Service User Survey 2019
At MD Support Centre we are constantly striving to measure and demonstrate the value of the work we do, and to improve and adapt our services to better meet the needs of our service users. A little of your time spent filling in the survey means a lot to us.
Many thanks,
The MD Support Centre Team
* Required
1. I Identify as:
*
Male
Female
Prefer not to say
Required
I am between the ages of
*
18-30
31-50
50+
Prefer not to say
Required
My condition is
Axonal Sensory Peripheral Neuropathy
Becker
Bethlem Myopathy
Charcot-Marie Tooth (CMT)
Congenital Myotonic Dystrophy
Distal Arthrogryposis
Distal Hereditary Motor Neuropathy
Duchenne
Emery-Dreifuss
Facioscapulohumeral (FSH)
Friedrich’s Ataxia
Inclusion Body Myositis
Juvenile Dermatomyositis
Limb-Girdle
Mini-Core Myopathy
Mitochondrial DNA Disease
Mitochondrial Muscle Disorder
Myofibrillar Myopathy
Myotonic
Nemaline Myopathy
Niemann Pick Disease
Peripheral Neyropathy
Pombe Disease
Spinal Muscular Atophy (SMA)
Ullrich MD
Prefer not to say
Other (please specify):
If you selected 'other' please give details
Your answer
How often do you attend MDSC?
fortnightly
monthly
every two months
other (please specify)
If you selected 'other' please give details
Your answer
5. How beneficial do you consider your therapy to your wellbeing?
Very beneficial
Somewhat beneficial
Neither beneficial nor unhelpful
Do not receive/ not applicable
Physiotherapy
Osteopathy
Hydrotherapy
Complementary therapy
Pilates Classes
Very beneficial
Somewhat beneficial
Neither beneficial nor unhelpful
Do not receive/ not applicable
Physiotherapy
Osteopathy
Hydrotherapy
Complementary therapy
Pilates Classes
6. Are there any barriers to you attending therapies?
Your answer
7. What other services would you be interested in accessing?
Yoga classes
Counselling
Online group classes (via private video feed)
In-Centre advocacy services provided by Muscular Dystrophy UK (not affiliated with our Centre)
In-Centre NHS Neuromuscular Care Advisor (by prior arrangement)
Other (please specify)
If you selected 'other' please give details
Your answer
8. What impact does the MD Support Centre have upon your wellbeing?
Improves
Doesn't change
Worsens
My self confidence
My inspiration to achieve more in my life
My feeling of being in control
My self esteem
My knowledge
Improves
Doesn't change
Worsens
My self confidence
My inspiration to achieve more in my life
My feeling of being in control
My self esteem
My knowledge
Coming to the MD Support Centre for therapy has meant that I have been able to:
Understand and manage my condition confidently
Do more with family/friends
Travel/ have a holiday
Drive a car
Do things around the house
Have a hobby
Other (please specify)
If you selected 'other' please give details
Your answer
10: My therapy: Please indicate the level of agreement with the following statements
Fully achieved
Partly achieved
Not achieved
Deteriorated
N/A
Keeps my joints flexible
Maintains my muscle strength
Keeps me walking
Helps me stay in work (paid or voluntarily)
Keeps me out of hospital
Reduces/ prevents me from having falls
Enables me to manage pain
Fully achieved
Partly achieved
Not achieved
Deteriorated
N/A
Keeps my joints flexible
Maintains my muscle strength
Keeps me walking
Helps me stay in work (paid or voluntarily)
Keeps me out of hospital
Reduces/ prevents me from having falls
Enables me to manage pain
11. What impact does the MD Support Centre have on the progression of your condition?
Slows deterioration
Prevents deterioration
Makes no difference
Speeds up deterioration
Other (please specify)
12. Have you had any unplanned hospital admissions in the last 12 months?
Yes
No
13. If yes, how many?
Your answer
14. Have you received MD Support Centre Physio when you've had and urgent or acute issue? If yes, please tick a box below to indicate the type of issue:
Acute chest infection
Injury after a fall
Acute pain (eg. Neck, back, shoulder, etc)
Some other urgent problem (please specify)
If you selected 'other' please give details
Your answer
15. If you answered YES to question above please say whether this avoided a visit to:
GP
Hospital A+E
Some other NHS department
16. Which professional do you feel plays the primary role in helping you manage your condition?
My GP
My Consultant
An MDSC therapist
Other (please specify)
If you selected 'other' please give details
Your answer
17. Thinking about your recent experiences at the MD Support Centre, how likely are you to recommend our services to friends and family if they needed similar care or treatment (please tick)?
Extremely likely
Likely
Neither likely nor unlikely
Unlikely
Extremely unlikely
Don't know
18. If you could change one thing about the MD Support Centre to make it better for you, what would it be?
Your answer
19. Do you have any other comments about MD Support Centre?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
Forms
