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©
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©
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©
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Thank you for your interest in the BAASIS©. Since this instrument is under copyright at the University of Basel we will require some information before we can grant you permission to use the scale.
In order to obtain the permission to use the BAASIS© for either a clinical or a research project, please fill out all sections below. It is crucial to provide sufficient detail on the organization where the project is conducted, details of the principle investigator as well as details of the senior supervisor/director overviewing the research and/or clinical setting. Please provide methodological details of your project to allow us to understand how your clinical or research project is organized. This information is needed for ongoing optimization and validation studies of the BAASIS©.
Principal Investigator:
The person, who conducts the project.
First Name
*
Last Name
*
Organization
*
Position in the project
*
--- Please choose ---
Student
Junior researcher
Senior researcher
Clinician
Other, please specify
Please specify your position
Email
*
Phone
*
Address
*
Street Address
City
ZIP / Postal Code
Country
*
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darrussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Additional contact person (senior supervisor/director)
The person, who is overviewing the research and/or clinical setting and who has a permanent position allowing him/her to serve as contact person over a long time period.
The 2nd person's name needs to be different from the 1st person's name.
First Name
*
Last Name
*
Organization
*
Position in the project
*
--- Please choose ---
Senior supervisor
Senior researcher
Leading clinician of the program
Project coordinator
Other, please specify
Please specify the position
Email
*
Country
*
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darrussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Project Description
Note: All information must be provided in English!
Title of project
*
Type of project
*
--- Please choose ---
Research study
Clinical project
Design of the project
*
--- Please choose ---
Experimental or quasi experimental
Observational cross-sectional
Observational cohort
Observational case control
Implementation science study
Only clinical use
Type of population
*
--- Please choose ---
Kidney transplant
Heart transplant
Lung transplant
Liver transplant
Stem cell transplant
Other, please specify
Please specify population
Expected number of participants
*
Time period of the planned research:
From
*
DD dot MM dot YYYY
To
*
DD dot MM dot YYYY
Aims of the project
*
Inclusion and exclusion criteria
*
Other adherence measurement used in the project (if applicable)
Other outcome variables assessed in addition to medication adherence, eg acute graft rejection, mortality etc. (if applicable)
Description of planned intervention. Please provide information in line with the TIDieR guidelines (if applicable)
TIDieR guidelines
Other information relevant for the project
This field is hidden when viewing the form
Abstract of planned research or clinical project:
*
Please add
detailed
info on aims and context of your study, also specify study design, sampling design & incl/excl criteria, other medication adherence measures in addition to the BAASIS, other outcome variables assessed in addition to medication adherence (if applicable), description of the intervention (if applicable) and planned statistical analysis.
External funding of the research / clinical project
*
--- Please choose ---
Pharmaceutical industry sponsored project
Clinical project (no external funding of the pharmaceutical industry)
Academic project (no external funding of the pharmaceutical industry)
You indicated that your study is purely an academic or clinical study with no sponsorship (in part or fully) from the pharmaceutical industry. Please confirm whether or not this is correct:
By checking YES, you confirm, that this project has no sponsorship from the pharmaceutical industry:
YES
NO, this project is sponsored by the pharmaceutical industry
You have specified, that your project is sponsored by the pharmaceutical industry.
Please provide further information about the type of external funding:
Type of external funding
*
Written & interview version of BAASIS
©
After accepting the terms of use you can select the language and type of BAASIS
©
needed for your research.
Terms of use of the BAASIS©:
©
:
I. The BAASIS
©
cannot be changed without written formal permission of the developers. Please contact us at baasis-nursing@unibas.ch.
II. The BAASIS
©
is under copyright at the University of Basel, permission needs to be requested for each new project in the future. Please contact us at baasis-nursing@unibas.ch.
III. Publications using the BAASIS
©
need to include the validation paper (Denhaerynck et al., 2023) and https://baasis.nursing.unibas.ch/ in the reference list.
Reference: Denhaerynck K, Dobbels F, Košťálová B, De Geest S; BAASIS consortium. Psychometric Properties of the BAASIS: A Meta-analysis of Individual Participant Data [published online ahead of print, 2023 Mar 23].
Transplantation
. 2023;10.1097/TP.0000000000004574. doi:10.1097/TP.0000000000004574
IV. Using the BAASIS
©
implies that you are willing to share your data for an ongoing validation project (psychometric properties of BAASIS
©
)
V. Any verbatim publication of the BAASIS
©
items and the full scale is prohibited and subject to retraction of the paper.
VI. You agree to send us all publications using the BAASIS
©
and you commit to send all publications of your project at time of acceptance of the paper to baasis-nursing@unibas.ch.
I agree
I agree to the BAASIS© terms of use
I agree
I have understood that the BAASIS© is under copyright of University of Basel and that therefore neither the BAASIS© as a whole nor individual items can be published verbatim. Its use is limited to research purposes only. Any verbatim publication of the BAASIS© will result in a request of retraction of the paper published. University of Basel reserves all rights in the BAASIS©.
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