MDS Foundation - MDS MANAGER Technology Use Survey

Please take a minute to answer each question.  Select the answer that best describes your feelings about each question by clicking on that response. 

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* 1. I have been using MDS Manager

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* 2. When were you diagnosed with MDS (Month/Year)?

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* 3. In what state or province do you live?

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* 4. In what year were you born? (enter 4-digit birth year; for example, 1976)

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* 5. What is your gender?

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* 6. What is the highest level of education you have completed?

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* 7. What is your approximate average household income?

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* 8. Please indicate your IPSS-R Score

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* 9. I am currently receiving treatment for my MDS?

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* 10. I can get health information by myself.

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* 11. I have talked with my health care provider about participating in a clinical trial?

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* 12. I find mobile health applications useful in my daily life.

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* 13. Using mobile health applications helps me to accomplish things more quickly.

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* 14. Using mobile health applications increases my ability to manage my health.

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* 15. Using mobile health application is easy for me.

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* 16. It is easy for me to become skillful at using mobile health applications.

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* 17. My interactions with mobile health applications are clear and understandable

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* 18. I find mobile health applications easy to use.

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* 19. I intend to continue using mobile health applications in the future.

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* 20. I will continue to use mobile health applications frequently

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* 21. I will continue to use mobile health applications frequently

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* 22. I will continue to use mobile health applications in my daily life.

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* 23. I have at least one health care provider who knows me well.

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* 24. I have at least one health care provider I can discuss my health problems with.

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* 25. I have the health care providers I need to help me work out what I need to do.

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* 26. I can rely on at least one health care provider.

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* 27. I spend quite a lot of time actively managing my health.

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* 28. I make plans for what I need to do to be healthy.

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* 29. Despite other things in my life, I make time to be healthy.

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* 30. I set my own goals about health and fitness.

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* 31. I can get access to several people who understand and support me.

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* 32. When I feel ill, the people around me really understand what I am going through.

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* 33. There are things I do regularly to make myself more healthy.

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* 34. I have at least one person who can come to medical appointments with me.

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* 35. If I need help, I have plenty of people I rely on.

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* 36. I have strong support from family and friends.

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* 37. I make sure that health care providers understand my health care needs.

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* 38. I have good discussions about my health with my health care providers.

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* 39. I discuss things with my health care provider until I understand all I need to.

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* 40. I feel able to discuss my health concerns with my health care provider.

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* 41. I ask healthcare providers questions to get the health information I need

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* 42. I can find the right healthcare.

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* 43. I can get to see the health care provider I need to manage my health.

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* 44. I can decide which healthcare provider I need to see

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* 45. I can make sure I find the right place to get the healthcare I need.

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* 46. I can find out what health care services I am entitled to.

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* 47. I can find information about health problems.

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* 48. I can get information about my health so I am up to date with the best information

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* 49. I can get information from several different places.

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* 50. I can get health information in words I understand.

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* 51. Please offer any additional comments about your ability to manage your health

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* 52. I currently use a patient portal to access my health information from my health care provider 

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* 53. I was able to install MDS Manager

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* 54. I was able to enter symptoms using the symptom tracker

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* 55. I have shared my symptom information with my health care team

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* 56. I was able to access the Clinical Trials web page for the MDS Foundation using MDS manager

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* 57. I have discussed clinical trials with my health care team

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* 58. I have participated in a clinical trial

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* 59. I was able to access additional resources on the MDS Foundation web page using MDS manager

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* 60. I was able to access the Quick Tips on the MDS Foundation web page using MDS Manager

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* 61. I found the Quick Tips to be

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* 62. I would like to learn more about MDS Manager and MDS Resources

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* 63. Please enter your email address if you would like more information about MDS Manager and MDS Foundation Resources.

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