{ "resourceType" : "Questionnaire", "id" : "ACP-zib2020", "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire ACP-zib2020

Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeFlagsDescription & Constraints\"doco\"
\".\"\".\" ACPzib2020This form was developed to clearly document agreements resulting from the advance care planning (ACP) process. It is NOT a checklist. It can only be completed by a healthcare provider after a professional and nuanced conversation. For advice on conducting these conversations, please refer to the guideline for advance care planning in the palliative phase and Palliaweb, see https://palliaweb.nl/zorgpraktijk/proactieve-zorgplanning. \nEnter 'unknown' if a topic is not discussed or if the patient does not (yet) have an opinion.When transferring to a long-term care setting, consider adding conversation records about advance care planning (ACP) to the transfer documents.Questionnairehttps://api.iknl.nl/docs/pzp/r4/Questionnaire/ACP-zib2020#1.0.0-rc2
\".\"\".\"\".\" 963Datum van invullen0..1dateTime
\".\"\".\"\".\" 7Naam patiënt0..1group
\".\"\".\"\".\"\".\" 964Voornamen0..1string
\".\"\".\"\".\"\".\" 965Voorvoegsels0..1string
\".\"\".\"\".\"\".\" 966Achternaam0..1string
\".\"\".\"\".\" 967Geboortedatum patiënt0..1date
\".\"\".\"\".\" 8Gesprek gevoerd door:0..1group
\".\"\".\"\".\"\".\" 16Naam zorgverlener0..1group
\".\"\".\"\".\"\".\"\".\" 968Voornamen0..1string
\".\"\".\"\".\"\".\"\".\" 969Voorvoegsels0..1string
\".\"\".\"\".\"\".\"\".\" 970Achternaam0..1string
\".\"\".\"\".\"\".\" 1405Functie (Specialisme)0..1choiceOptions: 6 options
\".\"\".\"\".\" 261. Wilsbekwaamheid & Wettelijke vertegenwoordiging0..1group
\".\"\".\"\".\"\".\" 1406Is de patiënt op dit moment wilsbekwaam m.b.t. medische behandelbeslissingen?0..1boolean
\".\"\".\"\".\"\".\"\".\" 1407Toelichting0..1string
\".\"\".\"\".\"\".\" 29Bij wilsonbekwaamheid m.b.t. medische behandelbeslissingen is/wordt de wettelijke vertegenwoordiger:0..1group
\".\"\".\"\".\"\".\"\".\" 30a). Naam wettelijk vertegenwoordiger0..1group
\".\"\".\"\".\"\".\"\".\"\".\" 973Voornamen0..1string
\".\"\".\"\".\"\".\"\".\"\".\" 974Voorvoegsels0..1string
\".\"\".\"\".\"\".\"\".\"\".\" 975Achternaam0..1string
\".\"\".\"\".\"\".\"\".\" 39b). Contactgegevens wettelijk vertegenwoordiger0..1group
\".\"\".\"\".\"\".\"\".\"\".\" 40Telefoonnummers0..*group
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 976Telefoonnummer0..1string
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 977TelecomType0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 978NummerSoort0..1choiceOptions: 3 options
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 979Toelichting0..1string
\".\"\".\"\".\"\".\"\".\"\".\" 41EmailAdressen0..*group
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 980EmailAdres0..1string
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 981EmailSoort0..1choiceOptions: 2 options
\".\"\".\"\".\"\".\"\".\" 982c). Relatie tot patiënt (1)0..*choiceOptions: 6 options
\".\"\".\"\".\"\".\"\".\"\".\" 411Anders, namelijk:0..1stringEnable When: 982 = Anders (COD472-VEKT Soort relatie cliënt#09)
\".\"\".\"\".\"\".\"\".\" 983c). Relatie tot patiënt (2)0..1choiceOptions: 10 options
\".\"\".\"\".\"\".\"\".\"\".\" 408Anders, namelijk:0..1stringEnable When: 983 = Anders (v3 Code System NullFlavor#OTH)
\".\"\".\"\".\"\".\"\".\" 984d). Is de wettelijk vertegenwoordiger ook de eerste contactpersoon?0..1boolean
\".\"\".\"\".\"\".\"\".\" 53e). Naam eerste contactpersoon0..1groupEnable When: 984 = false
\".\"\".\"\".\"\".\"\".\"\".\" 985Voornamen0..1string
\".\"\".\"\".\"\".\"\".\"\".\" 986Voorvoegsels0..1string
\".\"\".\"\".\"\".\"\".\"\".\" 987Achternaam0..1string
\".\"\".\"\".\"\".\"\".\" 61f). Contactgegevens eerste contactpersoon0..1groupEnable When: 984 = false
\".\"\".\"\".\"\".\"\".\"\".\" 62Telefoonnummers0..*group
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 988Telefoonnummer0..1string
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 989TelecomType0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 990NummerSoort0..1choiceOptions: 3 options
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 991Toelichting0..1string
\".\"\".\"\".\"\".\"\".\"\".\" 66EmailAdressen0..*group
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 992EmailAdres0..1string
\".\"\".\"\".\"\".\"\".\"\".\"\".\" 993EmailSoort0..1choiceOptions: 2 options
