The ARDS Support Center has heard from
many ARDS survivors who have experienced and have questions about cognitive changes noted
after surviving ARDS. Some of these conditions are short term memory loss, difficulty in
concentration, depression, anxiety and difficulty in performing normal everyday functions.
There is a great need for more research and the medical community is devoting increasing
attention to these post-ARDS cognitive problems.
Dr. William H. Shull, an Assistant Professor of Rehabilitative
Medicine and Director of Trauma Rehabilitation specializing in brain injury at the
University of Pennsylvania School of Medicine, and his associates are among those
performing research in this area. The ARDS Support Center has available an informal survey
that has been designed to provide information for research purposes. If you are an ARDS
survivor, we suggest that you complete this survey answering the questions as fully as you
can. There is space at the bottom of the survey for you to describe other problems or
questions you may have about difficulties involved in your recovery process. Your
responses will be forwarded to Dr. Shull.
Dr. Shull believes "this will definitely lead to research and
more importantly, to improved awareness of the importance of rehabilitation doctors in
helping the pulmonary physician treat the ARDS survivor, and most importantly, to improved
quality of life for patients and families."
Note: If you have problems using this form, please click here
--> Old survey
Please answer all the questions
Then submit the form.
Section A
Tell us how to get in touch with you:
Name
E-mail
Confirm E-mail
Telephone
Section B
1.) Do you have problems with loss of memory? If so, please
describe the problems.
Yes
No
2.) Do you have trouble concentrating?
Yes
No
3.) Do you have trouble organizing your day?
Yes
No
4.) Is it difficult to pay close attention to TV?
Yes
No
5.) Are you able to comprehend what you read?
Yes
No
6.) Do you find yourself having to go back and re-read
paragraphs that you just read?
Yes
No
7.) Do you lose your place while reading?
Yes
No
8.) Do you have problems with basic self-care?
Yes
No
9.) Do you have trouble driving?
Yes
No
10.) Do you have problems with community based mobility
skills, i.e. walking, attending meetings and understanding what was said, etc.?
Yes
No
11.) Do you have difficulty with fine motor skills?
Yes
No
12.) Do you feel that your judgment is impaired?
Yes
No
13.) Do you feel that you have poor safety awareness?
Yes
No
14.) Do you find yourself suddenly being impulsive?
Yes
No
15.) Are you having problems with sleep/wake cycles? If so,
please describe.
Yes
No
16.) Have you noticed any changes in your personality?
Yes
No
17.) Please tell us about any other areas in your mental
thinking/anxiety/emotions that you are having problems with.
Thank you for taking the time to complete
the survey !
