ID
10082
Beskrivning
CALGB: SOCIAL SUPPORT FORM 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=A50BF99D-12AE-2D64-E034-080020C9C0E0
Länk
Nyckelord
Versioner (2)
- 2014-12-18 2014-12-18 - Martin Dugas
- 2015-03-23 2015-03-23 - Martin Dugas
Uppladdad den
23 mars 2015
DOI
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Licens
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.
Beskrivning
Social support
Alias
- UMLS CUI-1
- C0037438
Beskrivning
Abouthowmanyclosefriendsandcloserelativesdoyouhavenow(peopleyoufeelateasewithandcantalktoaboutwhatisonyourmind)?
Datatyp
integer
Alias
- UMLS CUI-1
- C0079382
- UMLS CUI-2
- C0449788
Beskrivning
Someonetohelpifyouwereconfinedtobed
Datatyp
text
Beskrivning
Someoneyoucancountontolistentoyouwhenyouneedtotalk
Datatyp
text
Beskrivning
Someonetogiveyougoodadviceaboutacrisis
Datatyp
text
Beskrivning
Someonetotakeyoutothedoctorifyouneededit
Datatyp
text
Beskrivning
Someonewhoshowsyouloveandaffection
Datatyp
text
Beskrivning
Someonetohaveagoodtimewith
Datatyp
text
Beskrivning
Someonetogiveyouinformationtohelpyouunderstandasituation
Datatyp
text
Beskrivning
Someonetoconfideinortalktoaboutyourselforyourproblems
Datatyp
text
Beskrivning
Someone who hugs you (11.)
Datatyp
text
Beskrivning
Someonetogettogetherwithforrelaxation
Datatyp
text
Beskrivning
Someone to prepare your meals if you were unable to do it yourself (13.)
Datatyp
text
Beskrivning
Someone whose advice you really want (14.)
Datatyp
text
Beskrivning
Someone to do things with to help you get your mind off things (15.)
Datatyp
text
Beskrivning
Someone to help you with daily chores if you were sick (16.)
Datatyp
text
Beskrivning
Someone to share your most private worries and fears with (17.)
Datatyp
text
Beskrivning
Someone to turn to for suggestions about how to deal with a personal problem (18.)
Datatyp
text
Beskrivning
Someone to do something enjoyable with (19.)
Datatyp
text
Beskrivning
Someone who understands your problems (20.)
Datatyp
text
Beskrivning
Someone to love and make you feel wanted
Datatyp
text
Similar models
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.
C1705108 (UMLS 2011AA)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C0449788 (UMLS CUI-2)