\".\"\".\"\".\"\".\"\".\" 1644Rol0..1choice\"icon\"/\"icon\"/Enable When: 984 = false
Options: 1 option
\".\"\".\"\".\"\".\"\".\" 995g). Relatie tot patiënt0..1choiceEnable When: 984 = false
Options: 10 options
\".\"\".\"\".\"\".\"\".\"\".\" 412Anders, namelijk:0..1stringEnable When: 995 = Anders (v3 Code System NullFlavor#OTH)
\".\"\".\"\".\" 782. Gesprek gevoerd in bijzijn van0..1group
\".\"\".\"\".\"\".\" 82Patiënt0..1choiceOptions: 1 option
\".\"\".\"\".\"\".\" 997Rol0..*choiceOptions: 4 options
\".\"\".\"\".\"\".\"\".\" 414Anders, namelijk:0..1string
\".\"\".\"\".\"\".\" 998Relatie tot patiënt0..*choiceOptions: 10 options
\".\"\".\"\".\"\".\"\".\" 413Anders, namelijk:0..1stringEnable When: 998 = Anders (v3 Code System NullFlavor#OTH)
\".\"\".\"\".\" 5863. Belangrijkste overeengekomen doel van medisch beleid0..1group
\".\"\".\"\".\"\".\" 1408Belangrijkste doel van behandeling ([MetingNaam])0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\" 999Doel ([MetingWaarde])0..1choiceOptions: 4 options
\".\"\".\"\".\" 834. Behandelgrenzen0..1group
\".\"\".\"\".\"\".\" 1409a). Reanimatie0..1group
\".\"\".\"\".\"\".\"\".\" 1410Behandeling0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1386BehandelBesluit0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\"\".\"\".\" 1001SpecificatieAnders0..1stringEnable When: 1386 = Anders (BehandelBesluiten#1)
\".\"\".\"\".\"\".\"\".\"\".\" 1002Toelichting0..1string
\".\"\".\"\".\"\".\" 1411b). Kunstmatige invasieve beademing0..1group
\".\"\".\"\".\"\".\"\".\" 1412Behandeling0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1387BehandelBesluit0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\"\".\"\".\" 1388SpecificatieAnders0..1stringEnable When: 1387 = Anders (BehandelBesluiten#1)
\".\"\".\"\".\"\".\"\".\"\".\" 1389Toelichting0..1string
\".\"\".\"\".\"\".\" 1413c). Opname op intensive care0..1group
\".\"\".\"\".\"\".\"\".\" 1414Behandeling0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1390BehandelBesluit0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\"\".\"\".\" 1391SpecificatieAnders0..1stringEnable When: 1390 = Anders (BehandelBesluiten#1)
\".\"\".\"\".\"\".\"\".\"\".\" 1392Toelichting0..1string
\".\"\".\"\".\"\".\" 1415d). Opname in ziekenhuis0..1group
\".\"\".\"\".\"\".\"\".\" 1416Behandeling0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1393BehandelBesluit0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\"\".\"\".\" 1394SpecificatieAnders0..1stringEnable When: 1393 = Anders (BehandelBesluiten#1)
\".\"\".\"\".\"\".\"\".\"\".\" 1395Toelichting0..1string
\".\"\".\"\".\"\".\" 1417e). Behandeling met antibiotica0..1group
\".\"\".\"\".\"\".\"\".\" 1418Behandeling0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1396BehandelBesluit0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\"\".\"\".\" 1397SpecificatieAnders0..1stringEnable When: 1396 = Anders (BehandelBesluiten#1)
\".\"\".\"\".\"\".\"\".\"\".\" 1398Toelichting0..1string
\".\"\".\"\".\"\".\" 1419f). Toediening van een bloedproduct0..1group
\".\"\".\"\".\"\".\"\".\" 1420Behandeling0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1399BehandelBesluit0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\"\".\"\".\" 1400SpecificatieAnders0..1stringEnable When: 1399 = Anders (BehandelBesluiten#1)
\".\"\".\"\".\"\".\"\".\"\".\" 1401Toelichting0..1string
\".\"\".\"\".\"\".\" 1421g). Overige behandelgrenzen0..1group
\".\"\".\"\".\"\".\"\".\" 1422Behandeling0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1402BehandelBesluit0..1choiceOptions: 3 options
\".\"\".\"\".\"\".\"\".\"\".\" 1404Toelichting0..1string
\".\"\".\"\".\"\".\" 1006h). Heeft de patiënt een ICD?0..1choiceOptions: 3 options
\".\"\".\"\".\"\".\"\".\" 1008ProductType van ICD0..1choiceEnable When: 1006 = Ja (SNOMED CT#373066001)
Options: 6 options
\".\"\".\"\".\"\".\"\".\" 1009Toelichting0..1stringEnable When: 1006 = Ja (SNOMED CT#373066001)
\".\"\".\"\".\"\".\" 1425i). Is er een afspraak over het moment van uitzetten ICD?0..1groupEnable When: 1006 = Ja (SNOMED CT#373066001)
\".\"\".\"\".\"\".\"\".\" 1426Behandeling van uitzetten ICD (Behandeling)0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1005Afspraak uitzetten ICD (BehandelBesluit)0..1choiceEnable When: 1006 = Ja (SNOMED CT#373066001)
Options: 3 options
\".\"\".\"\".\"\".\"\".\"\".\" 1010Toelichting gemaakte afspraken0..1string
\".\"\".\"\".\" 1075. Behandelwensen0..1group
