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  1. Surveys
  2. 2005
  3. May
  4. S
  5. Sample Survey
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Hello:

You are invited to participate in our survey. In this survey, approximately 60 people will be asked to complete a survey that asks questions about Work absenteeism. It will take approximately 15 minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be stricly confidential and data from this research will be reported only to the course professor. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact May Al Otaibi .
Thank you very much for your time and support.
 
 
 
 
   
 
 

Gender
F m
 
 

Marital Status
Married Divorced single widowed Other  
 

Number od dependents
Less than 3 3 to 5 5 to 7 7 and more Other  
 
 

years at work
less than 5 years less than 10 years 10 to 15 part time Other  
 
 

Education
Higher than B.A. B.A. High school Other  
 
 

Health
v. good good weak Other  
 
 

Travel
Always sometimes none Other  
 
 

Salary
less than 500 BD More than 500 BD More than 1000 BD Other  
 

Other income
part time at same workplace part time at other places none Other  
 
 
 
What is your job title?
   
 

Job details
 
 
 
Job status
   
 
 
Rank
   
 
 

Distance to work
Far normal no problem Other  
 
 

Transportation
Own Car family car Bus Other  
 
 

Days of absence
 
With medical reason
 
None
 
Other
 

 
 

Work load
 
High
 
normal
 
Other
 

 

Is your scheduale flexible ?
Yes No
 

Do you work overtime ?
Yes No
 

Number of people on job ?
 
good number
 
moderate
 
need more
 
Other
 

 
 

training course
once twice many courses none Other  
 
 

How do you rate your training ?
Exellent very Good Good Not good Bad Other  
 
 

Role conflict
Home office
 

Family or community as motivation
Yes No
 

Conflicts often occur between my job and my responsibilities to my children.
Strongly agree Agree slightly agree slightly disagree disagree strongly disagree not applicable Other  
 

Centrality of work to life
High Average Equal Low None Other  
 

When do use sick leave ?
Really sick Often
 

Do you take sick leave when member of family is sick?
Always Often Depends Never No comment Other  
 
 

Reasons for abscence>
 
 

Work as principle motivation
Yes No
 

Strongly Agree Agree Neutral Disagree Strongly Disagree
Are you satisfied with your job?
 

Very Satisfied Somewhat Satisfied Neutral Somewhat Dissatisfied Very Dissatisfied
Job in general
work in general
supervisor
 

Very Satisfied Somewhat Satisfied Neutral Somewhat Dissatisfied Very Dissatisfied
Work mates
Pay
Promotional opportunities
 

How would you rate the level of your job stress?
Mild Moderate Severe Extreme
 

How many attempts have you made to relieve your job stress or solve the problem causing it?
None One Two Three or more
 

Is your job stress caused by your relationship with another person you work with?
Yes No
 

If your job stress doesn't involve another person, is it caused by the:
Volume of work Nature of the job and its responsibilities Physical work environment Personal health issue Other
 
 
What is/are the most stressful aspect(s) of your job?
   
 

Do u approve of the government system of reinforcement in controlling sick leave ?
Yes No Other  
 
 
 
What are the positive aspects of your job?
   
 
 
 
Additional Comments/Suggestions for improvement
   
Please contact [email protected] if you have any questions regarding this survey.
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