Information about the present disease of the child and the therapies applied:
1. What’s the disease of your child?
O Infection (fever, cough, diarrhoea etc.)
O Accident (bite, cut, burn, fracture etc.)
O Carcinogenic disease (leukaemia, tumour etc.)
O Lung disease (asthma, CF etc.)
O Cardiac disease (heart defect, irregular heart beat etc.)
O Disease of hormonal or metabolic origin (diabetes etc.)
O Disease of the nervous system (convulsions, epilepsy, defect etc.)
O Allergies (rash, insect bites etc.)
O Others, namely:______
2. Why did you come to the Emergency Department with your child?
O The family doctor /paediatrician has recommended to come
O The family doctor/paediatrician was not within reach
O We don’t have a family doctor/ paediatrician
O We think that the family doctor could not have helped us
O The therapy of the family doctor/ paediatrician did not help, that’s why we want a new check-up
O The child is very ill and needs immediate help
O Others: ______
3. Who did send you to hospital?
O nobody
O paediatrician
O family doctor (general doctor)
O specialist (neurologist, surgeon, etc.):______
O therapist (physiotherapist, naturopath, non-medical homeopath, etc.): ______
O hospital doctor/emergency call
O maternity centre
O others:______
4. Did the child already get classical therapies or medicaments in the case of the present disease
O no
O yes, namely ______
5. Did the child get complementary therapies in the case of the present disease?
O no
O yes, besides classical therapy
O yes, without classical therapy
O I don’t know
6. What kind of complementary therapy did the child get?
Please begin with column A. Fill in the corresponding circles, proceed then to columns B, C and D.
A Mark the therapies which the child got in the case of the present disease
and which were prescribed by a doctor
B Mark the therapies which the child got in the case of the present disease and which were not prescribed by a doctor (self-medication)
C Mark the therapies which the child got in the case of former disease and which were prescribed by a doctor.
D Mark the therapies which the child got in the case of former disease and which were not prescribed by a doctor (self-medication).
A B C D Choice of therapies:
Homeopathy:
Ο O O O commercial medicaments (Similasan-Grippetropfen, etc.):______
Ο O O O individual medicaments (Classic Homeopathy), namely: ______
Ο O O O Bach Flower Remedies
Phytotherapy (Herbal medicine):
Ο O O O herbal medicaments on sale (Echinaforce, etc.): ______
Ο O O O herbal cough mixtures, digestive potions etc..
Ο O O O compresses (with onions, vinegar etc.)
Ο O O O others:______
Anthroposophic medicine:
Ο O O O medicaments, namely:______
Ο O O O compresses and massages
Ο O O O kinesitherapy (eurhythmia)
Ο O O O linguistic therapy, music therapy
Ο O O O nutrition (bio-energetic)
Ο O O O oders:______
Chinese medicine (TCM)
Ο O O O acupuncture with needle. Where?______
Ο O O O acupuncture with laser. Where?______
Ο O O O Acupressure (Shiatsu)
Ο O O O herbal medicine
Ο O O O kinetotherapy (Yoga)
Ο O O O nutrition, diet
Ο O O O others:______
Ayurveda:
Ο O O O medicaments, namely:______
Ο O O O massages, wellness, meditation
Ο O O O others:______
Other therapies:
Ο O O O Schüssler-salt
Ο O O O Reflexology
Ο O O O Neuraltherapy
Ο O O O Bioresonancetherapy
Ο O O O others: ______
Questions concerning the medical treatment of your child
7. Who prescribes the respective therapies?
Please give an answer for classical therapies (column 1) and another one for complementary therapies (column 2):
O O auto-medication (family members, friends)
O O paediatrician
O O family doctor
O O therapist (physiotherapist, naturopath, non-medical homeopath etc.)
O O children’s hospital doctor
O O emergency doctor/emergency call
O O others: ______
8. Does your family doctor/paediatrician well versed in complementary therapies?
He knows all about it and is himself a specialist of:
Ο Homeopathy
Ο antroposophic medicine
Ο phytotherapy (herbal medicine)
Ο chinese medicine (TCM), acupuncture
Ο others ______
O We never talked to him about it
O He is against such therapies
O He tolerates them, but does not care.
9. Which members of your family prefer complementary therapies? (various answers possible)
O father of the child
O mother of the child
O child himself
O others:______
O nobody
10. Why did you have recourse to complementary therapies?
O in order to build up the immune system
O in order to moderate the side effects of the classical therapies
O in order to improve the chance of being cured
O in order to stabilize the body
O in order to balance the inner harmony/ mental situation
O in order to use all possibilities
O in order to avoid a relapse
O in order to achieve a better healing
O others:______
11. Did the child really get or take in the prescribed therapies?
Please distinguish between classical medicine (column 1) and complementary therapy (column 2)
