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> Questionnaire: Patient Experience Survey of Stroke Patients
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Questionnaire: Patient Experience Survey of Stroke Patients
Stroke Survey
This is a survey for people who have had RECENT experiences of stroke services – ie within the last year
1
Please indicate who is completing this questionnaire?
Select one
Patient
Relative
Carer
Other (Please specify)
2
At which hospital did you receive treament?
3
Which clinics do you attend?
4
If you rang 999 for an ambulance how long did it take for an ambulance to arrive?
5
What day of the week were you admitted to hospital
Tick all that apply
Day
Time (if known)
6
Which Accident and Emergency Department or Medical Assessment Unit were you taken to?
Select one
Royal Gwent Hospital
Nevill Hall Hospital
Other (Please specify)
7
Were you seen by a stroke nurse in the A and E or Medical Assessment Unit?
Select one
Yes (If yes, how long was this after arrival at the hospital)
No
Don't Know
8
How soon after arriving at A and E or Medical Assessment Unit did you have a scan?
How soon after arriving at A and E or Medical Assessment Unit did you have Thrombolysis (if required)?
9
When were you first told that you had had a stroke?
Select one
Before you went into hospital (eg the GP or ambulance crew, or other told you)
In the hospital
After you left hospital
Don’t know
10
What type of ward were you on for most of your hospital stay?
Select one
Stroke unit
Acute assessment ward
An intensive care unit
Don't Know
Other type of ward (please specify)
11
When you had important questions to ask a doctor, did you get answers that you could understand?
Select one
Always
Mostly
Never
Don't know
12
When you had important questions to ask nursing staff, did you get answers that you could understand?
Select one
Always
Mostly
Never
Don't Know
13
Were you involved as much as you wanted to be in decisions about your care and treatment in hospital?
Select one
Always
Mostly
Don't Know
14
Was enough information given to you about your condition and treatment in a language you could understand?
Select one
Always
Mostly
Never
Didn't know
15
If you needed help from staff in getting to the toilet or in providing a bedpan did you get it in time?
Select one
Always
Mostly
Never
Didn't need help
16
If you needed help from staff in eating your meals did you receive help when you needed it?
Select one
Always
Mostly
Never
Didn't need help
17
If you needed help from staff with brushing your teeth or other dental care did you receive it?
Select one
Always
Mostly
Never
Didn't need help
18
If you needed help from staff with washing yourself did you get help when you needed it?
Select one
Always
Mostly
Never
Didn't need help
19
If you needed help from staff with bathing did you get help when you needed it?
Select one
Always
Mostly
Never
Didn't need help
20
If you needed help from staff with showering did you get help when you needed it?
Select one
Always
Mostly
Never
Didn't need help
21
While you were in hospital did you get enough help with speech and communication problems?
Select one
Yes
No
Don't know
Did not have speech or communication problems
22
While you were in hospital did you get enough treatment to help improve your mobility? e.g. washing, dressing or walking
Select one
Yes
No
Don't know
Didn't have any mobility problems
23
While you were in hospital did you get enough help and support with any emotional issues which might be affecting you (such as confusion, depression or crying)?
Select one
Yes
No
Don't know
Didn't have any mobility problems
24
Before you left hospital were you given enough information about any medication you needed to take? (eg what it was for, how and when to take it, any possible side effects)
Select one
Yes, enough information
Some, but not enough
No information given
I had no medication to take home
25
Did hospital staff tell you who to contact if you were worried about your condition or treatment after you left hospital?
Select one
Yes
No
Don't know
26
Did hospital staff give you any information about national stroke organisations or local voluntary and support groups?
Select one
Yes
No
Don't know
27
Were there enough services available to help improve your condition when you left hospital? (eg occupational therapy, physiotherapy, speech therapy)
Select one
Yes, all the services I needed
Yes, some of the services I needed
No, not enough services available
Didn’t need any follow up services
28
Overall, how would you rate the care you received during your hospital stay?
Select one
Excellent
Very Good
Good
Fair
29
Is there anything which would have improved your care or treatment during your stay in hospital?