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Hello:
You are invited to participate in Pain Management Survey.
Your participation in this study is part of the course requirements for Psychology 201. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for me to gather your opinions on this topic.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Professor M. Haywood at 240-715-7929 or by email at the [email protected].
Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
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| Have you ever had a painful injury? |
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If you answered "Yes", was this painful injury to one of the following:
(Select all that apply.) |
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Did this injury require you to receive medical assistance?
(If yes, continue to Question 5)
(If no, please continue to Question 10) |
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| If you received medical assistance, did the medical provider (doctor, nurse, hospital) inquire your level of pain? |
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| What was the level of pain immediately following the injury? |
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| Do you remember the level of pain one hour after the injury? |
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| Did the pain increase or decrease one hour following the injury? |
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| If yes, did the pain require you to receive a painkiller? |
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| If the pain did not decrease, did you take an over the counter medication or narcotic? |
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| Please select the injury or injuries that you have ever experienced? |
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| Did the painful injury impact your ability to use your eyes, ears, nose, touch or taste? |
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| If you required a medically prescribed narcotic, how long did it take to eliminate the pain? |
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Did your pain require a visit to one of the following healthcare providers?
(select all that apply) |
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| If you were to experience pain due to an injury, how soon would you take a painkiller (Over the Counter or Prescribed) after the injury/pain? |
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| What is your ethnic origin? |
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| What is your age at this time? |
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| Which class are you enrolled in at this time? |
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