ID
10083
Descrição
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
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Versões (2)
- 18/12/2014 18/12/2014 - Martin Dugas
- 24/03/2015 24/03/2015 - Martin Dugas
Transferido a
24 de março de 2015
DOI
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Licença
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.
Descrição
Compliance behavior
Alias
- UMLS CUI-1
- C1321605
Descrição
ThebenefitsofmycancertreatmentoutweighthedifficultiesIhaveinfollowingit.
Tipo de dados
text
Descrição
IbelievethattakingmycancermedicationistoomuchtroubleforwhatIwillgetoutofit.
Tipo de dados
text
Descrição
Becausetheschedulefortakingmycancermedicationistoodifficult,itisnotbeworthfollowingit.
Tipo de dados
text
Descrição
Takingmycancermedicationisbetterformethannottakingit.
Tipo de dados
text
Descrição
Takingmycancermedicationishelpingmetobehealthy.
Tipo de dados
text
Descrição
IwillbejustashealthyevenifIwerenottakingmycancermedication
Tipo de dados
text
Descrição
Ibelievethatmycancertreatmentishelpingtocuremeofcancer
Tipo de dados
text
Descrição
Itishardtobelievethatmycancertreatmentishelpingme
Tipo de dados
text
Descrição
Lotsofthingsaregettinginthewayoffollowingtheschedulefortakingmycancermedication
Tipo de dados
text
Descrição
Ineedmoreassistanceinordertofollowtheschedulefortakingmycancermedication.
Tipo de dados
text
Descrição
IamgettingthehelpIneedtofollowmycancermedicationschedule.
Tipo de dados
text
Descrição
Iamabletodealwithanyproblemsintakingmycancermedication.
Tipo de dados
text
Descrição
Thesideeffectsofmycancermedicationdisruptmynormalactivities.
Tipo de dados
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.
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)