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    Questionnaire On Wellness and Lifestyle

    Uploaded by

    Daniel B. Opeña

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Questionnaire On Wellness and Lifestyle

    Uploaded by

    Daniel B. Opeña
    1 views8 pages

    Original Title

    Questionnaire on Wellness and Lifestyle

    Copyright

    © © All Rights Reserved

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    DOCX, PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    1 views8 pages

    Questionnaire On Wellness and Lifestyle

    Uploaded by

    Daniel B. Opeña

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 8

    Questionnaire on Wellness and Lifestyle

    Demographic Information:

    1. Age: _______
    2. Sex:

    o Male

    o Female

    o Other
    3. Civil Status:

    o Single

    o Married

    o Divorced

    o Widowed

    Section 1: Physical Wellness

    1. How often do you engage in physical exercise?

    o Never

    o 1-2 times a week

    o 3-4 times a week

    o Daily
    2. How would you rate your overall physical health?

    o Poor

    o Fair

    o Good
    o Excellent
    3. Do you have any chronic health conditions? (e.g., diabetes, hypertension)

    o Yes (please specify): ____________

    o No
    4. How often do you visit a healthcare professional for check-ups?

    o Never

    o Once a year

    o Twice a year

    o More than twice a year


    5. How would you describe your dietary habits?

    o Very Unhealthy

    o Unhealthy

    o Healthy

    o Very Healthy

    Section 2: Mental Wellness

    1. How often do you feel stressed at work?

    o Never

    o Occasionally

    o Frequently

    o Always
    2. How do you rate your ability to cope with stress?

    o Poor
    o Fair

    o Good

    o Excellent
    3. Do you take time for activities that promote mental relaxation (e.g., meditation,
    hobbies)?

    o Yes

    o No
    4. How often do you feel mentally fatigued by the end of the workday?

    o Never

    o Occasionally

    o Frequently

    o Always
    5. Do you have access to mental health resources (e.g., counseling, therapy)
    through your workplace?

    o Yes

    o No

    Section 3: Social Wellness

    1. How often do you engage in social activities with friends or family?

    o Never

    o Once a month

    o Once a week

    o Several times a week


    2. Do you feel supported by your colleagues at work?
    o Strongly Disagree

    o Disagree

    o Agree

    o Strongly Agree
    3. How comfortable do you feel in social settings?

    o Very Uncomfortable

    o Uncomfortable

    o Comfortable

    o Very Comfortable
    4. How often do you communicate with friends or family through digital platforms
    (e.g., social media, video calls)?

    o Never

    o Occasionally

    o Frequently

    o Always
    5. Do you participate in any group activities (e.g., clubs, sports teams) outside of
    work?

    o Yes

    o No

    Section 4: Emotional Wellness

    1. How often do you feel overwhelmed by your emotions?

    o Never
    o Occasionally

    o Frequently

    o Always
    2. Do you have healthy coping mechanisms for dealing with negative emotions?
    (e.g., talking to someone, journaling)

    o Yes

    o No
    3. How satisfied are you with your emotional life?

    o Very Dissatisfied

    o Dissatisfied

    o Satisfied

    o Very Satisfied
    4. How often do you express your feelings to others?

    o Never

    o Occasionally

    o Frequently

    o Always
    5. Do you feel comfortable discussing your emotions with friends or family?

    o Strongly Disagree

    o Disagree

    o Agree

    o Strongly Agree
    Section 5: Spiritual Wellness

    1. Do you engage in spiritual or religious practices? (e.g., prayer, meditation)

    o Yes

    o No
    2. How important is spirituality in your life?

    o Not Important

    o Somewhat Important

    o Important

    o Very Important
    3. Do you feel a sense of purpose in your life?

    o Strongly Disagree

    o Disagree

    o Agree

    o Strongly Agree
    4. How often do you reflect on your personal beliefs and values?

    o Never

    o Occasionally

    o Frequently

    o Always
    5. Do you feel connected to a larger community or belief system?

    o Strongly Disagree

    o Disagree

    o Agree
    o Strongly Agree

    Lifestyle Assessment

    1. How would you describe your eating habits?

    o Very Unhealthy

    o Unhealthy

    o Healthy

    o Very Healthy
    2. How many hours of sleep do you typically get per night?

    o Less than 5

    o 5-6

    o 7-8

    o More than 8
    3. Do you feel you maintain a good work-life balance?

    o Strongly Disagree

    o Disagree

    o Agree

    o Strongly Agree
    4. How often do you consume alcohol?

    o Never

    o Occasionally

    o Frequently
    o Daily
    5. How often do you engage in leisure activities outside of work?

    o Never

    o Occasionally

    o Frequently

    o Always

    Conclusion

    Thank you for participating in this questionnaire! Your responses will contribute to a
    better understanding of wellness and lifestyle among personnel at the Hawaiian
    Philippine Company Sugar Central. All responses will remain confidential.

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