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Caregiver Survey- FRIDAY

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Exit Survey
 
 
Avanir Pharmaceuticals is conducting a survey on a relatively common but under-recognized neurologic condition called pseudobulbar affect (PBA). We are seeking your opinion based on your experience with this condition.

Pseudobulbar affect (PBA) is a neurologic condition characterized by frequent, uncontrollable outbursts of crying or laughing. These involuntary episodes may appear suddenly, may be exaggerated, or may not match what the person is feeling inside. PBA is associated with underlying neurologic conditions or injuries including: Alzheimer’s disease or other dementias, stroke, traumatic brain injury (TBI), multiple sclerosis (MS), Parkinson’s disease and Lou Gehrig’s disease (ALS). PBA is sometimes referred to by other terms, such as emotional lability, pathological crying and laughing, or emotional incontinence. Thank you for taking the time to participate in this survey today.





© 2013 Avanir Pharmaceuticals, Inc. All rights reserved.
Date of preparation: 7 October 2013
NUE-MIS-0013
 
 
 
1. In which country do you primarily provide care?
   
 
 
 
2. In what setting do you primarily provide care
 
In-home
 
Day center
 
Residential / communal living facility
 
Hospice
 
Other
 
 
 
 
3. What is your relationship with the person(s) to whom you provide care?
 
I am a family member or relative
 
I am a professional caregiver
 
I am a volunteer (not related to the person)
 
Other
 
 
 
 
4. Are you familiar with the condition pseudobulbar affect (PBA)?
 
Yes
 
No
 
 
 
5. Does the person(s) to whom you provide care experience involuntary crying or laughing?
 
Yes
 
No
 
 
 
6. Have you seen pseudobulbar affect (PBA) symptoms, or involuntary crying or laughing, in the person(s) to whom you provide care?
 
Yes
 
No
 
 
 
7. If you provide care to only one person, has this person received a diagnosis for pseudobulbar affect (PBA)?
 
Yes
 
No
 
 
 
8. If you provide care to more than one person, what proportion of them have a diagnosis for pseudobulbar affect (PBA)? (%)
   
 
 
 
9. Have you ever discussed pseudobulbar affect (PBA) with a physician?
 
Yes
 
No
 
 
 
10. Is the person(s) to whom you provide care receiving medication for pseudobulbar affect (PBA)?
 
Yes
 
No
 
If yes, please specify
 
 
 
 
11. How significant do you think the burden associated with pseudobulbar affect (PBA) is? Consider the physical, emotional, and financial burden.
(Select one only)
 
Not at all significant
 
Mildly significant
 
Moderately significant
 
Very significant
 
Extremely significant
 
 
 
12. On a scale of 1-7, how important do you think it is to treat the symptoms of pseudobulbar affect (PBA)? (1 = not at all important; 7 = critically important)
(Select one only)
 
1
 
2
 
3
 
4
 
5
 
6
 
7