<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="The Delirium Observation Screening Scale is a tool to determine whether a patient has delirium. The DOSS includes 13 observations of behavior (verbal and non-verbal) which represent the symptoms of a delirium. These observations can be performed during regular contact with the patient. #### Purpose Delirium is one of the most forms of psychopathology among elderly patients and patients in the last phase of their lives. The main characteristic of delirium is the rapid onset and changing of symptoms. The DOSS is meant to qualify and quantify the nature and seriousness of delirium symptoms. This enables a quick start of treatment. The DOSS is used to signal risks and as an evaluation tool. #### Evidence Base The definitions of the concepts are based on the DOS score."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="De DOSS (Delirium Observatie Screening Schaal) is een hulpmiddel om te bepalen of er sprake is van een delier. De DOSS bevat 13 observaties van gedrag (verbaal en non-verbaal) die de symptomen van het delier weergeven. Deze observaties kunnen gedaan worden tijdens reguliere contacten met de patiënt. #### Purpose Het delier is een van de meest voorkomende vormen van psychopathologie bij oude patiënten en bij patiënten in de laatste fase van het leven. Kenmerkend voor het delier zijn het snelle ontstaan en de wisseling van de symptomen. De DOSS is bedoeld om de aard en ernst van de symptomen van een delier te kwalificeren en kwantificeren. Hierdoor kan snel een behandeling worden ingezet. De DOSS wordt gebruikt als risicosignalering en als evaluatie instrument. #### Evidence Base De definities van de concepten zijn gebaseerd op de DOS scorelijst." /> </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/DOSScore" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element" /> <derivation value="specialization" /> <snapshot> <element id="DOSScore"> <path value="DOSScore" /> <short value="Base for all elements" /> <definition value="Base definition for all elements in a resource." /> <min value="0" /> <max value="*" /> <base> <path value="DOSScore" /> <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="DOSScore.id"> <path value="DOSScore.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="DOSScore.extension"> <path value="DOSScore.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="DOSScore.Dosscore"> <path value="DOSScore.Dosscore" /> <short value="DOSScore"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOSScore" /> </extension> </extension> </short> <definition value="Root concept of the DOSScore information model. This root concept contains all data elements of the DOSScore 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 DOSScore. Dit rootconcept bevat alle gegevenselementen van de bouwsteen DOSScore." /> </extension> </extension> </definition> <min value="0" /> <max value="*" /> <base> <path value="Dosscore" /> <min value="0" /> <max value="*" /> </base> </element> </snapshot> <differential> <element id="Dosscore"> <path value="Dosscore" /> <short value="DOSScore"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOSScore" /> </extension> </extension> </short> <definition value="Root concept of the DOSScore information model. This root concept contains all data elements of the DOSScore 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 DOSScore. Dit rootconcept bevat alle gegevenselementen van de bouwsteen DOSScore." /> </extension> </extension> </definition> <min value="0" /> <max value="*" /> </element> <element id="Dosscore.DosscoreTotal"> <path value="Dosscore.DosscoreTotal" /> <short value="DOSScoreTotal"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOSScoreTotaal" /> </extension> </extension> </short> <definition value="Per shift a total score is calculated (minimum 0 and maximum 13). The total scores of three shifts (day, evening and night shifts) are summed to the total score of the day (minimum 0 and maximum 39). The DOS scale final score is calculated by dividing the total score of the day by 3 (minimum 0 and maximum 13). A DOS scale final score < 3 means that the patient is probably not delirious. A DOS scale final score > 3 means that the patiënt is probably delirious."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Per dienst wordt een totaal score berekend (minimaal 0 en maximaal 13). De totaal scores van drie diensten (dag, late en nachtdienst) worden opgeteld tot de totaal score van deze dag (minimaal 0 en maximaal 39). De DOS schaal eindscore wordt berekend door de totaal score van deze dag te delen door 3 (minimaal 0 en maximaal 13). Een DOS schaal eindscore < 3 betekent dat de patiënt waarschijnlijk niet delirant is. Een DOS schaal eindscore > 3 betekent dat de patiënt waarschijnlijk wel delirant is." /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.DosscoreDateTime"> <path value="Dosscore.DosscoreDateTime" /> <short value="DOSScoreDateTime"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOSScoreDatumTijd" /> </extension> </extension> </short> <definition value="The date on which the DOS score is registered."