Questions | Answers |
---|---|
A) Questions for the patient to be answered after the first infusion (administered at the hospital). | Â |
1. How long did the whole process take, from the time you arrived to the hospital until the time you left the hospital? | Hours: Minutes: |
2a. How long did the whole process take, from the time you left home until the time you got back home again? | Hours: Minutes: |
2b. How far did you have to travel from home to the hospital? | Miles/km (depending on country): |
2c. If you are travelling by public transport, how much does the return trip to hospital cost you? | Pounds/Swedish crowns (kronor): |
B) Questions for the patient to be answered before receiving the infusion at home at each cycle. The home care nurse can help the patient to answer these questions. | Â |
1. After your last chemotherapy, did you have any unplanned visits to the Accident and Emergency (A&E) department? | Yes/No/Unknown |
If yes, how many? | 1 2 3 4 ≥5 |
2. After your last chemotherapy, did you require any unplanned visits to your specialist (oncologist, pulmonologist, etc.)? | Yes/No/Unknown |
If yes, how many? | 1 2 3 4 ≥5 |
3. After your last chemotherapy, did you require any unplanned visits to your general practitioner (GP) or family doctor? | Yes/No/Unknown |
If yes, how many? | 1 2 3 4 ≥5 |
4. After your last chemotherapy, did you require any unplanned diagnostic procedures? | Yes/No/Unknown |
If yes, which ones? | Brain MRI |
Brain CT scan | |
PET scan | |
Chest radiography | |
Bone scintigraphy | |
Other (specify): | |
C) Questions for the patient to be answered after receiving the infusion at home at each cycle | Â |
1. How long did the whole process take, from the time the nurse arrived until the time the nurse left your home? | Hours: Minutes: |
D) Questions for the caregiver to be answered after the infusion at the hospital | Â |
1. How much additional time have you taken off work or for other duties related to infusion at the hospital? | Days: Hours: Minutes: |
E) Questions for the caregiver to be answered after the infusion at home at each cycle | Â |
1. How much additional time have you taken off work or for other duties related to infusion at home? | Days: Hours: Minutes: |
F) Questions for the home care nurse | Â |
1. To be answered after the infusion at home at each cycle | Â |
a. How long did the whole process take, from the time you left the hospital to the time you got to the patient’s home? | Hours: Minutes: |
b. How long did the whole process take, from the time you arrived at the patient’s home until the time you left patient’s home? | Hours: Minutes: |
2. To be answered only during the first infusion administered at home. | Â |
How far did you have to travel from hospital to the patient’s home? | Miles/km: |