Living with a chronic medical condition survey

If you or a loved one is currently experiencing a chronic medical condition, I would appreciate it if you could complete this survey. It should only take a few minutes.

Hello, my name is Paula Saneaux and I’m a visual artist. I’m currently working on an art project about the fragility of life. I'm looking into what it's like to live with a chronic medical condition and also, how a person is affected when a relative has a chronic medical condition. Your answers will help me understand what you are going through, how to help, and how to communicate this message through paintings and publications. If you want to know more about my work, here’s my website: www.paulasaneaux.com

You may complete this survey anonymously unless you wish to share only your name with me, only your story publicly, or both.

Thank you for sharing your experiences. I sincerely appreciate it. If you'd like to contact me for more information or to share something even more specific or detailed, please write me at paulasaneaux@gmail.com

Paula Saneaux

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1. How would you rate your overall health?
Clear selection
2. Have YOU or a LOVED ONE experienced any of these medical conditions?
Yes, I have
Yes, a loved one has
No, none of us have
Alzheimer’s disease
Dementia
Cancer
Diabetes
Heart Disease
Aneurism
Heart attack/Stroke
Arterial thrombosis or Deep Vein Thrombosis (DVT)
Pulmonary embolism (PE)
High Blood Pressure
3. Have you or a loved one experienced any of these medical conditions?
Yes, I have
Yes, a loved one has
No, none of us have
Depression
Bipolar Disorder
Development disorder: Ex. Aspergers, Autism, Intelectual
Fibromyalgia
Scoliosis
Polycystic ovary syndrome (PCOS)
Vitiligo
COVID 19
Substance Abuse (Alcohol or Medicine)
Substance Abuse (Illegal drugs)
4. Do you or a loved one have another medical condition not mentioned above?
Yes
No
Myself
A loved one
If "yes," could you please specify which one(s)?
5. Now, think about the medical condition(s) YOU have experienced from questions 2 through 4 and answer the following questions.*
Please write it/them in the space provided below, for my reference.

(* If you haven't been through any of them or just want to talk about "a LOVED ONE's medical condition(s)," please go to question 14.)
6. How often do YOU need to get care, tests, or treatment?
Clear selection
7. How many medicines are YOU taking for the condition(s)?
Clear selection
8. How many doctors do YOU see to manage the medical condition(s)?
Clear selection
9. In relation to this condition, do YOU feel supported by your family and close friends? Please check all that apply.
10. What was the behavior of society (for example, your community, people in general, etc.) after they knew about YOUR medical condition? Check all that apply.
11. How having this medical condition has affected your life? Check all that apply.
12. How are you handling the financial aspects of your medical condition?
13. Do you think enough is being done to raise awareness about YOUR medical condition(s)?
14. Now, think about the medical condition(s) your LOVED ONE has experienced from questions 2 through 4 and answer the following questions. 
If your loved one passed away as a result of this condition, please answer the following questions based on how it was while enduring it.
Please write it/them in the space provided below, for my reference.

(* If a loved one hasn't been through any of them or you just wanted to talk about "YOUR medical condition(s)," please go to question 22.)
15. How often does your LOVED ONE need (or needed) to get care, tests, or treatment?
Clear selection
16. How many doctors does (did) your LOVED ONE see to manage the medical condition(s)?
Clear selection
17. In relation to this condition, do you and your LOVED ONE feel (or felt) supported by your family and close friends? Please check all that apply.
18. What was the behavior of society (for example, your community, people in general, etc.) after they knew about your LOVED ONE'S medical condition? Please check all that apply.
19. How having a loved one with a medical condition has affected YOUR LIFE? Check all that apply.
20. How is your LOVED ONE handling the financial aspects of his/her medical condition?
21. Do you think enough is being done to raise awareness about your LOVED ONE'S medical condition(s)?
22. Now, please tell me anything else you think I should know about your experience living with a chronic medical condition or about your experience with a loved one's medical condition.
23. I may share brief stories on social media about people who have experienced a medical condition and how it has affected them. Could I share your story/experience?
24. If you'd like to share your name and email with me, please write them below. If not, just say "no, thanks."

I won't use your name UNLESS YOU GIVE ME PERMISSION ABOVE.
I need your email address in case I need to get in touch with you. I will never share it with anyone.
25. And finally, the demographics:

Where do you live? (City, State or Country)
 *
I identify as...
 *
I am... *
Thank you for sharing your experience. I truly appreciate it.
If you'd like to contact me for more information or to share something even more specific or detailed, please write me at paulasaneaux@gmail.com

***
If you or your loved one need free and confidential emotional support, please call 988
24 hours a day, 7 days a week in the United States.

If you live in another part of the world, here’s a list of numbers you can call:
https://bit.ly/3XhQbPP

“Believe in yourself and all that you are. Know that there is something inside of you that is greater than any obstacle.” – Christian D. Larson

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