\".\"\".\"\".\"\".\" 1427a). Wat zouden zorgverleners, volgens de patiënt, moeten weten om goede zorg te kunnen verlenen? Heeft deze patiënt specifieke wensen met betrekking tot zijn zorg? (incl. culturele/religieuze/sociale/spirituele aspecten)0..1group
\".\"\".\"\".\"\".\"\".\" 1428Wens en verwachting patient ([MetingNaam])0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1190Wens en verwachting patient ([MetingWaarde])0..1string
\".\"\".\"\".\"\".\" 1429b). Gewenste plek van overlijden0..1group
\".\"\".\"\".\"\".\"\".\" 1430Gewenste plek van overlijden ([MetingNaam])0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1191Voorkeursplek ([MetingWaarde])0..1choiceOptions: 6 options
\".\"\".\"\".\"\".\"\".\"\".\" 1192Toelichting0..1string
\".\"\".\"\".\"\".\" 1431c). Euthanasie standpunt0..1group
\".\"\".\"\".\"\".\"\".\" 1432Euthanasie standpunt ([MetingNaam])0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1193Euthanasie standpunt ([MetingWaarde])0..1choiceOptions: 4 options
\".\"\".\"\".\"\".\"\".\"\".\" 1194Toelichting0..1string
\".\"\".\"\".\"\".\" 1433d). Keuze orgaandonatie vastgelegd in donorregister?0..1group
\".\"\".\"\".\"\".\"\".\" 1434Keuze orgaandonatie vastgelegd in donorregister? ([MetingNaam])0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\"\".\" 1435Keuze orgaandonatie in donorregister ([MetingWaarde])0..1choiceOptions: 3 options
\".\"\".\"\".\" 5986. Wat verder nog belangrijk is0..1group
\".\"\".\"\".\"\".\" 1436Wat verder nog belangrijk is ([MetingNaam])0..1choice\"icon\"/\"icon\"/Options: 1 option
\".\"\".\"\".\"\".\" 1196Wat verder nog belangrijk is ([MetingWaarde])0..1string
\".\"\".\"\".\" 1157. Eerder vastgelegde behandelwensen0..1group
\".\"\".\"\".\"\".\" 1197a). Heeft de patiënt eerder behandelafspraken vastgelegd?0..1choiceOptions: 3 options
\".\"\".\"\".\"\".\"\".\" 1198Toelichting0..1string
\".\"\".\"\".\"\".\" 1199b). Staan in eerder vastgelegde behandelafspraken andere wensen dan nu in deze verklaring?0..1choiceEnable When: 1197 = Ja (SNOMED CT#373066001)
Options: 3 options
\".\"\".\"\".\" 1198. Informatie delen0..1group
\".\"\".\"\".\"\".\" 1200a). Heeft u patient geïnformeerd over eigen verantwoordelijkheid om deze behandelafspraken met naasten te bespreken?0..1boolean
\".\"\".\"\".\"\".\" 1201b). Patiënt gaat akkoord met het delen van deze behandelafspraken met andere betrokken hulpverleners0..1choiceOptions: 2 options

\"doco\" Documentation for this format

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" }, "url" : "https://api.iknl.nl/docs/pzp/r4/Questionnaire/ACP-zib2020", "version" : "1.0.0-rc2", "name" : "ACPzib2020", "title" : "Uniform vastleggen proactieve zorgpanning (PZP) o.b.v. zibs2020 - ReleaseCandidate2 03-03-2026", "status" : "draft", "experimental" : false, "date" : "2026-06-02T12:44:46+00:00", "publisher" : "IKNL", "contact" : [{ "name" : "IKNL", "telecom" : [{ "system" : "url", "value" : "https://iknl.nl/" }, { "system" : "email", "value" : "info@iknl.nl" }] }], "description" : "This form was developed to clearly document agreements resulting from the advance care planning (ACP) process. It is NOT a checklist. It can only be completed by a healthcare provider after a professional and nuanced conversation. For advice on conducting these conversations, please refer to the guideline for advance care planning in the palliative phase and Palliaweb, see https://palliaweb.nl/zorgpraktijk/proactieve-zorgplanning. \nEnter 'unknown' if a topic is not discussed or if the patient does not (yet) have an opinion.When transferring to a long-term care setting, consider adding conversation records about advance care planning (ACP) to the transfer documents.", "purpose" : "This form was developed to clearly document agreements resulting from the advance care planning (ACP) process.", "copyright" : "This form is subject to copyright, user rights and a disclaimer, as specified for all IKNL information standards. For details, see the paragraph on Gebruikersrechten en disclaimer at https://iknl.nl/onderzoek/eenheid-van-taal.", "item" : [{ "linkId" : "963", "text" : "Datum van invullen", "type" : "dateTime", "required" : false, "repeats" : false }, { "linkId" : "7", "text" : "Naam patiënt", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "964", "text" : "Voornamen", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "965", "text" : "Voorvoegsels", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "966", "text" : "Achternaam", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "967", "text" : "Geboortedatum