ID
10083
Descripción
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
Palabras clave
Versiones (2)
- 18/12/14 18/12/14 - Martin Dugas
- 24/3/15 24/3/15 - Martin Dugas
Subido en
24 de marzo de 2015
DOI
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Licencia
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.
Descripción
Compliance behavior
Alias
- UMLS CUI-1
- C1321605
Descripción
ThebenefitsofmycancertreatmentoutweighthedifficultiesIhaveinfollowingit.
Tipo de datos
text
Descripción
IbelievethattakingmycancermedicationistoomuchtroubleforwhatIwillgetoutofit.
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text
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Becausetheschedulefortakingmycancermedicationistoodifficult,itisnotbeworthfollowingit.
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text
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Takingmycancermedicationisbetterformethannottakingit.
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text
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Takingmycancermedicationishelpingmetobehealthy.
Tipo de datos
text
Descripción
IwillbejustashealthyevenifIwerenottakingmycancermedication
Tipo de datos
text
Descripción
Ibelievethatmycancertreatmentishelpingtocuremeofcancer
Tipo de datos
text
Descripción
Itishardtobelievethatmycancertreatmentishelpingme
Tipo de datos
text
Descripción
Lotsofthingsaregettinginthewayoffollowingtheschedulefortakingmycancermedication
Tipo de datos
text
Descripción
Ineedmoreassistanceinordertofollowtheschedulefortakingmycancermedication.
Tipo de datos
text
Descripción
IamgettingthehelpIneedtofollowmycancermedicationschedule.
Tipo de datos
text
Descripción
Iamabletodealwithanyproblemsintakingmycancermedication.
Tipo de datos
text
Descripción
Thesideeffectsofmycancermedicationdisruptmynormalactivities.
Tipo de datos
text
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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)