Opinion Survey from People with Wounds



INTRODUCTION
Thank you for taking part in this Survey. Your time and your opinions are valuable to us!

When a new wound care product is developed, it is tested on people who have wounds. In these tests, the researchers decide what results they want to keep track of in order to determine how well the product works. These results are called "endpoints". For example, the researchers may decide they want to track the measurements of a wound until it closes, or the color of the wound, or how much pain medicine is needed.

There are many results (endpoints) that researchers feel are very important. But researchers, the FDA, and Medicare and Medicaid want to do a better job of understanding how people with wounds feel. In this survey, we want to find out what is most important to you as you treat your wound.

We would like to hear from people with wounds or from their caregivers or family members.

Instructions for Returning the Survey
If you are answering the Survey on your computer online then please fill it out below and click the "Submit Survey" button on the bottom.
If you are filling out a paper version of the Survey, please complete and return the Survey by mail to:
Wound Healing Society
500 Cummings Center
Suite 4400
Beverly, MA 01915

Please tell us a little bit about yourself and your wound. Or tell us about the person you take care of and their wound.

How did you obtain this survey?
Downloaded from Internet
Wound Center, please enter clinic name:

1. Are you the person with the wound?
Yes No

2. Are you the family or caregiver for the person with the wound?
Yes No

3. What state does the person with the wound live in?


ANSWER ALL THE FOLLOWING QUESTIONS ABOUT THE PERSON WITH THE WOUND

1. Gender Male Female

2. Age Younger than 40 40-49 50-59 60-69 70-79 80 or older

3. Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

4. Ethnicity Hispanic or Latino Not Hispanic or Latino

5. Highest Level of Education
Did not complete high school
High school diploma or GED
One - Two years of college
Three - Four years of college
Graduate school
Professional degrees (MD, DDS, DVM, or JD) or PhD

6. Employment Status
Homemaking
Employed at a job for pay:
  Full-time   Part-time
Unemployed
Retired

7. Income Range (in last 12 months)
Less than $20,000
$20,000 to $34,999
$35,000 to $74,999
$75,000 or more

8. Who Helps You Treat your Wound?
Specialty wound care clinic
Wound specialist in their office
My regular doctor
Home Health/Visiting Nurse
Local emergency room or urgent care clinic
None of the above, I do it myself

9. Is the Person with the Wound a Diabetic?
Yes
No

10. How Long has the Wound Been Open?
0-6 months
6 months - 1 year
longer than 1 year

11. Has the person with the wound ever had an amputation? (check all that apply)
Toes
Foot
Lower Leg
Thigh Level
Fingers

Survey Questions

1. How valuable are each of the following endpoints to you? Please select one of the four choices below for each endpoint.
No value Low value Medium value High value
To reduce infection
To reduce amputations
To reduce the need to take antibiotics
To stop /reduce scarring
To reduce dead tissue in my wound
To reduce the chance of the wound returning
To lower what I have to pay for my care (for example hospital, emergency room, clinic, supplies and doctor visits costs)
To increase blood flow to my wound
To improve the strength of my healing wound


2. How valuable are each of the following endpoints in your daily life? These are known as QUALITY OF LIFE outcomes. Please select one of the four choices below for each endpoint.
No value Low value Medium value High value
To have less pain
To reduce swelling (edema)
To reduce the need for pain medicines for my wound
That my wound does not have an odor
To improve my ability to walk or do things for myself
To go outside my home, shop, to be able do things with my family and friends, go to work
To reduce sadness or depression related to having my wound


3. How much of a difference would each of these endpoints make in your life? Please select one of the four choices below for each endpoint.
No difference Little difference Medium difference Big difference
Quicker wound healing time
Reduce infection
Reduce amputation (loss of toe, foot, leg, etc.)
Decrease the need for antibiotics
Stop / reduce scarring
Lower what I have to pay for my care (for hospital, emergency room, clinic, supplies and doctor visits costs)
Less pain
Decrease the need for pain medication
Reduce or end swelling (edema)
Reduce or end odor
Improve my ability to walk or do things for myself
Reduce feelings of being isolated (able to maintain job, go to social events, do things with family/ friends, shop, go to church, etc.)
Reduce sadness or depression related to having my wound


4. In your opinion, which of the following do you believe would be useful to measure the success for a new drug, device or therapy for wound healing? Select up to 10 choices only.
Reduce wound size (by measurement)
Partial healing of the wound
Faster time to heal the wound
Reduce infection
Reduce amputations [loss of limb, toes, foot, or leg]
Reduce need for antibiotics
Stop / reduce scarring
Reduce dead tissue in your wound
Reduce the chance of the wound returning
Reduce my care costs (hospital, emergency room, clinic, and doctor visits)
Improve strength of the wound tissue once it is healed
Faster return to work, able to attend social activities with family/friends
Decrease Pain
Reduce or end swelling (edema)
Reduce the need for pain medication
Reduce or end wound odor
Improve physical function, do more for self or walking more / better
Reduce feelings of being isolated or not wanting to be in public
Reduce sadness or depression about the wound


5. In the open space below, please add any other valuable endpoints of treatment that may be important to you that have not been included in the questions. Please also add any other comments or questions you may have.