OncoLink Surveys

Primary Care Doctor's role in Cancer Survivorship: Internet Based Study

We are interested in your opinion about how your primary care doctor (family doctor or general internist) can provide the best care for you as a survivor.


Please read the informed consent before completing this survey.

Sex:
Race:
Age at Diagnosis:
Current Age:
Highest Education Level:
What is your relationship to the patient?
What Type of Cancer?
Select all that apply by holding the control/Apple key then selecting
What Type of Treatment?
Select all that apply by holding the control/Apple key then selecting
Have you (or the patient) ever been offered survivorship health information before? No Yes
Who is currently managing your healthcare needs?

If other, please specify:
What is your geographical location?
USA
Canada
Other Country
Where do you consider yourself living?
Urban (city)
Suburban (Near city)
Rural (Country side)
Where have you received most of your cancer care?
University based cancer clinic/center
Non-university based cancer clinic/center in your community
Both
How far do you live from the cancer center where you received most of your cancer treatment?
Less than 20 miles (32 kilometers)
Greater than 20 miles (32 kilometers)

1. Have you ever had a primary care doctor?

Yes No

If No, who do you see for regular follow up?

OB/GYN (gynecologist)

Specialists, please specify:

2. Have you changed (switched) primary care doctor since your cancer diagnosis?

No Yes

If Yes, What is the main reason for the change?

Change in insurance

Change of residence

I don't like my previous primary care physician

3. How long have you known your current primary care doctor?

Less than 1 year 1-4 years 5-9 years 10 years or greater

4. How often have you seen your primary care doctor since the diagnosis of your cancer?

Not at all Once/yr 2-4 times/yr 5-11 times/yr
monthly or more

5. How much do you trust your primary care physician has your best interest as a patient?

Not at all Very Much So
0 1 2 3 4 5 6 7 8 9 10

6. Please tell us how much you agree with each statement about your primary care physician's ability to take care of you as a cancer survivor by checking the appropriate box:

Communicates well with my oncologist since my cancer diagnosis.
Strongly Disagree
Disagree
Not Sure
Agree
Strongly Agree
Is knowledgeable about the appropriate follow-up care for cancer survivors.
Strongly Disagree
Disagree
Not Sure
Agree
Strongly Agree
Is aware of the potential long term effects of cancer treatment.
Strongly Disagree
Disagree
Not Sure
Agree
Strongly Agree
Pays attention to my emotional well-being.
Strongly Disagree
Disagree
Not Sure
Agree
Strongly Agree
Is skilled at diagnosing and treating symptoms associated with cancer or cancer therapy.
Strongly Disagree
Disagree
Not Sure
Agree
Strongly Agree
Helps me live a healthier life by discussing diet, exercise, and weight management.
Strongly Disagree
Disagree
Not Sure
Agree
Strongly Agree
Is sensitive to my needs as a whole person.
Strongly Disagree
Disagree
Not Sure
Agree
Strongly Agree

7. How satisfied are you with your primary care doctor's care?

Not at all A little bit Somewhat Moderately Very Much

8. How well does your primary care doctor and oncologist(s) work together to treat you as a patient?

Outstanding Excellent Good Average Poor


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