Villanova University / College of Nursing Health Promotion for Women with Disabilities Project Survey of Interests of Caregivers
We are interested in learning about what health promotion topics are of interest to you, the caregiver of a person with a disability. Please check those topics of interest to you:
Overview: Staying healthy (cardiovascular health, cancer prevention, etc.)
Stress management
Maintaining the caregiver’s mental health
Problem solving
Resolving conflicts
Handling difficult emotional situations
Sexuality and intimacy
Pregnancy issues
Parenting issues related to disability (addressing children’s issues as the able-bodied parent)
How to be an effective advocate for my disabled relative
Alternative therapies: Supporting safe use of my relative’s choices
Grief and loss in relationships
Aging with a disability
Coping with changes in cognitive status of my relative
What is your age? What is your gender? Please Specify Male Female
Ethnicity Choose Ethnicity African American Asian Caucasian Hispanic Other
The disabled person you care for is your: Please specify spouse / partner sister parent daughter friend other
The person you care for: Please Specify walks without problems walks with problems / with assistance walks with cane, walker or crutches propels herself in a wheelchair/scooter needs assistance to propel herself in wheelchair is visually impaired is hearing impaired
The level of self-care of the person: Please Specify takes complete care of self requires minimal help to care for self requires some help for most activities requires help for all activities unable to care for self (eat, dress, use toilet, make decisions)
How many hours do you typically spend each day caring for or assisting the person you care for?
Do you need help in providing care?
Are you able to receive the help you need?
Do you receive emotional support?