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="De datum waarop de DOS score is vastgelegd." /> </extension> </extension> </definition> <min value="1" /> <max value="1" /> <type> <code value="dateTime" /> </type> </element> <element id="Dosscore.DozesOff"> <path value="Dosscore.DozesOff" /> <short value="DozesOff"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="ZaktWeg" /> </extension> </extension> </short> <definition value="DOS observation: patient dozes off during conversation or activities. Score: 0: never 1: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt zakt weg tijdens gesprek of bezigheden. Score: 0: nooit 1: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.EasilyDistracted"> <path value="Dosscore.EasilyDistracted" /> <short value="EasilyDistracted"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="SnelAfgeleid" /> </extension> </extension> </short> <definition value="DOS observation: patient is easily distracted by stimuli from the environment. Someone is easily distracted by stimuli from the environment when he/she responds verbally or non-verbally to sounds or movements that have no relation to him/her and the nature of which does not make you expect a reaction from him/her. Score: 0: never 1: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt is snel afgeleid door prikkels uit de omgeving. Iemand is snel afgeleid door prikkels uit de omgeving wanneer hij/zij verbaal of nonverbaal reageert op geluiden of bewegingen die geen betrekking op hem/haar hebben en die van dien aard zijn dat je geen reactie van hem/haar zou verwachten. Score: 0: nooit 1: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.MaintainsAttention"> <path value="Dosscore.MaintainsAttention" /> <short value="MaintainsAttention"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="HeeftAandacht" /> </extension> </extension> </short> <definition value="DOS observation: patient maintains attention to conversation or action. Someone is maintaining attention to a conversation or action if he/she verbally or non-verbally shows that they are following the conversation or action. Score: 1: never 0: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt heeft aandacht voor gesprek of handeling. Iemand heeft aandacht voor gesprek of handeling als hij /zij verbaal of nonverbaal blijk geeft het gesprek of de handeling te volgen. Score: 1: nooit 0: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.UnfinishedQuestionAnswer"> <path value="Dosscore.UnfinishedQuestionAnswer" /> <short value="UnfinishedQuestionAnswer"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="VraagAntwoordNietAf" /> </extension> </extension> </short> <definition value="DOS observation: patient does not finish question or answer. Score: 0: never 1: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt maakt vraag of antwoord niet af. Score: 0: nooit 1: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.AnswersNoFit"> <path value="Dosscore.AnswersNoFit" /> <short value="AnswersNoFit"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="AntwoordenNietPassend" /> </extension> </extension> </short> <definition value="DOS observation: patient gives answers that do not fit the question. Score: 0: never 1: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt geeft antwoorden die niet passen bij de vraag. Score: 0: nooit 1: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.ReactsSlowly"> <path value="Dosscore.ReactsSlowly" /> <short value="ReactsSlowly"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="ReageertTraag" /> </extension> </extension> </short> <definition value="DOS observation: patient reacts slowly to instructions. Someone reacts slowly to instructions when acting is delayed and/or there are moments of stillness/inactivity before moving into action. Score: 0: never 1: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt reageert traag op opdrachten. Iemand reageert traag op opdrachten wanneer het handelen is vertraagd en/of er momenten van stilte/inactiviteit zijn voordat tot handelen wordt overgegaan. Score: 0: nooit 1: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.ThinksSomewhereElse"> <path value="Dosscore.ThinksSomewhereElse" /> <short value="ThinksSomewhereElse"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DenktErgensAnders" /> </extension> </extension> </short> <definition value="DOS observation: patient thinks they are somewhere else. Someone thinks