跌倒衛教影片問卷

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跌倒衛教影片問卷

看完影片後請回答下列問題

10D病房衛教影片-住院病人跌倒預防

衛教者 *

請問您的身分是? *

家屬

病人本人

Other:

請問您的床號是?

住院病人的診斷為？ *

乳癌

頭頸癌(包含口腔癌、喉癌、舌癌、唇癌、頰部、牙齦部、咽部)

消化道系統癌症(大腸、直腸、肛門、胃癌、食道、胰臟、膽管、肝癌)

肺癌

淋巴癌

血液癌(包含急性白血病、慢性白血病、多發性骨髓瘤、骨髓再生不良症候群)

生殖系統癌症(卵巢癌、子宮頸癌、輸卵管、陰道癌、睪丸癌、陰莖癌、前列腺癌)

泌尿系統癌症(腎臟癌、輸尿管癌、膀胱癌、尿道癌)

腦腫瘤

Other:

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