<status value="draft" /> <date value="2022-07-07T15:04:03.2592055+00:00" /> <publisher value="Healthdata.be (Sciensano)" /> <contact> <name value="Service portal – healthdata.be" /> <telecom> <system value="url" /> <value value="https://sciensano.service-now.com/sp" /> <use value="work" /> </telecom> </contact> <description value="Being able to urinate, defecate and keep up hygiene during a menstrual cycle independently is part of self-care. Limitations in this ability indicate a reduced ability to cope for oneself. This activity and activities such as those including eating, getting dressed and bathing are also known as activities of daily living (ADL). These are the activities people go through in daily life. The extent to which a person is able to do all these activities by themselves is a measure for their total ability to do things independently. #### Purpose Information on limitations in a patient’s ability to urinate, defecate and keep up their hygiene during their menstrual cycle is important in determining the nature and intensity of the care the patient needs. In a transfer situation, it gives the receiving organization the ability to anticipate the intensity of the care to be given to the patient, enabling continuity in healthcare for the patient. If policy has been implemented to improve a patient’s ability to do things independently, the entered extent of independence helps to determine the efficiency of the treatment. #### Evidence Base The definitions of the concepts were (partially) taken from the BarthelIndex definitions. In addition to this information model, there are other tools to record independence, such as the KATZ-ADL and the BarthelIndex. The KATZ-ADL is mainly used for vulnerable seniors and the BarthelIndex is mainly used for patients who have had a stroke. This information model evaluates the ability to use the toilet on a three-point scale that is in accordance with this aspect in the BarthelIndex. In the KATZ-ADL, this falls under the aspect of Toilet Hygiene."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Zelfstandig kunnen zorgdragen voor urineren, defeceren en de zorg bij menstruatie is een onderdeel van zelfzorg. Beperkingen in dit vermogen duiden op een verminderde zelfredzaamheid op dit gebied. Deze activiteit wordt samen met activiteiten zoals onder andere eten, zich kleden en zich wassen, ook aangeduid als algemene dagelijkse levensverrichtingen (ADL). Dit zijn de handelingen die mensen dagelijks in het gewone leven verrichten. De mate waarin een persoon al deze activiteiten zelfstandig kan verrichten zijn een maat voor de totale zelfredzaamheid. #### Purpose Informatie over beperkingen in het vermogen om zelfstandig zorg te kunnen dragen voor urineren, defeceren en verzorging bij menstruatie is van belang bij het bepalen van de aard en intensiteit van de zorg die aan de patiënt geboden moet worden. In een overdrachtsituatie biedt het de ontvangende organisatie de mogelijkheid te anticiperen op de zwaarte van de te leveren zorg waardoor continuïteit van de zorgverlening gerealiseerd kan worden. Indien beleid is ingezet om de zelfredzaamheid te verbeteren, biedt de vastgelegde mate van zelfstandigheid de mogelijkheid de doeltreffendheid van de behandeling vast te stellen. #### Evidence Base Voor de definities van de concepten is gebruik gemaakt van de omschrijvingen uit de Barthel index. Naast deze bouwsteen zijn er meer instrumenten om zelfredzaamheid vast te leggen, zoals KATZ-ADL en de BarthelIndex. De KATZ-ADL wordt vooral gebruikt bij kwetsbare ouderen en de BarthelIndex wordt met name gebruikt voor patiënten met een beroerte. Deze bouwsteen evalueert het vermogen tot toiletgang met een driepuntsschaal die overeenkomt met dit aspect in de BarthelIndex. Bij KATZ-ADL valt dit onder het aspect WC-bezoek." /> </extension> </extension> </description> <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." /> <fhirVersion value="4.0.1" /> <kind value="logical" /> <abstract value="true" /> <type value="https://fhir.healthdata.be/StructureDefinition/LogicalModel/AbilityToUseToilet" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element" /> <derivation value="specialization" /> <snapshot> <element id="AbilityToUseToilet"> <path value="AbilityToUseToilet" /> <short value="Base for all elements" /> <definition value="Base definition for all elements in a resource." /> <min value="0" /> <max value="*" /> <base> <path value="AbilityToUseToilet" /> <min value="0" /> <max value="*" /> </base> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AbilityToUseToilet.id"> <path value="AbilityToUseToilet.id" /> <representation value="xmlAttr" /> <short value="xml:id (or equivalent in JSON)" /> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <comment value="Note that FHIR strings may not exceed 1MB in size" /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <code value="string" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="AbilityToUseToilet.extension"> <path value="AbilityToUseToilet.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional Content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <condition value="ele-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() | (children().count() > id.count())" /> <xpath value="@value|f:*|h:div" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="AbilityToUseToilet.ToiletUseAbility"> <path value="AbilityToUseToilet.ToiletUseAbility" /> <short value="ToiletUseAbility"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="VermogenTotToiletgang" /> </extension> </extension> </short> <definition value="Root concept of the ToiletUse information model. This root concept contains all data elements of the ToiletUse information model."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Rootconcept van de bouwsteen VermogenTotToiletgang. Dit rootconcept bevat alle gegevenselementen van de bouwsteen VermogenTotToiletgang." /> </extension> </extension> </definition> <min value="0" /> <max value="*" /> <base> <path value="ToiletUseAbility" /> <min value="0" /> <max value="*" /> </base> </element> </snapshot> <differential> <element id="ToiletUseAbility"> <path value="ToiletUseAbility" /> <short value="ToiletUseAbility"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="VermogenTotToiletgang" /> </extension> </extension> </short> <definition value="Root concept of the ToiletUse information model. This root concept contains all data elements of the ToiletUse information model."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Rootconcept van de bouwsteen VermogenTotToiletgang. Dit rootconcept bevat alle gegevenselementen van de bouwsteen VermogenTotToiletgang." /> </extension> </extension> </definition> <min value="0" /> <max value="*" /> </element> <element id="ToiletUseAbility.ToiletUse"> <path value="ToiletUseAbility.ToiletUse" /> <short value="ToiletUse"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Toiletgebruik" /> </extension> </extension> </short> <definition value="Coordinating and realizing urination or defecation, such as indicating the need, getting into the right position, finding and reaching a suitable spot, manipulating clothing before and after urination, and cleaning up (the body) afterwards."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Het coördineren en zorg dragen voor urineren of defecatie, zoals door het aangeven van de noodzaak, het in de juiste positie komen, een geschikte plaats vinden en bereiken, het manipuleren van de kleding voor en na, en het zich schoonmaken." /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <binding> <strength value="required" /> <description value="ToiletUse codes" /> <valueSet value="https://fhir.healthdata.be/ValueSet/Toiletgebruik" /> </binding> </element> <element id="ToiletUseAbility.MenstrualCare"> <path value="ToiletUseAbility.MenstrualCare" /> <short value="MenstrualCare"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="ZorgBijMenstruatie" /> </extension> </extension> </short> <definition value="Coordinating, planning and hygiene in the event of menstruation, such as anticipating the menstruation and using sanitary napkins and tampons."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Het coördineren, plannen en de verzorging bij de menstruatie, zoals door anticipatie op de menstruatie en het gebruiken van maandverband en tampons." /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="CodeableConcept" /> </type> <binding> <strength value="required" /> <description value="MenstrualCare codes" /> <valueSet value="https://fhir.healthdata.be/ValueSet/ZorgBijMenstruatie" /> </binding> </element> </differential> </StructureDefinition>