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Home-Care Survey

What are your attitudes, experiences, and habits regarding home-care?

1.How old are you?(Required.)
2.Gender:(Required.)
3.What is the highest level of education that you have completed?(Required.)
4.What is your current occupation?(Required.)
5.What is your total household (if single, personal) income per year?(Required.)
6.Language (Check all that you are fluent)(Required.)
7.How often do you go to the doctor?(Required.)
8.What types of medications / medical devices have you used? We want to understand which of these you have administered to yourself or others. (Choose all that apply)(Required.)
9.If you use any wearable wellness tools or use mobile wellness apps, please tell us what you currently use (e.g., heart rate monitor for running, nutrition app on phone, etc.)
10.How comfortable are you when using technology, like laptops, tablets, and cell phones?(Required.)
1 (Not at all comfortable)
2
3
4
5 (Very comfortable)
11.How comfortable would you be with administering oral medications that you DO NOT need to measure, such as pills, at home?(Required.)
1 (Not at all comfortable)
2
3
4
5 (Very comfortable)
12.How comfortable would you be with administering oral medications that you DO need to measure, such as liquid or suspension (powder/tablets you mix in water) medications, at home?(Required.)
1 (Not at all comfortable)
2
3
4
5 (Very comfortable)
13.How comfortable would you be with administering nasal or sprayable medications, including nebulizer-like products, at home?(Required.)
1 (Not at all comfortable)
2
3
4
5 (Very comfortable)
14.How comfortable would you be with administering topically applied medications, such as skin creams and gels, at home?(Required.)
1 (Not at all comfortable)
2
3
4
5 (Very comfortable)
15.How comfortable would you be with administering medication with an injection device, such as a syringe or auto-injector, at home?(Required.)
1 (Not at all comfortable)
2
3
4
5 (Very comfortable)
16.Overall, how confident are you that you have received the correct medication and dose if it is administered by a healthcare professional? (Required.)
1 (Not at all confident)
2
3
4
5 (Very confident)
17.Overall, how confident are you that you have received the correct medication and dose if you administer it yourself, according to your doctor’s orders?(Required.)
1 (Not at all confident)
2
3
4
5 (Very confident)
18.If given the choice, would you prefer to go to the doctor to receive medication or administer the medication yourself at home?(Required.)
19.In the past, when you had questions regarding how to use a medical device, what did you do first?(Required.)
20.Ideally, if you had questions regarding how to use a medical device, where would you prefer to look first to find an answer?(Required.)
21.At what point would you seek professional assistance when using a medical device at home? (Choose all that apply)(Required.)
22.What would make you more comfortable with using medical devices to self-administer treatment at home?(Required.)
23.In the past, how did you usually remind yourself to take a medication that you had to take regularly (e.g., daily, weekly, twice a month, etc.)? Check all that apply.(Required.)
24.Ideally, how would you like to be reminded to take a medication that you have to take regularly (e.g., daily, weekly, twice a month, etc.)? Check all that apply.(Required.)