Survey
My name is Mackenzy Skinner and I attend Maitland Grossmann High School. I am currently completing an Independent Research Project for the HSC course, Community and Family Studies. This questionnaire has been designed to investigate whether or not there are an adequate amount of support services for breast cancer patients in the Hunter Valley Area. All information gathered is confidential and your responses will be anonymous. If you feel uncomfortable you may skip the question and leave it blank. Your time, honesty and participation is greatly appreciated and valued. Highlight the answer in which you feel is correct, pick as many or as little as you please.
1. Age:
o 16-25
o 26-35
o 36-45
o 46-55
o 56+
2. Age when first diagnosed:
o <16
o 17-25
o 26-35
o 36-45
o 46-55
o 56+
3. Occupation
___________________
4. Have you ever accessed a formal service in regards to support?
o Yes
o No
5. If yes, which were they? If no go straight to question 8.
o Doctor
o Face to face support groups e.g. councellor/ social worker or psychologist
o Local Support Group
o Dragon Boat racing/ Enrich/ Encore program
o Physiotherapist/ lymphedema specialist
o Online discussion forums i.e. www.cancerconnections.com.au, www.bcna.org.au etc.
o Telephone support groups e.g. Cancer Council Helpline
Other ___________________
6. Why did you access them?
o Emotional ( e.g. counselling)
o Financial
o Physical (e.g. exercise & fitness, dragon boating, lymphedema massage)
o Social
o Other ____________
7. Were they helpful?
o Yes
o No
8. Have you accessed any informal services in regards to support?
o Yes
o No
9. If yes, which were they? If no go straight to question 13
o Family
o Friends
o Religious/ Spiritual advisor
o Other __________________
10. Where they helpful?
o Yes
o No
11. Why did you access them? (emotional, physical, financial)
o Emotional ( e.g. counselling)
o Financial
o Physical (e.g. exercise & fitness, dragon boating, lymphedema massage)
o Social
o Other _________________
If you answered NO to question 4
12. Why have you never accessed support?
o No time
o Didn’t know of any
o Other _________________
13. Which services have you heard of?
o BCNA ( Breast Cancer Network Australia)
o Dragon Boat Racing
o Look Good… Feel Better
o People Living with Cancer
o Quest for life foundation
o Cancer Council Helpline
o Other ______________________
14. How did you find out about the services?
o Friend
o Internet
o Doctor
o Hospital
o Other ________
15. Did the hospital provide you with any information on support groups?
o Yes
o No
16. Do you believe there is enough support for Breast Cancer patients?
o Yes
o No
Explain
Thank you for your time and help, it is appreciated. If you would like to add anything else please feel free.