Stress Tool Question
Stress Tool Question
Stress Tool Question
Please answer the following questions. Your replies will be treated in the strictest
confidence – we are not asking you to provide your name. Please return the completed
form to your UCU reps or direct to ……….. using the attached envelope, by …………
The questionnaire applies to all teaching staff, UCU and non-UCU members alike. We
hope that all members of the teaching staff will appreciate the importance of this and take
a few minutes to fill it in. You should find it takes no more than 10 to 15 minutes to
complete.
Please Circle
2. Is your post: Permanent 1
Temporary 2
Please Circle
3. Are you: Male 1
Female 2
Yes
No
Model stress questionnaire
Please Circle
5. Are you: White – British 1
Irish 2
Other 3
Asian/British
Bangladeshi 4
Indian 5
Pakistani 6
Other 7
Black/Black British
African 8
Caribbean 9
Other 10
Mixed
White/Asian 11
White/Black African 12
White/Black Caribbean 13
Other 14
Chinese/Other Ethnic Group
Chinese 15
Any Other 16
Please Circle
6. Age: Under 26 1
26-35 2
36-45 3
46-55 4
56+ 5
2
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7. How would you describe your general health 3 years ago and now:
Please Circle
Good 1 2
Reasonable 1 2
Poor 1 2
8. Are you experiencing, or have you experienced any of these stress symptoms in
the last year?
Please Circle
a. Headaches/migraine 1 2 3
b. Aches and pains 1 2 3
c. High blood pressure 1 2 3
d. Poor sleep patterns 1 2 3
e. Skin Rashes 1 2 3
f. Indigestion 1 2 3
g. Stomach ulcers 1 2 3
h. Asthma 1 2 3
i. Anxiety 1 2 3
j. Depression 1 2 3
k. Heart disease 1 2 3
l. Changes in appetite 1 2 3
m. Exhaustion 1 2 3
n. Increased consumption of
tobacco. 1 2 3
o. Increased consumption of
alcohol. 1 2 3
p. Inability to concentrate 1 2 3
q. Erratic moods 1 2 3
r. Low self esteem/confidence 1 2 3
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10. Have you taken leave in the past 12 months due to work related stress?
Please Circle
Yes No
1 2
Please circle
Yes No
1 2
13. Has your GP suggested that your condition was due to your work?
Please circle
Yes No
1 2
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14. Are you receiving treatment from your GP for stress related symptoms?
Please Circle
Yes No
1 2
Part 3: Workload
15. Please estimate the average number of hours per week that you work (both on
and off site) during term time.
Please circle
30 – 35 1
36- - 40 2
41 – 45 3
46 – 50 4
51 + 5
16. (a) Please indicate how, if at all, your total workload has changed over the last
five years, and two years
Please circle
5 years 2 years
If your workload has decreased or remained the same, please go to question 18.
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16 (b) If your workload has increased, please indicate below the approximate extent
by which it has changed.
17. If your workload has increased please indicate on the scale below:
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18. Which factors associated with your current post do you think create work related
stress? Please circle on the scale below, how significant each of these factors are:
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Part 5: Overview
19. What do you see yourself doing five years from now? Please circle
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20. What are the two things, which would make a significant difference to the stress
concerns identified above?
…………………………………………………………………………………………………………
21. Please use the space below to provide any other information or comments you wish to
make about Lecturer’s workload and factors affecting levels of stress.
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Thank you for taking the time to fill in the questionnaire. (If you are not a UCU member you
are welcome to join. Please contact ……………………………..for an application form).
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