Table 1

Questionnaires used in the study

Patient questionnaires

Administered at baseline

• Basic demographic information (7 questions)

Administered at baseline and every week

ESAS (Edmonton Symptom Assessment System)

- 10 items on symptom assessment

Administered at baseline and every four weeks

PNPC-sv (Problems and Needs in Palliative Care - short version)

- 33 questions on experienced problems and needs for care

HADS (Hospital Anxiety and Depression Scale)

- 14 items on anxiety (7 items) and depression (7 items)

NCQ (Nijmegen Continuity Questionnaire)

- 28 items within 3 subscales on continuity of care

Family caregiver questionnaire

Administered at baseline and every two weeks

EDIZ (one dimensional assessment of care burden)

- 9 items on the experienced burden from informal care

Patient, GP and a member of the palliative consultation team

Administered after the first two teleconsultations

PSQ (Patient Satisfaction Questionnaire)

- 5 questions on satisfaction with the teleconsultation


Duursma et al. BMC Palliative Care 2011 10:13   doi:10.1186/1472-684X-10-13

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