QUESTIONNAIRE

Part I. Demographic Profile

Direction: Please answer the following personal information. Write it on the space
provided

1. Age:
( ) 20-25 ( ) 31-35 ( ) 40 above
( ) 26-30 ( ) 36 - 40
2. Sex:
( ) Male
( ) Female
3. Civil Status:
( ) Single ( ) Widow
( ) Married
4. Employment Status:

( ) Casual ( ) Regular/Permanent
( ) Probationary
( ) Contractual
5. Length of Service in previous job:
( ) 5 – 10 years ( ) 16 years above
( ) 11- 15 years

Part II. Factors that affect the attrition of nurses

Direction: Please answer the following questions by putting () check on the appropriate
space that indicates the factor that affect the attrition rate of nurses.

5 – Strongly Satisfied 3 – Fair 1 – Strongly Dissatisfied

4 –Satisfied 2 – Dissatisfied

Compensation and Benefits 5 4 3 2 1

1. We are paid according to the numbers of hours work in the
hospital
2. Authorized overtime rendered is always paid
3. The institution gives mandatory benefits (13th Month Pay,
etc.)
4. The salary commensurate my job
5. I receive salary in prompt time
6. The institution provides incentives such as travel
allowances and other allowances incidental to work
performance
7. The company has a special development such as seminars
and team buildings.
 8. We are given other types of leaves such as
paternity/maternity leave, birthday, leave of absence,
mandatory and others.
Career Planning
1. The goals of the organization are being identified,
established and explained
2. Conducts frequent performance review and feedback
3. The management assists us in evaluating our own career
needs
4. Improve and disseminate available career opportunities in
the organization
5. The management prepares you together with the
organization to take greater job and personal responsibility
for their future
6. The institution initiates training to expand my knowledge
and skills
Interpersonal Relationship
1. The management show trust and respect to gain
harmonious and sound relationship among us that can
motivate me to work well
2. The management is friendly and approachable
3. Discussion is an open platform where every individual has
the liberty to express his/her views and opinions.
4. Acknowledgement/appreciation of the work done
5. Management gave me a good idea on how should I handle
my personal and work stress.
6. Work is equally allocated to each other.
7. Actively participates in hospital activities
8. My colleagues are easy to deal with
Job Function
1. The job description match to the job done by the nurse
2. Give proper shifting to the nurses
3. Work assignments are based on standards and are
acceptable
4. The amount of work assigned to the nurse is convenient to
them
5. Giving appropriate training regarding work shift
6. The amount of work assigned to you is convenient
7. The standard hours of work have less than one hour for
break of work is observed

Problems encountered:

1. __________________________________
2. __________________________________
3. __________________________________