Covid-19 Impact on cancer patients

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Thank you for volunteering to participate in a two minute research survey. You do not have to worry about privacy as this study is totally anonymous.

1. Which country does the patient live ? *

2.Age of the patient *

3. Gender of the patient *

Male

Female

Other

4.Number of years since cancer was diagnosed ?

5. Current/Previous treatments for cancer if any ?

Surgery

Chemotherapy/drugs

Radiotherapy

Other:

6.Have you been tested positive for COVID-19 ?

Yes

Not sure

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7.Did you decide not to attend in-person doctor appointment due to Covid-19 ?

Yes

Other:

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8.Did you participate in a telehealth medical appointment ( e.g., Zoom, google meet, facetime) since Covid-19 pandemic ?

never

once

few

many

Clear selection

9.If you had a telehealth appointment for cancer care, how satisfied are you on a scale from 1-5 with your experience ?

Very dissatisfied

Very satisfied

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10.What did you miss the most in telehealth consultation/treatment as compare to in-person visit ?

11.How much do you feel anxious/worried for your cancer ?

Not at all

A little bit

Somewhat

Quite a bit

Very much

Clear selection

12.How much do you feel fragile/vulnerable for your cancer ?

Not at all

A little bit

Somewhat

Quite a bit

Very much

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13.How much impact is COVID-19 outbreak having on the quality of your cancer care/treatment ?

Not at all

A little bit

Somewhat

Quite a bit

Very much

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14.Since the breakout of the COVD-19 pandemic: I experience the following emotional distress

I worry about possibly infecting others.

I am concerned about a family member or close friend getting or dying from covid-19

I fear how covid-19 pandemic will impact my cancer care or recovery

I am concerned that cancer puts me at greater risk for being infected or dying from COVID-19

I do not have any emotional distress

15.Since the breakout of the COVD-19 pandemic: My concerns about medical care

My cancer care or follow up has been disrupted or delayed

I experience disruptions in day to day social interactions with family and or friends

I have been unable to perform my typical daily routines( eg., work, physical activity, leisure)

I have had difficulty or been unable to perform my work as usual.

No concerns about medical care

16. I experience the following perceived benefits due to the pandemic

I have greater appreciation for my family and close friends

I have deeper appreciation for life

I have been more grateful for each day

I have been more accepting of things that I cannot change

I have found new ways of connecting with family and friends

I have used my experience in coping with cancer to deal with Covid-19

I do not experience any perceived benefits

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