Fallopian tube removal decision aid
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Enquete
What is your age?
*
Please let us know your name.
In which hospital will you undergo surgery?
In which hospital will you undergo surgery?
Catharina ziekenhuis Eindhoven
Amphia ziekenhuis Breda
Gelderse Vallei Ede
Other, namely:
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How did you discover the decision aid?
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?
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?
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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Why did you want to use the decision aid? (multiple answers possible)
Why did you want to use the decision aid? (multiple answers possible)
I wanted to get more information about removing the Fallopian tubes and the chance of developing ovarian cancer
I wanted to get more information about the pros and cons of removing the Fallopian tubes
I wanted to Gain more insight into the items that are important to me when making a decision
I wanted to get more information because I was unsure about my choice
I wanted to Check if I understood everything correctly
I wanted to get more information about the impact of Fallopian tube removal on the age of menopause
Other, namely: (open text field)
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What is your final choice?
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?
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?
What grade would you give the decision aid?
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10
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To what extent would you recommend the decision aid to an acquaintance or friend?
To what extent would you recommend the decision aid to an acquaintance or friend?
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2
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10
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Do you have any other comments or suggestions for improving the decision aid?
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?
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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