Glioma "*" indicates required fields Step 1 of 10 10% Glioma: Impact of treatments on patients’ lives and their Families Description Being socially active, like working and studying, is crucial for our financial and emotional well-being. Cancer, like glioma, profoundly affects our social engagement capabilities and entourage. Heal Canada, a not-for-profit patient organization, is working to understand glioma patients’ needs to improve healthcare services. The 15-minute survey covers treatments’ impact on your social engagement capabilities. To ensure your privacy and confidentiality, we have designed the survey without requiring identifying information. Your anonymized responses are used only by Heal Canada for this project. By participating in this survey, you share your experiences and contribute to a significant change in the brain tumour community. Your answers are instrumental in enhancing patient care. We sincerely appreciate your willingness to be a part of this positive change. Thank you. Diagnosis: What?1. What was your precise glioma diagnosis?* Astrocytoma Oligodendroglioma Glioblastoma Not sure Other (please specify) 1. What was your precise glioma diagnosis? (Specify)*2. Can you specify the grade of your cancer at diagnosis?* Grade 1 Grade 2 Grade 3 Grade 4 a. I don`t remember Diagnosis: When?3. How long ago did you receive your diagnosis?* less than 6 months 6 to 12 months 1 to 2 years 2 to 5 years More than five years 4. What was your age at diagnosis?* <18 years old 19-30 years old 31-49 years old 50-64 year old 65+ years old Diagnosis: Impact on your living situation5. Which of the following categories best describes your employment status at diagnosis?* Working and/or Studying full-time Working and/or Studying part-time Not working and/or studying, looking for work Not working and/or studying, not looking Retired Disabled, not able to work or study 6. In which city did you live at diagnosis?*7. Did you have to move to receive your glioma treatments?* No Yes General glioma impact on your work/study and financial situation8. How do your glioma-related needs affect your working or studying capabilities? Glioma-related needs include: tests, treatments and all medical follow-ups.* My glioma-related needs didn’t impact my working and/or studying capabilities I kept my job and/or study program, but I was frequently absent to accommodate my glioma-related needs. I reduced my working and/or studying hours to accommodate my glioma-related needs. I had to change jobs and/or career plans to accommodate my glioma-related needs I retired early to accommodate my glioma-related needs. I adhere to a disability program due to my glioma-related limitations Impact on your work/study and financial situation9. Did your glioma-related needs affect your caregivers' working or studying capabilities?* My glioma-related needs didn’t impact their working or studying capabilities. They kept their job and/or academic programs but were frequently absent to accommodate my glioma-related needs. They reduced their working and/or studying hours to accommodate my glioma-related needs. They changed jobs and/or career plans to accommodate my glioma-related needs. They retired early to accommodate my glioma-related needs. 10. Did glioma have a financial impact on your life and entourage? From 0 (no impact at all) to 100 (significant impact)* Surgery11. Did you receive surgery for your glioma treatment?* No Yes Watching-and-Waiting strategy (W&W)12. Since the diagnosis, did you have a period where you were on a watching-and-waiting strategy without active treatment (W&W)?* No Yes Chemotherapy13. Did you receive chemotherapy for your glioma?* No Yes Radiotherapy14. Did you receive radiotherapy for your glioma?* No Yes CommentsThis field is for validation purposes and should be left unchanged. Δ
