ReSPECT baseline confidence survey

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* 1. What is your role?

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* 2. Where do you usually work?

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* 3. Which practice or organisation do you work for?

Thinking now about a time where you have started a conversation with patients or families about treatment decisions, particularly advance decisions or at end of life

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* 4. How comfortable did you feel starting the conversation?

Not confident

Very confident

Not confident

Very confident

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* 5. How confident do you feel generally in having discussions about these types of decisions?

Not confident

Very confident

Not confident

Very confident

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* 6. What barriers stop you from talking to patients about their future outlook?

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* 7. I am able to find the relevant information to make immediate decisions in an emergency situation.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

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* 8. Information to make decisions in an emergency situation is useful, accessible and up-to-date

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Please answer the following questions so we can assess baseline knowledge in our region:

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* 9. How many people aged over-80 survive CPR?

<=1%

<=2%

<=3%

<=10%

<=20%

>20%

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* 10. How many people with advanced cancer survive CPR?

<1%

<2%

<3%

<10%

<20%

>20%

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* 11. DNACPR forms are legally binding

True

False

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* 12. Families and patients can demand CPR even if it will be futile

True

False

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* 13. People, patients and healthcare professionals do not want to talk about death

True

False

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* 14. Every patient who is dying should be made aware

True

False

Every patient will have individual preferences

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* 15. Patients don’t want to die in hospital

True

False

Every patient will have individual preferences

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* 16. Please tick any of the following that apply to you:

I am aware of the ReSPECT process.

I have received training on the ReSPECT process.

I have completed a ReSPECT conversation with a patient.

I have had opportunities to practice conversations like this with feedback

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* 17. What further support and training would you need in your role to have conversations with patients about realistic future treatment options?

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* 18. Please let us know if you have any other comments or queries about the ReSPECT process. If there are any risks or issues you foresee please let us know along with any suggested solutions.

Thank you for your input!