Health Coaching SIG Survey This survey will take you 5 minutes and help shape the Health Coaching SIG agenda and its impact. We have identified 5 themes where health coaching can make an important contribution to your work in supporting your patients. We are working closely with the Mental Health Professionals SIG who will also benefit from your response. We would like your input on these themes. About You Question Title * 1. Are you a member of SIO? Yes No Question Title * 2. Your Role Physician Surgeon Clinical Oncologist Integrative Physician Nurse Allied Health Professional Integrative Practitioner Mental Health Practitioner Other (please specify) Question Title * 3. Country in Which You Practice Question Title * 4. What type of institution do you work in? (can check multiple boxes)- Academic-university setting Academic affiliated hospital Regional hospital system Community Hospital Cancer Center Cancer support non-profit Other (please specify) Question Title * 5. Is there a formalized Integrative Medicine department within your health institution? Yes No Question Title * 6. If You Answered Yes to Question 4: Do they provide care for oncology patients Yes No Question Title * 7. If You Answered Yes to Question 4: Would you qualify it as a formalized Integrative Oncology program/department? Yes No Theme 1: Emotional Concerns Question Title * 8. How Frequently do you discuss Emotional Concerns during your patient consultation? 1 Not at all 3 Somewhat 5 Often Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 9. What level of IMPORTANCE do your patients place on this theme (Emotional Concerns)? 1 Not Important 3 Average 5 Significant Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 10. How well is your practice doing to support patients Emotional Concerns? Question Title * 11. Who are the Top Two Professionals you refer your Patients to for Emotional Concerns? Nutritionist/Registered Dietician Social Worker Exercise Physiologist Lifestyle Medicine Practitioner Licensed Mental Health Professional Peer Group/Support Group Nurse/ Nurse Practitioner Yoga Therapist/Mindfulness/Meditation Health Coach Health Education Professional None of the above Other (please specify) Question Title * 12. Indicate the Top Two Barriers to supporting your patients with Emotional Concerns Limited Discussion in Consultation Not part of my role Low patient motivation Insurance does not pay for it Do not have someone to refer to Insufficient time Other (please specify) Theme 2: Developing a Healthy Lifestyle Question Title * 13. How Frequently do you discuss Developing a Healthy Lifestyle during your patient consultation? 1 Not at all 3 Somewhat 5 Often Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 14. What level of IMPORTANCE do your patients place on this theme (Developing a Healthy Lifestyle)? 1 Not Important 3 Average 5 Significant Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 15. How well is your practice doing to support patients in Developing a Healthy Lifestyle? Question Title * 16. Who are the Top Two Professionals you refer your Patients to for Developing a Healthy Lifestyle? Nutritionist/Registered Dietician Social Worker Exercise Physiologist Lifestyle Medicine Practitioner Licensed Mental Health Professional Peer Group/Support Group Nurse/ Nurse Practitioner Yoga Therapist/Mindfulness/Meditation Health Coach Health Education Professional None of the above Other (please specify) Question Title * 17. Indicate the Top Two Barriers to Supporting your Patients Develop Healthy Lifestyles Limited Discussion in Consultation Not part of my role Low patient motivation Insurance does not pay for it Do not have someone to refer to Insufficient time Other (please specify) Theme 3: Relationships – to self and others Question Title * 18. How Frequently do you discuss Relationships during your patient consultation? 1 Not at all 3 Somewhat 5 Often Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 19. What level of IMPORTANCE do your patients place on this theme (Relationships)? 1 Not Important 3 Average 5 Significant Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 20. How well is your practice doing to support patients with their Relationships? Question Title * 21. Who are the Top Two Professionals you refer your Patients to for addressing Relationships? Nutritionist/Registered Dietician Social Worker Exercise Physiologist Lifestyle Medicine Practitioner Licensed Mental Health Professional Peer Group/Support Group Nurse/ Nurse Practitioner Yoga Therapist/Mindfulness/Meditation Health Coach Health Education Professional None of the above Other (please specify) Question Title * 22. Indicate the Top Two Barriers to offering Support to address Relationships Limited Discussion in Consultation Not part of my role Low patient motivation Insurance does not pay for it Do not have someone to refer to Insufficient time Other (please specify) Theme 4: Managing Symptoms Question Title * 23. How Frequently do you discuss Managing Symptoms during your patient consultation? 1 Not at all 3 Somewhat 5 Often Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 24. What level of IMPORTANCE do your patients place on this theme (Managing Symptoms)? 1 Not Important 3 Average 5 Significant Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 25. How well is your practice is doing to support patients in Managing Symptoms? Question Title * 26. Who are the Top Two Professionals you refer your patients to Manage Symptoms? Nutritionist/Registered Dietician Social Worker Exercise Physiologist Lifestyle Medicine Practitioner Licensed Mental Health Professional Peer Group/Support Group Nurse/ Nurse Practitioner Yoga Therapist/Mindfulness/Meditation Health Coach Health Education Professional None of the above Other (please specify) Question Title * 27. Indicate the Top Two Barriers to offering Support to Manage Symptoms Limited Discussion in Consultation Not part of my role Low patient motivation Insurance does not pay for it Do not have someone to refer to Insufficient time Other (please specify) Theme 5: Reset/Recovery – integrating cancer into my life Question Title * 28. How Frequently do you discuss Reset/Recovery during patient consultation? 1 Not at all 3 Somewhat 5 Often Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 29. What level of IMPORTANCE do your patients place on this theme (Reset/Recovery?) 1 Not Important 3 Average 5 Significant Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 30. How well is your practice doing to support patients in Reset/ Recovery? Question Title * 31. Who are the Top Two Professionals you refer your Patients to Reset and Recovery? Nutritionist/Registered Dietician Social Worker Exercise Physiologist Lifestyle Medicine Practitioner Licensed Mental Health Professional Peer Group/Support Group Nurse/ Nurse Practitioner Yoga Therapist/Mindfulness/Meditation Health Coach Health Education Professional None of the above Other (please specify) Question Title * 32. Indicate the Top Two Barriers to Supporting Reset/Recovery Limited Discussion in Consultation Not part of my role Low patient motivation Insurance does not pay for it Do not have someone to refer to Insufficient time Other (please specify) Question Title * 33. Have you referred to a Health Coach within Cancer Care? Yes No Question Title * 34. Which of the following areas would you be comfortable referring to a health coach to support your patients: Emotional Concerns Developing a Healthy Lifestyle Managing Symptoms Relationships - to self and others Reset/Recovery – integrating cancer into my life Other (please specify) None of the above Done
