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PT Self-Care Survey March, 22.22
1.
Do you know what self-care is?
Yes
No
2.
Is it difficult for you to practice self-care?
Yes
No
3.
Is it difficult to know what to do to improve your sleep?
Yes
No
4.
Do you know how to slowly increase your activity and become more functional despite your pain?
Yes
No
5.
Would you be willing to learn how to practice self-care if you had guidance and support to help you through the process to find out which self-care practices will actually help you to reduce your pain?
Yes
No
6.
How important is it to you to take back control over your health?
1 Not Important
2
3
4
5
6
7
8
9
10 Very Important
7.
Do you believe that with the right kind of help you could reduce your pain and improve your health?
Yes
No
8.
How valuable would it be to you to have access to a program on your phone that:
could personalize (based on your input) and guide you on a daily basis, by way of digital messaging, human coaching, video education, and interaction with pain experts and others in the pain community,
to help you to evaluate, test, and then practice your own individualized self-care program, where you can track and see improvements and be given the motivation to help you to achieve your
overall health and reduction of pain goals?
1 not valuable
2
3
4
5
6
7
8
9
10 very valuable
Please explain why