Fallopian tube removal decision aid
Enquete
What is your age?
*
Please let us know your name.
In which hospital will you undergo surgery?
Amphia ziekenhuis
Bernhoven ziekenhuis
Catharina ziekenhuis
Anders
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How did you discover the decision aid?
Through my doctor
Through my relatives
Found it myself via the internet
Other
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Did you already know, before using the decision aid, whether you wanted to have your Fallopian tubes removed?
No, I did not know it yet
Yes, I already knew that I wanted my Fallopian tubes to be removed
Yes, I already knew that I did not want my Fallopian tubes to be removed
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To what extent did the decision aid help you in making a choice?
The decision aid helped me very much
The decision aid helped me somewhat
The decision aid helped me did not help
The decision aid helped me did not help at all
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Waarom wilde u de keuzehulp gebruiken?
Ik wilde meer informatie over het weghalen van de eileiders en de kans op het krijgen van eierstokkanker
Ik wilde meer informatie over de voor- en nadelen van het weghalen van de eileiders
Ik wilde meer inzicht in de dingen die voor mij belangrijk zijn bij het maken van een keuze
Ik wilde meer informatie omdat ik twijfelde over mijn keuze
Ik wilde controleren of ik alles goed begrepen heb
Ik wilde meer informatie over de invloed van het weghalen van de eileiders op de leeftijd waarop de overgang begint
Anders
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What is your final choice?
I want to have my Fallopian tubes removed
I do not want to have my Fallopian tubes removed
I am still undecided
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To what extent are you satisfied with the information in the decision aid?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
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What are you most satisfied with?
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What are you least satisfied with?
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What grade would you give the decision aid?
Your choice
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To what extent would you recommend the decision aid to an acquaintance or friend?
Your choice
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10
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Do you have any other comments or suggestions for improving the decision aid?
No
Yes
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Do you have any ideas on how we can raise more awareness among women regarding the relationship of the Fallopian tubes and ovarian cancer?
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May we contact you later for additional questions about the decision aid?
No
Yes
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Please enter your email and/or phone number.
Phone
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Email
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