Patients should answer each question in Sections A, B, C, and D (questions 1 to 16) on the day of infusion of Cycle 4 after home administration of study treatment (only patients who have not discontinued from study treatment by Cycle 4) and at the 30-day post-discontinuation visit (all subjects). | |
---|---|
A) Please evaluate your hospital experience in this trial | Â |
1. What do you consider advantages of having chemotherapy at hospital? Please specify which ones (choose all that apply): | Support from other patients |
Access to other medical specialists | |
Access to more technical services | |
Safer in case something goes wrong | |
Other (specify): | |
2. What do you consider disadvantages of having chemotherapy at hospital? | Need to travel |
Having to wait for treatment | |
Please specify which ones (choose all that apply): | |
Not having a personalised treatment | |
Lack of privacy on the ward | |
Other (specify): | |
3. How would you rate your overall satisfaction with chemotherapy at the hospital? | Very dissatisfied |
Somewhat dissatisfied | |
Neither satisfied nor dissatisfied | |
Somewhat satisfied | |
Very satisfied | |
4. How would you rate your overall satisfaction with the nursing staff during chemotherapy at the hospital? | Very dissatisfied |
Somewhat dissatisfied | |
Neither satisfied nor dissatisfied | |
Somewhat satisfied | |
Very satisfied | |
B) Please evaluate your home experience in this trial | Â |
5. What do you do consider advantages of having chemotherapy at home? | No need to travel |
Not having to wait for treatment | |
Please specify which ones (choose all that apply): | |
Personalised service | |
More privacy | |
Other (specify): | |
6. What do you consider disadvantages of having chemotherapy at home? | Lack of other patients’ support |
Please specify which ones (choose all that apply): | |
Extra burden for family/friends | |
Safety concerns | |
Need to rely on one medical specialist | |
Other (specify): | |
7. How would you rate your overall satisfaction with chemotherapy at home? | Very dissatisfied |
Somewhat dissatisfied | |
Neither satisfied nor dissatisfied | |
Somewhat satisfied | |
Very satisfied | |
C) Could you please provide us additional information regarding your home care nurse during your home treatment? | Â |
8. Was the nurse an easy person to talk to? | Yes/No |
9. When the nurse came, did you feel he/she had enough time to do the required things? | Yes/No |
10. Do you think the nurse had time to discuss things with you? | Yes/No |
11. Did you feel that the nurse knew enough about you and your illness? | Yes/No |
12. Were you able to get all the information you wanted about your illness or treatment? | Yes/No/Uncertain |
13. Would you say that the nurse gave: | a lot of reassurance and support; |
some reassurance and support; | |
hardly any reassurance and support? | |
14. How would you rate your overall satisfaction with the nursing staff during chemotherapy at home? | Very dissatisfied |
Somewhat dissatisfied | |
Neither satisfied nor dissatisfied | |
Somewhat satisfied | |
Very satisfied | |
D) Could you please evaluate your preferences regarding home and/or hospital treatment? | Â |
15. Do you prefer having your chemotherapy at home or at the hospital, or are you indifferent? | Home/Hospital/Indifferent |
16. Would you recommend having chemotherapy at home to someone else in your same situation? | Yes/No/Not sure |