patiënt", "type" : "date", "required" : false, "repeats" : false }, { "linkId" : "8", "text" : "Gesprek gevoerd door:", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "16", "text" : "Naam zorgverlener", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "968", "text" : "Voornamen", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "969", "text" : "Voorvoegsels", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "970", "text" : "Achternaam", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "1405", "text" : "Functie (Specialisme)", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode", "code" : "01.000", "display" : "Arts" } }, { "valueCoding" : { "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode", "code" : "01.015", "display" : "Huisarts" } }, { "valueCoding" : { "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode", "code" : "01.047", "display" : "Specialist ouderengeneeskunde" } }, { "valueCoding" : { "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode", "code" : "30.000", "display" : "Verpleegkundige" } }, { "valueCoding" : { "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode", "code" : "81.000", "display" : "Physician assistant" } }, { "valueCoding" : { "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode", "code" : "99.000", "display" : "Zorgverlener andere zorg" } }] }] }, { "linkId" : "26", "prefix" : "1", "text" : "Wilsbekwaamheid & Wettelijke vertegenwoordiging", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1406", "text" : "Is de patiënt op dit moment wilsbekwaam m.b.t. medische behandelbeslissingen?", "type" : "boolean", "required" : false, "repeats" : false, "item" : [{ "linkId" : "1407", "text" : "Toelichting", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "29", "text" : "Bij wilsonbekwaamheid m.b.t. medische behandelbeslissingen is/wordt de wettelijke vertegenwoordiger:", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "30", "prefix" : "a)", "text" : "Naam wettelijk vertegenwoordiger", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "973", "text" : "Voornamen", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "974", "text" : "Voorvoegsels", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "975", "text" : "Achternaam", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "39", "prefix" : "b)", "text" : "Contactgegevens wettelijk vertegenwoordiger", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "40", "text" : "Telefoonnummers", "type" : "group", "repeats" : true, "item" : [{ "linkId" : "976", "text" : "Telefoonnummer", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "977", "text" : "TelecomType", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "LL", "display" : "Land Line" } }, { "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "FAX", "display" : "Fax" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse", "code" : "PG", "display" : "Pieper" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse", "code" : "MC", "display" : "Mobiel telefoonnummer" } }] }, { "linkId" : "978", "text" : "NummerSoort", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse", "code" : "HP", "display" : "Telefoonnummer thuis" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse", "code" : "TMP", "display" : "Tijdelijk telefoonnummer" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse", "code" : "WP", "display" : "Zakelijk telefoonnummer" } }] }, { "linkId" : "979", "text" : "Toelichting", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "41", "text" : "EmailAdressen", "type" : "group", "repeats" : true, "item" : [{ 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"type" : "string", "required" : false, "repeats" : false }] }] }, { "linkId" : "1413", "prefix" : "c)", "text" : "Opname op intensive care", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1414", "text" : "Behandeling", "type" : "choice", "required" : false, "repeats" : false, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "305351004", "display" : "opname op intensive care" }, "initialSelected" : true }] }, { "linkId" : "1390", "text" : "BehandelBesluit", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "0", "display" : "Wel uitvoeren" } }, { "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "1", "display" : "Anders" } }, { "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "2", "display" : "Niet