1 | I have been able to bring to mind words that I wanted to use while talking to someone. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
2 | I have been able to focus my attention. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
3 | I have been able to remember to do things, like take medicine or buy something I needed. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
4 | I have been able to think clearly. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
5 | I have been able to remember the name of a familiar object. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
6 | I have been able to concentrate. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
7 | I have been able to pay attention and keep track of what I am doing without extra effort. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
8 | I have been able to learn new things easily, like telephone numbers or instructions. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
9 | In a busy environment I find myself quickly bothered by excessive stimuli. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
10 | I feel tense or ‘wound up’. | Most of the time | A lot of the time | From time to time, occasionally | Not at all | |
11 | I still enjoy the things I used to enjoy. | Definitely as much | Not quite so much | Only a little | Hardly at all | |
12 | I get a sort of frightened feeling as if something awful is about to happen. | Very definitely and quite badly | Yes, but not too badly | A little, but it doesn’t worry me | Not at all | |
13 | I can laugh and see the funny side of things. | As much as I always could | Not quite so much now | Definitely not so much now | Not at all | |
14 | Worrying thoughts go through my mind. | A great deal of the time | A lot of the time | From time to time but not too often | Only occasionally | |
15 | I feel cheerful. | Not at all | Not often | Sometimes | Most of the time | |
16 | I can sit at ease and feel relaxed. | Definitely | Usually | Not often | Not at all | |
17 | I feel as if I am slowed down. | Nearly all the time | Very often | Sometimes | Not at all | |
18 | I get a sort of frightened feeling like ‘butterflies’ in the stomach. | Not at all | Occasionally | Quite often | Very often | |
19 | I have lost interest in my appearance. | Definitely | I don’t take so much care as I should | I may not take quite as much care | I take just as much care as ever | |
20 | I feel restless as I have to be on the move. | Very much indeed | Quite a lot | Not very much | Not at all | |
21 | I look forward with enjoyment to things. | As much as I ever did | Rather less than I used to | Definitely less than I used to | Hardly at all | |
22 | I get sudden feelings of panic. | Very often indeed | Quite often | Not very often | Not at all | |
23 | I can enjoy a good book or radio or TV programme. | Often | Sometimes | Not often | Very seldom | |
24 | I feel fatigued. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
25 | I have trouble starting things because I am tired. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
26 | How run-down did you feel on average? | Not at all | A little bit | Somewhat | Quite a bit | Very much |
27 | How fatigued were you on average? | Not at all | A little bit | Somewhat | Quite a bit | Very much |
28 | I have trouble doing all of my regular leisure activities with others | Never | Rarely | Sometimes | Usually | Always |
29 | I have trouble doing all of the family activities that I want to do | Never | Rarely | Sometimes | Usually | Always |
30 | I have trouble doing all of my usual work (include work at home) | Never | Rarely | Sometimes | Usually | Always |
31 | I have trouble doing all of the activities with friends that I want to do | Never | Rarely | Sometimes | Usually | Always |
32 | I am a different person than I was before the (subarachnoid) hemorrhage. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
33 | How difficult do you find it to hold a conversation? | Not at all | A little bit | Somewhat | Quite a bit | Very much |
34 | How difficult do you find it to follow a conversation? | Not at all | A little bit | Somewhat | Quite a bit | Very much |
35 | How much difficulty do you have with your sight? | Not at all | A little bit | Somewhat | Quite a bit | Very much |
36 | How much difficulty do you have with your sense of taste? | Not at all | A little bit | Somewhat | Quite a bit | Very much |
37 | How much difficulty do you have with your sense of smell? | Not at all | A little bit | Somewhat | Quite a bit | Very much |
38 | How much difficulty do you have with your hearing? | Not at all | A little bit | Somewhat | Quite a bit | Very much |
39 | How bothered are you by headaches? | Not at all | A little bit | Somewhat | Quite a bit | Very much |
40 | Has the (subarachnoid) hemorrhage affected your sex life? | Not at all | A little bit | Somewhat | Quite a bit | Very much |
Proxy questions for family members | ||||||
41 | My family member is a different person than he/she was before the (subarachnoid) hemorrhage. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
42 | My family member has been able to bring to mind words that he/she wanted to use while talking to someone. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
43 | My family member has been able to focus his/her attention. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
44 | My family member has been able to remember to do things, like take medicine or buy something he/she needed. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
45 | My family member has been able to think clearly. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
46 | My family member has been able to remember the name of a familiar object. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
47 | My family member has been able to concentrate. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
48 | My family member has been able to pay attention and keep track of what he/she is doing without extra effort. | Not at all | A little bit | Somewhat | Quite a bit | Very much |
49 | My family member has been able to learn new things easily, like telephone numbers or instructions. | Not at all | A little bit | Somewhat | Quite a bit | Very much |