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PROMS Survey for Root Canal Treatment (After)
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proms survey for rootcanaltreatment after
Page Content
Patient-Reported Outcome Measures for Root Canal Treatment (After)
2 mins
estimated time to complete
Instructions
Thank you for choosing to have your treatment done at the National Dental Centre Singapore. As part of our efforts to continuously improve our service, we would like to find out about your experience with us.
Please answer the following questions by choosing the most relevant option on the scale.
Visit Date
Queue Ticket Number
Root Canal Tooth Number
Please circle only
one
response for each question. Thank you!
SECTION A. AREAS OF CONCERN FOR ENDODONTIC TREATMENT
1. On a scale of 0-10, please rate the degree of pain you are currently experiencing from the tooth.
0
1
2
3
4
5
6
7
8
9
10
Having undergone your endodontic treatment in National Dental Centre Singapore:
2. Have you had any trouble pronouncing any words because of problems with the tooth?
Never
Hardly ever
Occasionally
Fairly often
Very often
3. Have you found it uncomfortable to eat any foods because of problems with the tooth?
Never
Hardly ever
Occasionally
Fairly often
Very often
4. Have you felt self-conscious because of problems with the tooth?
Never
Hardly ever
Occasionally
Fairly often
Very often
5. Have you had difficulty doing your usual jobs because of problems with your tooth?
Never
Hardly ever
Occasionally
Fairly often
Very often
6. Have you felt that life in general was less satisfying because of problems with the tooth?
Never
Hardly ever
Occasionally
Fairly often
Very often
SECTION B. OVERALL EXPERIENCE WITH ENDODONTIC TREATMENT
1. In the course of your treatment, how often did the doctors:
a. Explain things in a way you could understand?
Never
Sometimes
Usually
Always
b. Listen carefully to you?
Never
Sometimes
Usually
Always
c. Treat you with courtesy and respect?
Never
Sometimes
Usually
Always
d. Give you the opportunity to ask questions or raise concerns?
Never
Sometimes
Usually
Always
e. Address your dental concerns?
Never
Sometimes
Usually
Always
2. What is your overall experience?
Worse than expected
Slightly below expectation
Slightly above expectation
Better than expected
3. Would you recommend NDCS to your family and friends, if they needed similar treatment?
Definitely no
Probably no
Probably yes
Definitely yes
4. Taking into account the treatment outcome and the cost of treatment, would you say the treatment was worth it?
Definitely no
Probably no
Probably yes
Definitely yes
SECTION C. FEEDBACK ON ENDODONTIC TREATMENT
1. If there is one area for improvement for the treatment, what would that be? Please provide input in the box below.
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Name
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