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End of Life Care Education Internet Project Users Survey

Please complete the following survey to let us know about your experience using the site. Your feedback is valuable to us in our effort to improve this site and better meet your needs.

1. How did you find the End of Life Care Education Website? (Check all that apply.)
	Search Engine	Recommendation from Friend/Colleague
	Link from Other Site	Recommendation from Health Care Provider
	Inservice Program	Advertisement (please specify)
	Other (please specify)

 

2. How often have you used this site?
	Once	Twice
	3 – 4 Times	5 or More Times

 

3. What is the longest period of time you have used the site on a single occasion?
	More than an hour	31 minutes to an hour	16 to 30 minutes
	5 to 15 minutes	Less than 5 minutes

 

Please let us know about your general experience with our End of Life Care Education Website.
	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
4. Easy to use and navigate.
5. Attractive design and layout.
6. Material was well organized.
7. Structure was intuitive and logical.
8. Graphics were pleasing and effective.
9. Found what I was looking for quickly.
10. Convenient way to learn about palliative care and end-of-life decisions.

 

Information provided at the End of Life Care Education Website:
	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
11. Was up to date.
12. Was appropriate to my level of training and experience.
13. Was helpful to me in caring for my patients or my loved ones.
14. Provided a valuable learning experience for me.

 

15. Please indicate how helpful the content of each of the following specific areas of the End of Life Care Education Website is to you in your current work:
	Helpful	Not Helpful	Did Not Use
a. Pain control and symptom management.
b. Cultural and religious issues.
c. Psychology of dying & grief.
d. Ethical and legal issues.

 

16. Based upon your overall impression of the End of Life Care Education Website:
	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
a. I intend to use this Internet site again.
b. I would recommend this Internet site to others.
c. Fully met my expectations.
d. Was worth my time and effort.
e. I was fully satisfied.
f. Compares favorably with other medical information websites.

 

What about the site helped you the most? (Please limit to 20 lines)
What about the site did you like the least? (Please limit to 20 lines)
What about the site would you improve? (Please limit to 20 lines)

 

Please tell us about yourself:

D1. Are you a health care professional?
	Yes	No

 

D1a. If yes, what is your discipline?
	Nurse	Physician	Chaplain
	Social Worker	Psychologist	Volunteer
	Other (please specify)

 

D1b. If no, what is your interest in using this site?
	Patient	Family Member	Researcher
	Educator	Other (please specify)

 

D2. If you are a student, what is your level of training?
	Student	Intern	Resident or Fellow

 

D3. If you are a professional who has completed your training, what is your level of experience in this discipline?
	Less than five years	Five to ten years	More than ten years

 

D4. What percent of your current work involves the care of dying patients and their families?
	Less than 10%	11% to 25%	26% to 50%
	51% to 75%	More than 75%

 

D5. What computer and internet access do you have?
	Yes	No
a. Access to a computer at work?
b. Internet access at work?
c. Access to a computer at home?
d. Internet access at home?

 

D6. What is your gender?
	Male	Female

 

D7. What is your age?
	Under 18	18 - 29	30 - 39
	40 - 49	50 - 59	60 and older

 

D8a. What is your race or ethnicity?
	White/Caucasian	Black/African American	Asian
	Native American/American Indian	Multi-ethnic	Pacific Islander
	Other (please describe)

 

D8b. Are you of Hispanic or Latino ethnicity?
	Yes	No

 

D8c. If you are multi-ethnic, which of the following groups describe your ethnic background? Please check all that apply.
	White/Caucasian	Black/African American	Asian
	Native American/American Indian	Multi-ethnic	Pacific Islander
	Other (please describe)

 

D9. What is your city, state/province, country?

Thank you very much for completing this survey. We appreciate your effort to help us improve the site.