ID
10083
Beschreibung
CALGB: ADHERENCE QUESTIONNAIRE FORM (FOLLOW-UP) Comparison of Combination Chemotherapy Regimens in Treating Older Women Who Have Undergone Surgery for Breast Cancer NCT00024102 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A50CC350-FC34-364B-E034-080020C9C0E0
Link
Stichworte
Versionen (2)
- 18.12.14 18.12.14 - Martin Dugas
- 24.03.15 24.03.15 - Martin Dugas
Hochgeladen am
24. März 2015
DOI
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Lizenz
Creative Commons BY-NC 3.0 Legacy
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Breast Cancer NCT00024102
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice. Print text in capital letters. Avoid contact with the edges of the boxes. Circle amended items and check "Amended data" box to the right. If submitting by mail, retain a copy for your records and send the original to the CALGB Data Management Center. If faxing, use an original form for maximum clarity in transmission and fax to 919-416-4990. If submitting electronically, click the Send button when you have completed the PDF version of the form.
Beschreibung
Compliance behavior
Alias
- UMLS CUI-1
- C1321605
Beschreibung
ThebenefitsofmycancertreatmentoutweighthedifficultiesIhaveinfollowingit.
Datentyp
text
Beschreibung
IbelievethattakingmycancermedicationistoomuchtroubleforwhatIwillgetoutofit.
Datentyp
text
Beschreibung
Becausetheschedulefortakingmycancermedicationistoodifficult,itisnotbeworthfollowingit.
Datentyp
text
Beschreibung
Takingmycancermedicationisbetterformethannottakingit.
Datentyp
text
Beschreibung
Takingmycancermedicationishelpingmetobehealthy.
Datentyp
text
Beschreibung
IwillbejustashealthyevenifIwerenottakingmycancermedication
Datentyp
text
Beschreibung
Ibelievethatmycancertreatmentishelpingtocuremeofcancer
Datentyp
text
Beschreibung
Itishardtobelievethatmycancertreatmentishelpingme
Datentyp
text
Beschreibung
Lotsofthingsaregettinginthewayoffollowingtheschedulefortakingmycancermedication
Datentyp
text
Beschreibung
Ineedmoreassistanceinordertofollowtheschedulefortakingmycancermedication.
Datentyp
text
Beschreibung
IamgettingthehelpIneedtofollowmycancermedicationschedule.
Datentyp
text
Beschreibung
Iamabletodealwithanyproblemsintakingmycancermedication.
Datentyp
text
Beschreibung
Thesideeffectsofmycancermedicationdisruptmynormalactivities.
Datentyp
text
Ähnliche Modelle
INSTRUCTIONS: Complete and submit this form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice. Print text in capital letters. Avoid contact with the edges of the boxes. Circle amended items and check "Amended data" box to the right. If submitting by mail, retain a copy for your records and send the original to the CALGB Data Management Center. If faxing, use an original form for maximum clarity in transmission and fax to 919-416-4990. If submitting electronically, click the Send button when you have completed the PDF version of the form.
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)