"*" indicates required fields 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 ---StudentJunior researcherSenior researcherClinicianOther, please specifyPlease specify your positionEmail* Phone*Address* Street Address City ZIP / Postal Code Country*AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe 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 supervisorSenior researcherLeading clinician of the programProject coordinatorOther, please specifyPlease specify the positionEmail* Country*AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Project Description Note: All information must be provided in English!Title of project*Type of project*--- Please choose ---Research studyClinical projectDesign of the project*--- Please choose ---Experimental or quasi experimentalObservational cross-sectionalObservational cohortObservational case controlImplementation science studyOnly clinical useType of population*--- Please choose ---Kidney transplantHeart transplantLung transplantLiver transplantStem cell transplantOther, please specifyPlease specify populationExpected 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 guidelinesOther information relevant for the projectThis field is hidden when viewing the formAbstract 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 projectClinical 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©. Required language versions: Arabic Brazilian Portuguese Chinese Czech Dutch English French German Hebrew Hungarian Italian Japanese Korean Latvian Norwegian Persian Spanish Swedish Thai Traditional Chinese Turkish
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