PLEASE TICK WHICH OF YOUR TEAM MEMBERS (INCLUDING YOURSELF) has a MAJOR ROLE in discussing patient problems in the following areas.(You may tick more than one box for each area). | ||||||||||
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Surgeon | Oncologist | Breast care nurse | Radiologist | Radiographer | Research nurse | Clinic nurse | Ward nurse | Chemo nurse | Other (please state) .................................................... | |
Physical well being (i.e. pain, side effects, lethargy) | ||||||||||
Functional well being (i.e. work, sleeping) | ||||||||||
Sexual well being (i.e. attractiveness, personal relationships) | ||||||||||
Social well being (i.e. social activities, relationship with family and friends) | ||||||||||
Psychological/ emotional well being (i.e. depression, anxiety, hope) |