uitvoeren" } }, { 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: "BehandelBesluit", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "0", "display" : "Wel uitvoeren" } }, { "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "1", "display" : "Anders" } }, { "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "2", "display" : "Niet uitvoeren" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Onbekend" } }], "item" : [{ "linkId" : "1394", "text" : "SpecificatieAnders", "type" : "string", "enableWhen" : [{ "question" : "1393", "operator" : "=", "answerCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "1", "display" : "Anders" } }], "enableBehavior" : "any", "required" : false, "repeats" : false }, { "linkId" : "1395", "text" : "Toelichting", "type" : "string", "required" : false, "repeats" : false }] }] }, { "linkId" : "1417", "prefix" : "e)", "text" : "Behandeling met antibiotica", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1418", "text" : "Behandeling", "type" : "choice", "required" : false, "repeats" : false, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "281789004", "display" : "antibiotische therapie" }, "initialSelected" : true }] }, { "linkId" : "1396", "text" : "BehandelBesluit", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "0", "display" : "Wel uitvoeren" } }, { "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "1", "display" : "Anders" } }, { "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "2", "display" : "Niet uitvoeren" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Onbekend" } }], "item" : [{ "linkId" : "1397", "text" : "SpecificatieAnders", "type" : "string", "enableWhen" : [{ "question" : "1396", "operator" : "=", "answerCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "1", "display" : "Anders" } }], "enableBehavior" : "any", "required" : false, "repeats" : false }, { "linkId" : "1398", "text" : "Toelichting", "type" : "string", "required" : false, "repeats" : false }] }] }, { "linkId" : "1419", "prefix" : "f)", "text" : "Toediening van een bloedproduct", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1420", "text" : "Behandeling", "type" : "choice", "required" : false, "repeats" : false, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "116762002", "display" : "toediening van bloedproduct" }, "initialSelected" : true }] }, { "linkId" : "1399", "text" : "BehandelBesluit", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "0", "display" : "Wel uitvoeren" } }, { "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "1", "display" : "Anders" } }, { "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "2", "display" : "Niet uitvoeren" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Onbekend" } }], "item" : [{ "linkId" : "1400", "text" : "SpecificatieAnders", "type" : "string", "enableWhen" : [{ "question" : "1399", "operator" : "=", "answerCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "1", "display" : "Anders" } }], "enableBehavior" : "any", "required" : false, "repeats" : false }, { "linkId" : "1401", "text" : "Toelichting", "type" : "string", "required" : false, "repeats" : false }] }] }, { "linkId" : "1421", "prefix" : "g)", "text" : "Overige behandelgrenzen", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1422", "text" : "Behandeling", "type" : "choice", "required" : false, "repeats" : false, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "OTH", "display" : "Other" }, "initialSelected" : true }] }, { "linkId" : "1402", "text" : "BehandelBesluit", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "0", "display" : "Wel uitvoeren" } }, { "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "2", "display" : "Niet uitvoeren" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Onbekend" } }], "item" : [{ "linkId" : "1404", "text" : "Toelichting", "type" : "string", "required" : false, "repeats" : false }] }] }, { "linkId" : "1006", "prefix" : "h)", "text" : "Heeft de patiënt een ICD?", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "373066001", "display" : "Ja" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "373067005", "display" : "Nee" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Nog onbekend" } }], "item" : [{ "linkId" : "1008", "text" : "ProductType van ICD", "type" : "choice", "enableWhen" : [{ "question" : "1006", "operator" : "=", "answerCoding" : { "system" : "http://snomed.info/sct", "code" : "373066001", "display" : "Ja" } }], "enableBehavior" : "any", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "72506001", "display" : "implanteerbare cardioverter-defibrillator" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "465460004", "display" : "univentriculaire implanteerbare cardioverter-defibrillator" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "468542000", "display" : "implanteerbare tweekamercardioverter-defibrillator" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "704707009", "display" : "implanteerbare biventriculaire cardioverter-defibrillator" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "1263462004", "display" : "pulsgenerator van defibrillator voor cardiale resynchronisatietherapie" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "1236894001", "display" : "subcutane implanteerbare cardioverter-defibrillator" } }] }, { "linkId" : "1009", "text" : "Toelichting", "type" : "string", "enableWhen" : [{ "question" : "1006", "operator" : "=", "answerCoding" : { "system" : "http://snomed.info/sct", "code" : "373066001", "display" : "Ja" } }], "enableBehavior" : "any", "required" : false, "repeats" : false }] }, { "linkId" : "1425", "prefix" : "i)", "text" : "Is er een afspraak over het moment van uitzetten ICD?", "type" : "group", "enableWhen" : [{ "question" : "1006", "operator" : "=", "answerCoding" : { "system" : "http://snomed.info/sct", "code" : "373066001", "display" : "Ja" } }], "enableBehavior" : "any", "repeats" : false, "item" : [{ "linkId" : "1426", "text" : "Behandeling van uitzetten ICD (Behandeling)", "type" : "choice", "required" : false, "repeats" : false, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "400231000146108", "display" : "uitzetten van cardioverter-defibrillator in laatste levensfase (verrichting)" }, "initialSelected" : true }] }, { "linkId" : "1005", "text" : "Afspraak uitzetten ICD (BehandelBesluit)", "type" : "choice", "enableWhen" : [{ "question" : "1006", "operator" : "=", "answerCoding" : { "system" : "http://snomed.info/sct", "code" : "373066001", "display" : "Ja" } }], "enableBehavior" : "any", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1", "code" : "0", "display" : "Wel uitvoeren" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "ASKU", "display" : "Nee, nog geen besluit genomen" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "NASK", "display" : "Niet besproken" } }], "item" : [{ "linkId" : "1010", "text" : "Toelichting gemaakte afspraken", "type" : "string", "required" : false, "repeats" : false }] }] }] }, { "linkId" : "107", "prefix" : "5", "text" : "Behandelwensen", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1427", "prefix" : "a)", "text" : "Wat zouden zorgverleners, volgens de patiënt, moeten weten om goede zorg te kunnen verlenen? Heeft deze patiënt specifieke wensen met betrekking tot zijn zorg? (incl. culturele/religieuze/sociale/spirituele aspecten)", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1428", "text" : "Wens en verwachting patient ([MetingNaam])", "type" : "choice", "required" : false, "repeats" : false, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "153851000146100", "display" : "Wensen en verwachtingen met betrekking tot uitkomst van behandeling" }, "initialSelected" : true }] }, { "linkId" : "1190", "text" : "Wens en verwachting patient ([MetingWaarde])", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "1429", "prefix" : "b)", "text" : "Gewenste plek van overlijden", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1430", "text" : "Gewenste plek van overlijden ([MetingNaam])", "type" : "choice", "required" : false, "repeats" : false, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "395091006", "display" : "Gewenste plek van overlijden" }, "initialSelected" : true }] }, { "linkId" : "1191", "text" : "Voorkeursplek ([MetingWaarde])", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "264362003", "display" : "Thuis" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "22232009", "display" : "Ziekenhuis" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "108344006", "display" : "Verpleeghuis" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "284546000", "display" : "Hospice" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "OTH", "display" : "Anders" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Nog onbekend" } }], "item" : [{ "linkId" : "1192", "text" : "Toelichting", "type" : "string", "required" : false, "repeats" : false }] }] }, { "linkId" : "1431", "prefix" : "c)", "text" : "Euthanasie standpunt", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1432", "text" : "Euthanasie standpunt ([MetingNaam])", "type" : "choice", "required" : false, "repeats" : false, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "340171000146104", "display" : "Standpunt ten opzichte van euthanasie (waarneembare entiteit)" }, "initialSelected" : true }] }, { "linkId" : "1193", "text" : "Euthanasie standpunt ([MetingWaarde])", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "340181000146102", "display" : "Heeft euthanasieverklaring" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "340201000146103", "display" : "Wenst geen euthanasie" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "340191000146100", "display" : "Geen euthanasieverklaring, zou wel verzoek kunnen doen in bepaalde situaties" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Nog onbekend" } }], "item" : [{ "linkId" : "1194", "text" : "Toelichting", "type" : "string", "required" : false, "repeats" : false }] }] }, { "linkId" : "1433", "prefix" : "d)", "text" : "Keuze orgaandonatie vastgelegd in donorregister?", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1434", "text" : "Keuze orgaandonatie vastgelegd in donorregister? ([MetingNaam])", "type" : "choice", "required" : false, "repeats" : false, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "570801000146104", "display" : "Geregistreerd in orgaan donorregister (bevinding)" }, "initialSelected" : true }] }, { "linkId" : "1435", "text" : "Keuze orgaandonatie in donorregister ([MetingWaarde])", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "373066001", "display" : "Ja" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "373067005", "display" : "Nee" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Nog onbekend" } }] }] }] }, { "linkId" : "598", "prefix" : "6", "text" : "Wat verder nog belangrijk is", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1436", "text" : "Wat verder nog belangrijk is ([MetingNaam])", "type" : "choice", "required" : false, "repeats" : false, "readOnly" : true, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "247751003", "display" : "Gevoel van zingeving (waarneembare entiteit)" }, "initialSelected" : true }] }, { "linkId" : "1196", "text" : "Wat verder nog belangrijk is ([MetingWaarde])", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "115", "prefix" : "7", "text" : "Eerder vastgelegde behandelwensen", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1197", "prefix" : "a)", "text" : "Heeft de patiënt eerder behandelafspraken vastgelegd?", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "373066001", "display" : "Ja" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "373067005", "display" : "Nee" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Nog onbekend" } }], "item" : [{ "linkId" : "1198", "text" : "Toelichting", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "1199", "prefix" : "b)", "text" : "Staan in eerder vastgelegde behandelafspraken andere wensen dan nu in deze verklaring?", "type" : "choice", "enableWhen" : [{ "question" : "1197", "operator" : "=", "answerCoding" : { "system" : "http://snomed.info/sct", "code" : "373066001", "display" : "Ja" } }], "enableBehavior" : "any", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "373066001", "display" : "Ja" } }, { "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "373067005", "display" : "Nee" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Nog onbekend" } }] }] }, { "linkId" : "119", "prefix" : "8", "text" : "Informatie delen", "type" : "group", "repeats" : false, "item" : [{ "linkId" : "1200", "prefix" : "a)", "text" : "Heeft u patient geïnformeerd over eigen verantwoordelijkheid om deze behandelafspraken met naasten te bespreken?", "type" : "boolean", "required" : false, "repeats" : false }, { "linkId" : "1201", "prefix" : "b)", "text" : "Patiënt gaat akkoord met het delen van deze behandelafspraken met andere betrokken hulpverleners", "type" : "choice", "required" : false, "repeats" : false, "answerOption" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "441898007", "display" : "Akkoord" } }, { "valueCoding" : { "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor", "code" : "UNK", "display" : "Nog onbekend" } }] }] }] }