We are looking for people aged 45-70, who have been diagnosed with heart failure to take part in a group discussion in London for 2 hours.
There will be a pre-task to complete prior to the group discussion that will take 20 minutes to complete
LOCATION:
London EC1
DATE:
Wednesday 8th March 2017
INCENTIVE:
£80.00 including completed pre-task
TIME:
1pm, 5pm or 7.30pm (depending on answers)
Please answer the questions below.
Name:
Telephone number:
Home Postcode:
Work Postcode:
Age:
Occupation:
Working status i.e. Student, Full time working, part time working, etc.
Ethnicity:
Which of the following have you been diagnosed with?
Atrial Fibrillation
Type 2 Diabetes
Obesity
Heart Failure
Venous Thromboembolism
Hypertension
None of the above
How long ago were you diagnosed with heart failure?
Which of the following best describes your class of heart failure?
No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitations, shortness of breath
Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity
Marked limitation in activity due to symptoms even during less than ordinary activity i.e. walking short distances (comfortable only at rest)
Severe limitations experiences symptoms even while at rest – mostly bed bound
Have you stayed in hospital in the past due to heart failure? Yes/No?
How often do you access the internet?
Which of the following devices do you use to access the internet?
Laptop
Desktop
Smartphone
Tablet
Please forward this on to anyone you know who may be interested.
Unfortunately, it is impossible to reply to all emails or phone messages. We receive lots of responses to researches that are emailed out. You will be contacted by phone if your application is successful. However, we apologise if you do not hear from us, but please keep trying for future projects that are sent out.