O O no
O O rarely
O O in part
O O mostly
O O always
12. How often does your child get a therapy respectively a medicament ?
O O every day
O O 1 – 4 times a week
O O 1 – 3 times a month
O O 1 – 10 times a year
O O has never had any therapy
13. Did the therapies have an effect ?
O O always
O O sometimes
O O rarely
O O never
14. Compared to classical medicine how do you judge complementary therapies?
O are not effective
O are less effective
O equivalent effect
O more effective in certain cases/against certain disorders
O others:______
15. Did you notice side effects of the therapies?
O O strong side effects
O O weak side effects
O O no side effects
16. Which vaccinations did the child get? (various answers possible)
O the paediatrician made the vaccinations which are usual in Switzerland
O the doctor recommended us to renounce to certain vaccinations. Which ones? ______
O we refused certain vaccinations although the doctor recommended them. Which ones? ______
O the child was once vaccinated against influenza
O the child is vaccinated against FSME (ticks)
O the child is vaccinated against pneumocoques
O the child is vaccinated against meningocoques
Questions concerning health insurance and health policy
17. Does the child’s health insurance pay for complementary therapies (or would it pay if the therapies were prescribed by a doctor)?
O I don’ t know
O no, nothing
O partly (you pay more than the patient’s contribution)
O nearly all (you pay only the patient’s contribution)
18. Have you got an additional insurance for complementary therapies?
O I don’t know
O Yes
O No
19. How much money do you spend approximately per year for your child’s therapies ?
p. ex. for medicaments, herbal products, compresses, homeopathy, Chinese medicine, massages etc.)
without counting the contributions paid by your health insurance and without
insurance premiums
O O 1 – 100 frs.
O O 100 – 200 frs.
O O 200 – 500 frs.
O O 500 – 1000 frs.
O O more than 1000 frs.
20. Should complementary therapies be included in basic health insurance?
O yes, all complementary therapies
O yes, only the most usual complementary therapies
O yes, but only the ones prescribed or practiced by a doctor
O no, none
21. Which medical systems should be included in basic health insurance? (various answers possible)
O classical medicine
O homeopathy
O phytotherapy (herbal medicine)
O antroposophic medicine
O chinese medicine (TCM), acupuncture
O neuraltherapy
O others:______
22. Which medical systems should be taught at the universities? (various answers possible)
O classical medicine
O homeopathy
O phytotherapy (herbal medicine)
O antroposophic medicine
O chinese medicine (TCM), acupuncture
O neuraltherapy
O others:______
Expectations concerning complementary therapies at the Kinderspital
23. How much should doctors at the Emergency Department know about complementary therapies?
O there is no need of specific knowledge
O they should know the complementary therapies used by the parents, their effects and secondary effects
O they should be able to propose and recommend themselves complementary therapies
24. Should complementary therapies be offered by the Emergency Department of our hospital? (various answers possible)
O yes, if the disease permits, even instead of classical medicine
O yes, but only in addition to classical medicine
O yes, the doctors should recommend complementary therapies themselves if the disease permits
O yes, but only if the parents propose them themselves and want them explicitly
O there should be an informative documentation instructing parents about possibilities and limits of complementary therapies
O no
25. To what extent should complementary therapies be offered at the children’s hospital? (various answers possible)
Ο there is no need for it
Ο an external doctor qualified in complementary therapies should be at the disposal of the parents if they want so
Ο a hospital doctor, qualified in complementary therapies, should be at the disposal of the parents if they want so
Ο a hospital doctor should contact the parents actively and discuss with them the possibilities of complementary therapy
Ο in the hospital there should be a special department where complementary therapies should be applied automatically when it is advisable
Ο there should be a group of researchers in the hospital who study and control all complementary therapies
Personal data
Remark: The following data are very important for the statistic evaluation of the survey. The data will be treated with the strictest confidence and will exclusively be for scientific purposes.
26. How old is the child?
O 0 – 1 year
O 1 – 3 years
O 3 – 6 years
O 6 – 10 years
O 10 – 16 years
27. The child is
O a boy
O a girl
28. Does the child live with his parents?
O yes
O only with his mother
O only with his father
O no, but with a new partner
29. What’s the child’s insurance?
O basic insurance
O half private
O private
30. Place of birth of the parents and the child
O O O Switzerland
O O O Germany
O O O France
O O O Italy
O O O Spain
O O O Portugal
O O O Great Britain
O O O Scandinavia, country: ______
O O O Eastern Europe, country: ______
O O O South eastern Europe:______
O O O Africa, country:______
O O O Asia, country: ______
O O O Middle East, country: ______
O O O America
O O O other:______
31. Date of birth of the parents
O O Before 1955
O O 1955 – 1959
O O 1960 – 64
O O 1965 – 69
O O 1970 – 1974
O O 1975 – 1979
O O 1980 – 1984
O O after 1985
32. School education of the parents?
O O no school qualification
O O secondary school
O O professional apprenticeship
O O high school (matura)
O O high professional school
O O university
O O others:______
33. What’s your net monthly family income?
O < 4000 frs.
O 4000 – 6000 frs.
O 6000 – 8000 frs.
O 8’000 – 10’000 frs.
O 10’000 – 12’000 frs.
O 12’000 – 16’000 frs.
O > 16’000 frs.
34. Who did fill in this questionnaire?
O mother
O father
O others:______
Your remarks concerning complementary therapies, Emergency Department or this questionnaire:
______
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