Role functioning
Keep up with household tasks. Scale 0-10; not at all–usual
Confidence in ability to care for child. Scale 0-10; no confidence–very confident
Independence. Scale 0-10; very clingy–as usual
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What is it like caring for your child when they are ill?
What are the extra resources and help required to keep your family functioning during fever neutropenia episodes?
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Emotional functioning
Level of concern about child’s condition. Scale 0-10; very anxious–very calm
Confidence in ability to care for child. Scale 0-10; no confidence–very confident
Satisfaction with overall care. Scale 0-10; very unhappy–very happy
Mood. Scale 0-10; very upset–very happy
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How has your child’s illness emotionally affected you?
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Cognitive functioning
Interest or concentration. Scale 0-10; not as usual–as usual
Sleep at night. Scale 0-10; much worse–as usual
Activity or energy level. Scale 0-10; not at all–most of the time
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Will you describe how school and work have been affected by your child’s illness?
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Social functioning
Spend time with partner. Scale 0-10; not at all–usual
Spend time with other children. Scale 0-10; not at all–usual
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How has your child’s illness affected members in your family?
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SymptomsAppetite. Scale 0-10; very poor–very good
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How are symptoms different when you are at home versus in the hospital?
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GlobalWell-being. Scale 0-10; very poor–very good
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In your opinion, what value listed above is most important to you?
Is there anything else you would like to share about caring for your child during fever neutropenia?
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