Survey
1. Have you read the guide yet??
Yes
No
2. I understand the various types and grades of brain tumors.
1 = Strongly Disagree
2 = Disagree
3 = Neither Agree nor Disagree
4 = Agree
5 = Strongly Agree
3. I can identify the common symptoms of brain cancer.
1 = Strongly Disagree
2 = Disagree
3 = Neither Agree nor Disagree
4 = Agree
5 = Strongly Agree
4. I comprehend the diagnostic procedures used to confirm brain cancer.
1 = Strongly Disagree
2 = Disagree
3 = Neither Agree nor Disagree
4 = Agree
5 = Strongly Agree
5. I know the various treatment options available for brain cancer.
1 = Strongly Disagree
2 = Disagree
3 = Neither Agree nor Disagree
4 = Agree
5 = Strongly Agree
6. I can describe the potential side effects of brain cancer treatments and ways to manage them.
1 = Strongly Disagree
2 = Disagree
3 = Neither Agree nor Disagree
4 = Agree
5 = Strongly Agree
7. I feel confident in discussing treatment options with my medical team.
1 = Strongly Disagree
2 = Disagree
3 = Neither Agree nor Disagree
4 = Agree
5 = Strongly Agree
8. I feel equipped to communicate my condition, concerns, and decisions to my caregivers and loved ones.
1 = Strongly Disagree
2 = Disagree
3 = Neither Agree nor Disagree
4 = Agree
5 = Strongly Agree
(Respond to 9-11 only if you already read the guide!)
Yes
No
Maybe
10. Grade this guide on a scale of A=best, F=worst
A
B
C
D
F
11. Suggestions:
12.What is your age?
A. Less than 25 years old
B. 25 - 44 years old
C. 45 - 65 years old
D. 65+ years old
E. Prefer not to answer
13.
What gender do you identify as?
A. Male
B. Female
C. Other
D. Prefer not to answer
14. What is your ethnicity?
A. Caucasian
B. African-American
C. Latino or Hispanic
D. Asian
E. Native American
F. Native Hawaiian or Pacific Islander
G. Two or More
H. Other/Unknown
I. Prefer not to answer
15. What is the highest degree or level of education you have completed?
A. Some High School
B. High School
C. Bachelor´s Degree
D. Master´s Degree
E. Ph.D. or higher
F. Trade School
G. Prefer not to answer
