Questionnaires Neo-ACT
Questionnaires, instructions and time points are specified below for the different sites.
DYNAREG
All Questionnaires except for Amsterdam Cognition Scan are administered thorough an electronic portal, Dynareg: .
- Username and password are provided by Dynareg when you create a user
- To administer questionnaires and follow up status of completion please follow the instruction in Instruction Dynareg ePROM Neo-ACT
Documents
Instruction Dynareg ePROM Neo-Act (PDF, 648.54 KB)
AMSTERDAM COGNITION SCAN
Amsterdam Cognition Scan (ACS) is an online cognitive test. It measures several of cognitive domains. In the Neo-ACT trial, patients receive links to ACS at two time-points (baseline and 1 year after surgery).
TIMEPOINT: BEFORE INITIATION OF NACT
Baseline questionnaires
- EORTC QLQ-C30 (HRQL)
- EORTC QLQ-B23 (HRQL-breast cancer)
- Sense of Coherence (SOC-13) SE Neo-ACT
- Godin Leisure Time Self-Reported Physical Activity questionnaire
- Self-Efficacy of Exercise (SEE) questionnaire
TIMEPOINT: PRE-SURGERY
Repeat baseline questionnaires
- EORTC QLQ-C30 (HRQL)
- EORTC QLQ-B23 (HRQL-breast cancer)
- Godin Leisure Time Self-Reported Physical Activity questionnaire
- Self-Efficacy of Exercise (SEE) questionnaire
TIMEPOINT:Â 1 & 2 YEAR FOLLOW-UP
| Follow-up (years after surgery) | 1 | 2 |
|---|---|---|
| EORTC QLQ-C30 | x | x |
| EORTC QLQ-B23 | x | x |
| Godin (physical activity) | x | x |
| SEE Scale | x | |
| Amsterdam Cognition Scan | x |
English
Documents (English)
Adapted Godin questionnaire English (PDF, 128.95 KB)
Additional background questions English (PDF, 149.17 KB)
BR23 English (PDF, 70.34 KB)
QLQ-C30 English (PDF, 74.02 KB)
Self-efficacy for exercise English (PDF, 89.87 KB)
SOC13 English (PDF, 77.59 KB)
Neo-ACT Satisfaction questionnaire V1.1 27 Sep 2024 English (PDF, 194.9 KB)
Finnish
Documents (Finnish)
Neo-ACT Satisfaction questionnaire V1.0 10 Jul 2024 FINNISH (PDF, 197.67 KB)
German
Documents (German)
SEE Self Efficacy questionnaire German (PDF, 137.26 KB)
ECORT QLQ-C30 and BR23 plus SOC-13 German (PDF, 542.17 KB)
Background Information German (PDF, 166.72 KB)
Adapted Godin German (PDF, 132.8 KB)
Neo-ACT Satisfaction questionnaire v1.0 27 Sep 2024 German (PDF, 152.53 KB)
Swedish
Documents (Swedish)
EORTC QLQ-C30 Swedish Neo-ACT (health-related quality of life (HRQL) (PDF, 120.38 KB)
EORTC-BR23 Swedish Neo-ACT (HRQL-breast cancer) (PDF, 46.1 KB)
Sense of Coherence (SOC-13) SE Neo-ACT (PDF, 94.35 KB)
Self-Efficacy of Exercise (SEE) Questionnare_SE Neo-ACT (PDF, 61.83 KB)
Neo-ACT Satisfaction questionnaire V1.2 27 Sep 2024 Swedish (PDF, 925.08 KB)