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\ p None B a = c @ = Z ?N*8 X" 1 Arial1 Arial1 Arial1 Arial1 Arial1 Arial1 Arial General ` Table_3 G Item Subitens 1. Identification Name, HR, age and identification of the person responsible for the information given in the evaluation (patient and/or companion). 2. Information regarding disease and treatment4 Medical diagnosis, chemotherapy protocol, treatment purpose (as it may be altered), evaluation of oral chemotherapy compliance (if applicable to the context) and adverse reactions, based on the reference Common Terminology Criteria for Adverse Events, version 4.0(14) 3. Physical examination Same to the instrument of admission, with the addition of the scales of evaluation of phlebitis and infiltration as possible complications of the intravenous therapy 4. Psychosocial aspects Maintained the evaluation of communication, perception of illness and treatment, self-esteem and maintenance of Daily Life Activities&