Professional Documents
Culture Documents
Instructions
This questionnaire is framed to identify the stress levels in your life. Kindly
furnish the details, as it will enable my research study. Read each question carefully
and answer as accurately as you can. Please note that your personal information and
other details provided by you will be kept confidential.
1. Name:
2. Sex :
a) Male b) Female
3. Designation:
4. Age:
6. Educational Qualification:
7. Job Experience:
8. Monthly Income:
e) > Rs.20,000
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9. Marital Status:
a) Married b) Unmarried
a) < 4 b) 4 – 5 c) > 5
B. Below is a list of stress symptoms and factors influencing work stress. Tick
the appropriate options for the questions 12-16.
12. What are the symptoms of stress that you experience? (Please put a tick mark in
the relevant column)
2 Irritability
3 Short- temper
Accelerated
4
speech
5 Nail-biting
6 Restlessness
Lack of
7
confidence
Getting confused
8
easily
Gain/Loss of
9
weight
Feeling negative
10
about everything
11 Worrying
12 Nervousness
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13. What causes you to get stress in your job? Rank the following options.
a) Group behavior
b) Lack of information
c) Office politics and conflicts
d) Excessive interruptions
e) Lack of recognition
15. What makes you feel that you are overloaded in work?
16. When forced to work overtime, how do you deal with it?
a) Redouble my efforts
b) Slowly take efforts
c) Get annoyed with work
d) Won’t take any extra efforts
e) Complain about it
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C. This section [questions 17-20] deals with the impact of stress on health,
behavior and job. Tick the appropriate options.
a) Yes b) No
18. Are you suffering from the following physical and mental health problems?
(Please put a tick mark in the relevant column)
S. Some Most of
Problems Never Rarely Always
No times the times
1 Headache
2 High blood pressure
3 Stomach disorder and Ulcer
4 Chest pain
5 Back pain
6 Skin irritation and allergies
7 Cancer
8 Diabetes
9 Asthma
10 Fatigue
11 Sleep disturbances
12 Anxiety
13 Depression
14 Tendency to remain alone
15 Poor concentration
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19. What are the behavioral changes that you experience due to physical and mental
health problems? (Please tick all the options that is applicable to you)
20. How stress shows its ill effects on your job performance? (Please put a tick
mark for all the options that is applicable to you in the square brackets given
below)
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D. This section [questions 21-25] deals with the organizational and individual
strategies for managing stress. Tick the appropriate options.
21. Did you utilize stress management facilities offered by your workplace?
a) Yes b) No
If ‘Yes’ answer from 22, If ‘No’ means answer from 23
22. Which of the following stress management facilities are utilized by you? (Please
put a tick mark for all the options that is applicable to you in the square brackets
given below)
a) Health awareness programmes [ Yes ] / [ No ]
b) Vacation and holiday trips [ Yes ] / [ No ]
c) Stress management course [ Yes ] / [ No ]
d) Job redesign [ Yes ] / [ No ]
e) Recreation centre [ Yes ] / [ No ]
f) Social support system at the work Place [ Yes ] / [ No ]
g) Stress management workshops [ Yes ] / [ No ]
23. What are the coping strategies that you are practicing yourself to reduce stress?
(Please put a tick mark in the relevant column)
Some Most of
S.No Coping Strategies Never Rarely Always
times the times
1 Yoga/Meditation
2 Physical exercise
3 Entertainment
Away from stressful
4
environments
5 Sleep
Speaking with
6
likeminded persons
7 Playing with pet animals
8 Prayer
9 Medications
10 Positive thinking
11 Time management
12 Tour
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24. Do you feel that some other coping strategies should be followed to reduce
stress?
a) Yes b) No
If ‘Yes’ specify______________________
25. To what extent, do you overcome the stress by utilizing stress management
facilities and practicing coping strategies?
a) To a great extent
b) To some extent
c) No change
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27. Under which situation, do you get support from above people?
c) Work-related issues
e) Difficult situation
28. What are your expectations from the management to make workplace stress
free? (Please put a tick mark for all the options that is applicable to you in the
square bracket given below)
harvesting [ Yes ] / [ No ]
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