
integer
Alias
- UMLS CUI [1]
- C0030685
- UMLS CUI [2,1]
- C0087111
- UMLS CUI [2,2]
- C0549178
Description
Other discharge to / ongoing treatment in
Data type
text
Alias
- UMLS CUI [1]
- C0030685
- UMLS CUI [2,1]
- C0087111
- UMLS CUI [2,2]
- C0549178
Description
Place of death
Data type
integer
Alias
- UMLS CUI [1]
- C0421611
Description
final evaluation of the team's satisfaction with the medical assistance for the entire treatment
Data type
integer
Alias
- UMLS CUI [1]
- C0220825
- UMLS CUI [2]
- C0242428
- UMLS CUI [3,1]
- C0087111
- UMLS CUI [3,2]
- C0439751
Description
final evaluation of the team's satisfaction with the medical assistance for the final stage
Data type
integer
Alias
- UMLS CUI [1]
- C0220825
- UMLS CUI [2]
- C0242428
- UMLS CUI [3]
- C0205088
Similar models
Palliative and Hospice Care Baseline Form
- StudyEvent: ODM
C1515023 (UMLS CUI [1,2])
C0011900 (UMLS CUI [2])
C0870733 (UMLS CUI [3])
C0011900 (UMLS CUI [2])
C0450429 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
C0025070 (UMLS CUI [1,2])
C0205156 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,2])
C0033213 (UMLS CUI [2,1])
C0205476 (UMLS CUI [2,2])
C0033213 (UMLS CUI [1,2])
C0221198 (UMLS CUI [2])
C0011127 (UMLS CUI [3])
C0001288 (UMLS CUI [1,2])
C0009676 (UMLS CUI [2])
C1822380 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,2])
C0679840 (UMLS CUI [2])
C0040616 (UMLS CUI [2])
C0033613 (UMLS CUI [1,2])
C0003364 (UMLS CUI [2])
C1285530 (UMLS CUI [1,2])
C0013103 (UMLS CUI [2])
C0392747 (UMLS CUI [2])
C0085590 (UMLS CUI [1,2])
C0332282 (UMLS CUI [1,2])
C1300196 (UMLS CUI [1,3])
C0080103 (UMLS CUI [1,2])
C0018235 (UMLS CUI [1,3])
C0011008 (UMLS CUI [2,1])
C0443172 (UMLS CUI [2,2])
C0025070 (UMLS CUI [2,3])
C1148348 (UMLS CUI [3])
C0444930 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
C0087111 (UMLS CUI [2,1])
C0549178 (UMLS CUI [2,2])
C0087111 (UMLS CUI [2,1])
C0549178 (UMLS CUI [2,2])
C0242428 (UMLS CUI [2])
C0087111 (UMLS CUI [3,1])
C0439751 (UMLS CUI [3,2])
C0242428 (UMLS CUI [2])
C0205088 (UMLS CUI [3])