Stress and Quality of Life Questionnaire

 Stress and Quality of Life Questionnaire

 

            You were chosen as a respondent to answer this survey – questionnaire on “An Examination of the Relationship Between Stress and Quality of Life Factors in College Students.” Your answers will provide the data needed in this study. Rest assured that your answers would be treated with utmost confidentiality. Thank you very much.

           

                                                                                                         Researcher     

 

Part 1.  Demographic Profile of Respondent

 

Direction: Please fill up in all the necessary information about yourself. Don’t leave any item unanswered.

 

a.            Age  _______

b.            Gender

Male ( )           Female ( )

c.            Civil Status

Single ( )        Married ( )      Separated ( )             Widow/Widower ( )

d.            Monthly Income

U$ 500 and below               (  )        U$ 3001-4000           (  )

U$ 501-1000             (  )        U$ 4001-5000           (  )

U$ 1001-2000           (  )        U$ 5001-10,000       (  )

U$ 2001-3000           (  )

           

e.            Amount of Credit Hours taking in School

3 units            and below    (  )

6-9 units                    (  )

12-15  units               (  )

15 and above            (  )       

           

f.             Social Support

Fully Supported       (  )

Partial Support         (  )

Self-Supporting        (  )

 

            g.         Living Arrangement: ____________________

 

h.         Religion _________________

Part II. A. Quality of Life Scale

Please read each item and circle the number that best describes how satisfied you are at this time. Please answer each item even if you do not currently participate in an activity or have a relationship.

The items will be measured using the following interpretations:

7             Delighted

6             Pleased

5             Mostly Satisfied

4             Mixed

3             Mostly Dissatisfied

2             Unhappy

1             Terrible

 

1.    Material comforts: home, food conveniences, financial security

2.    Health- being physically fit and vigorous

3.    Relationships with parents, siblings and other relatives- communicating, visiting and helping

4.    Having and rearing children

5.    Close relationship with spouse or significant other

6.    Close friends

7.    Helping and encouraging others

8.    participating in organizations and Public Affairs

9.    Learning- attending school, improving understanding and getting additional knowledge

10. Understanding yourself- knowing your assets and limitations- knowing what life is all about

11. Work- job or in home

12. Expressing yourself creatively

13. Socializing- meeting other people, doing things, parties, etc.

14. Reading, listening to music or observing entertainment

15. Participating in active recreation

 

7       6       5     4      3      2         1

 

7       6       5     4      3      2         1

 

7       6       5     4      3      2         1

 

7       6       5     4      3      2         1

7       6       5     4      3      2         1

 

7       6       5     4      3      2         1

 

7       6       5     4      3      2         1

 

7       6       5     4      3      2         1

 

7       6        5     4       3      2      1

 

7       6       5     4      3      2         1

7       6       5     4      3      2         1

7       6       5     4      3      2         1

 

7       6      5     4         3      2        1

 

7       6      5     4         3      2        1

 

 

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