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Questionnaire On Stress

The document contains a questionnaire to assess stress levels with questions about how respondents describe their life, how they handle problems, whether they feel stress affects problem-solving, what physical feelings they associate with stress, and what solutions they use for stress. It also includes exercises on physical activity, relaxation, and communication to evaluate habits and behaviors related to stress management.

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Raymund Christopher Dela Peña
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30 views3 pages

Questionnaire On Stress

The document contains a questionnaire to assess stress levels with questions about how respondents describe their life, how they handle problems, whether they feel stress affects problem-solving, what physical feelings they associate with stress, and what solutions they use for stress. It also includes exercises on physical activity, relaxation, and communication to evaluate habits and behaviors related to stress management.

Uploaded by

Raymund Christopher Dela Peña
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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QUESTIONNAIRE ON STRESS LEVEL

Name:……………………………………….

I) How would you describe your life in general?


A) Interesting B) Challenging C) Miserable

II) How do you handle problems?


A) You try my best to sort them out.
B) You enjoy the challenge that problems present.
C) You get angry and find someone to blame.

III) Do you think stress can be one of the reasons for not handling problems easily?
A) Yes B) No

IV) When you stressed you feel: (please answer in yes or no)
A) Pain ___________ B) Anger ____________ C) Embarrassment __________
D) Exhausted _________ E) Headaches _________ F) Tense ___________

V) Do you try to find any solution for the problem of your stress?
A) Yes B) No

VI) If yes, how do you handle your stress? (tick one or more than one)
A) Yoga B) Exercise C) Entertainment D) Ayurvedic therapy
E) Eating F) Other (please specify it below)

VII) What is your opinion to reduce stress?


__________________________________________________________________________________________
__________________________________________________________________________________________

 Exercise:

Respond to the following statements by placing yes or no ( Y or N) on the line preceding each one which you
presently practicing.( Adapted from The Wellness Workbook, by John W. Ttravis and Regina Sara Ryan, copyright
1981)

 ----- I climb stairs rather than ride elevators.


 ----- I include moderate physical efforts (gardening, child care, standing all day) in my daily activities.
 ----- I include Strenuous physical efforts ( construction work, farming, hauling) in my daily activities
 ----- I jog at least one mile twice times a week (or equivalent).
 ----- I jog at least one mile four times a week (or equivalent).
 ----- I regularly walk or ride a bicycle for exercise.
 ----- I participated in a strenuous sport once a week.
 ----- I participated in a strenuous sport more than once a week.
 ----- I do yoga or some form of stretching and limbering exercise for fifteen to twenty minutes at least
twice a week.
 ----- I do yoga or some form of stretching and limbering exercise for fifteen to twenty minutes at least
four times a week.
Total number of activities practiced presently_______________

 Relaxation:

Answer the following questions by placing a number on the lines preceding each one. Select the number
that best describes your behavior.( Adapted from The Wellness Workbook, by John W. Ttravis and Regina
Sara Ryan, copyright 1981)

1 = Seldom 2 = Sometimes 3 = Always

 ----- Are you able to shut out your worries when you go to bed at night?
 ----- Are you able to take a nap during the day and awaken refreshed?
 ----- Is your clothing well fitting and comfortable?
 ----- Are you able to concentrate on one problem at a time?
 ----- Do you plan your day’ activities?
 ----- Do you find time to relax and stretch during the day?
 ----- Do you find to prevent tension by relieving sustained positions required in your work?
 ----- Do you know how to relax by doing simple movements when you feel yourself becoming tense
because of sustained positions?
 ----- Do you check yourself frequently for habitual tension habits, such as scowling, clenched fists, tight
jaws hunched shoulders, or pursed lips?
 ----- Do you relax these evidences of tension at will when you find them?
 ----- Do you find it easy to relax so that you sleep easily and deeply?
 ----- Do you know how to release tension through simple movements so that you can sleep well?
 ----- Do you play with such interest that you become completely absorbed in what you are doing?
 ----- Do you plan your life so that you can have change of people. scenery and thoughts?
Total score__________________

 Communication:
Answer the following questions by placing a number on the lines preceding each one. Select the number
that best describes your behavior. (Adapted from The Wellness Workbook, by John W. Ttravis and Regina
Sara Ryan, copyright 1981.)

0 = No, Never or Hardly ever 1 = Occasionally, Rarely 2 = Sometimes, May be


3 = Often 4 = Very, Always or Usually

 ----- I am able to initiate a conversation on my own.


 ----- I am able to communicate with strangers.
 ----- I can introduce a difficult topic and stay with it until I have received a satisfactory response from
the other person.
 ----- I enjoy communicating and interested in what others have to say.
 ----- I enjoy silence.
 ----- I have at least 3 friends with whom I can communicate intimately.
 ----- I can communicate my weakness to others when appropriate.
 ----- I am aware of how other people are likely to react when I initiate a communication.
 ----- I consider my thoughts and feelings with care before responding to others.
 ----- I am aware of how I communicate with others nonverbally.
 ----- I am aware when I’m responding to my internal tapes rather than thinking independently.
 ----- I communicate clearly with friends and family.
 ----- I am not asked to repeat myself or speak loudly.
 ----- Instruction I give to others are carried out properly.
 ----- I assert myself to get what I need rather than feel resentment toward others for taking advantage of
me.
 ----- I am aware of situation when I want to blame others rather than accept that I may be wrong.
 ----- I admit my mistakes when I am aware of them.
 ----- I can let go of my negative judgments of others, and I can accept that they only are doing what
they think is best.
 ----- I am aware of my defense mechanisms.
 ----- I am able to listen to and objectively consider opposing viewpoints.
 ----- I am good listener.
 ------ I don’t try to change the subject during a conversation in order to win.
 ----- I am aware of my tone of voice, facial expression, and body language when communicating with
others.
 ----- I like myself and can accept my failings rather than beat up on myself because I think I’ m
unworthy.
 ----- I don’t interrupt or finish others’ sentences for them.
 ----- I am not responsible for keeping other people happy.
 ----- I take charge and control a situation when it is appropriate.
 ----- I let others take charge and control a situation when it is appropriate.
 ----- I cooperate with others when it is necessary for several of us to take a charge of a situation.
 ----- I am able to control and allow a situation to work itself out through means I don’t fully understand.
 ----- I am aware of the psychological games people play.
 ----- I am aware of the psychological games I play with others.
 ----- I can stop playing a psychological game and instead communicate directly.
Total score____________

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