Item | Score | Provenancea |
---|---|---|
1. Discusses patient’s personal aspects of quality of life | 1 | x, y |
2. Discusses how to achieve patient’s personal goals | 1 | q, x, y |
3. Adheres to the patient’s preferences | 1 | q, y |
Provides attention to the following dimensions: | q, x, y | |
4. Somatic problems | ||
5. Social context and finances | ||
6. Caregiving and activities of daily living | ||
7. Existential and psychological issues | ||
8. Involves other disciplines, including consultation team palliative care | 1 | y |
9. Provides palliative care alongside disease-oriented care | 1 | x |
Discusses advance care planning aspects: | ||
10. Hospital admissions | 1 | q, z |
11. Antibiotics use | 1 | q, z |
12. CPR policy | 1 | q, y, z |
13. Mechanical ventilation | 1 | q, z |
14. Treatment limitations – not specified | 1 | q, y |
15. Dying scenario’s | 1 | q, y |
16. Life prolonging treatments (e.g. artificial feeding and i.v. fluids) | 1 | q, z |
17. Preferences for end-of-life care (e.g. palliative sedation, euthanasia) | 1 | q, y, z |
18. Preferred place of death | 1 | q, y, z |
19. Writes assignment for the out-of-hours GP cooperative | 1 | q |
20. Involves family and loved-ones in care planning | 1 | q, x, y |
21. Provides care to family and loved-ones | 1 | x, y |
Maximum score | 21 |