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Click ‘Get Form’ to open the Stanford Integrated Psychosocial Assessment for Transplant in the editor.
Begin by entering the patient's name and medical record number at the top of the form. This information is essential for identification.
Proceed to section A, where you will assess the patient’s readiness level. For each item, select a score from 0 to 4 based on the patient's understanding and willingness regarding their medical condition and treatment options.
In section B, evaluate the social support system. Identify available support persons and their engagement levels, scoring from 0 (excellent) to 8 (poor).
Move to section C, focusing on psychological stability. Assess any history of psychopathology and score accordingly using the provided criteria.
Finally, complete section D regarding lifestyle factors and substance use. Carefully review each question and assign scores based on the patient's habits.
Once all sections are filled out, calculate the total score at the end of the form to determine recommendations for transplant candidacy.
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