Please fill out this survey. 1. a. Have you heard of the syndrome Fibromyalgia? Yes Yes, but I am not sure what it is No (if the answer is No, skip to question #2) b. Have you or anyone you know been diagnosed with Fibromyalgia? Yes, I have been diagnosed with Fibromyalgia Yes, someone I know has been diagnosed with Fibromyalgia Yes, I am a caregiver for someone who suffers from Fibromyalgia No c. If the answer to question b is "yes", were you (or they) misdiagnosed with other diseases, conditions, or symptoms? (Yes or No) Yes No If yes, what were they? d. Fibromyalgia signs and symptoms (and co-existing conditions) can consist of: (Check all that apply) Widespread pain and tender points Fatigue and sleep disturbances Irritable bowel syndrome (IBS) Depression Headaches All of the Above e. Based on your experience, how effective are healthcare providers at recognizing signs and symptoms of fibromyalgia? Very effective Effective Not effective I have no experience and therefore don't know f. Comment - How has fibromyalgia impacted you or your family (missed work, no family functions, depression/anxiety, lost contact with friends, etc.)? 2. Do you think a man's experience with fibromyalgia is different than female sufferers? Yes No If so, why is it different? 4. If you were experiencing some of the symptoms of Fibromyalgia, including widespread pain or tender points, fatigues, sleep disturbances, headaches, etc, how long would you wait before consulting a healthcare provider? I would contact a doctor right away 1 - 6 months 6 - 12 months 1 - 2 years 3 + years New fieldset 5. Where would you go to learn more about fibromyalgia? (Rank 1 to 5) Patient advocacy / education organization Online health information / resources Your healthcare provider or pharmacist Printed health literature or materials A family member or friend Please tell us a little about yourself: What is your sex Male Female Age What is your race White African American Hispanic/Latino Asian/Pacific Islander Other What is your Marital Status? Married Divorced Widowed Never been married CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. What code is in the image? * Enter the characters shown in the image. Log in to post comments