they are somewhere else when he/she shows this in words or actions. Score: 0: never 1: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt denkt ergens anders te zijn. Iemand denkt ergens anders te zijn als hij/zij in woorden of handelen dit laat blijken. Score: 0: nooit 1: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.KnowsPartDay"> <path value="Dosscore.KnowsPartDay" /> <short value="KnowsPartDay"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="BeseftDagdeel" /> </extension> </extension> </short> <definition value="DOS observation: patient knows which part of the day it is. Someone knows what part of the day it is when he/she shows such in words or actions. Score: 1: never 0: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt beseft wel welk dagdeel het is. Iemand beseft welk dagdeel het is als hij/zij in woorden of handelen dit laat blijken. Score: 1: nooit 0: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.RemembersRecent"> <path value="Dosscore.RemembersRecent" /> <short value="RemembersRecent"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="HerinnertRecent" /> </extension> </extension> </short> <definition value="DOS observation: patient remembers recent events. Someone remembers recent events when he/she can for example tell whether they had visitors or what he/she ate. Score: 1: never 0: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt herinnert zich recente gebeurtenis. Iemand herinnert zich recente gebeurtenissen wanneer hij/zij bijvoorbeeld juist kan vertellen of er bezoek is geweest of wat hij/zij gegeten heeft. Score: 1: nooit 0: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.Restless"> <path value="Dosscore.Restless" /> <short value="Restless"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Rusteloos" /> </extension> </extension> </short> <definition value="DOS observation: patient is picking, disorderly, restless. Score: 0: never 1: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt is plukkerig, rommelig, rusteloos. Score: 0: nooit 1: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.PullsWires"> <path value="Dosscore.PullsWires" /> <short value="PullsWires"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="TrektDraden" /> </extension> </extension> </short> <definition value="DOS observation: patient pulls IV tubing, feeding tubes, catheters, etc. Score: 0: never 1: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt trekt aan infuus, sonde, catheter, enz. Score: 0: nooit 1: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.EasilyEmotional"> <path value="Dosscore.EasilyEmotional" /> <short value="EasilyEmotional"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="SnelGeemotioneerd" /> </extension> </extension> </short> <definition value="DOS observation: patient is easily or suddenly emotional. Someone is easily or suddenly emotional when he/she responds with a fierce emotion without provocation or when the fierceness of the emotion does not seem to match the provocation. Score: 0: never 1: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt is snel of plotseling geëmotioneerd. Iemand is snel of plotseling geëmotioneerd wanneer hij/zij reageert met een heftige emotie zonder aanleiding of wanneer de heftigheid van de emotie niet in overeenstemming lijkt met de aanleiding. Score: 0: nooit 1: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.Hallucinations"> <path value="Dosscore.Hallucinations" /> <short value="Hallucinations"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Hallucinaties" /> </extension> </extension> </short> <definition value="DOS observation: patient sees/hears things which are not there. Someone sees/hears things which are not there when he/she shows this verbally (ask!) or non-verbally. Score: 0: never 1: sometimes-always -: don't know"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="DOS observatie: patiënt ziet/hoort dingen die er niet zijn. Iemand ziet/hoort dingen die er niet zijn wanneer hij/zij hiervan verbaal (navragen!) of nonverbaal blijk geeft. Score: 0: nooit 1: soms-altijd -: weet niet" /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="Count" /> </type> </element> <element id="Dosscore.Comment"> <path value="Dosscore.Comment" /> <short value="Comment"> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Toelichting" /> </extension> </extension> </short> <definition value="Comment on the DOS score."> <extension url="http://hl7.org/fhir/StructureDefinition/translation"> <extension url="lang"> <valueCode value="nl-NL" /> </extension> <extension url="content"> <valueMarkdown value="Toelichting op de DOS score." /> </extension> </extension> </definition> <min value="0" /> <max value="1" /> <type> <code value="string" /> </type> </element> </differential> </StructureDefinition>