Stress and Burnout Survey
Welcome to the Stress and Burnout Survey. Your responses will help assess workplace stress, burnout symptoms, work-life balance, and overall well-being. Please answer each question as honestly as possible.
1) What best describes your current employment status?
Full-time
Part-time
Self-employed
Student
Unemployed
Other
2) Which factors contribute most to your stress? (Select up to 3)
Please select at most 3 choices.
Workload
Deadlines
Financial concerns
Family responsibilities
Health issues
Relationships
Lack of sleep
Job insecurity
Other
3) How often do you experience the following?
Never
Rarely
Sometimes
Often
Always
Feeling emotionally exhausted
Difficulty concentrating
Trouble sleeping
Feeling overwhelmed
Loss of motivation
4) How would you rate your current stress level?
Very low
Low
Moderate
High
Very high
5) To what extent do you agree with the following statements?
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
I feel appreciated for my work.
I can maintain a healthy work-life balance.
I have enough time to recover after work.
I feel supported by my colleagues.
I have control over my workload.
6) How many hours do you typically sleep per night?
Less than 5
5-6
6-7
7-8
More than 8
7) What is your primary role or occupation?
8) How often do you take breaks during a typical workday?
Never
Rarely
Sometimes
Often
Always
9) How frequently do the following affect your daily life?
Headaches
Never
Rarely
Sometimes
Often
Very often
Muscle tension
Never
Rarely
Sometimes
Often
Very often
Irritability
Never
Rarely
Sometimes
Often
Very often
Fatigue
Never
Rarely
Sometimes
Often
Very often
Difficulty relaxing
Never
Rarely
Sometimes
Often
Very often
10) Which activities help you manage stress? (Select at least 1)
Please select at least 1 choice.
Exercise
Meditation
Reading
Talking with friends or family
Hobbies
Music
Professional counseling
Other
None
11) Describe the biggest source of stress in your life right now.
12) Have you ever felt close to burnout?
Yes
No
Not sure
13) Rate your satisfaction with the following areas.
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
Work-life balance
Physical health
Mental health
Social support
Personal time
14) What is one word that best describes how you have felt over the past week?
15) How comfortable are you seeking help when you feel overwhelmed?
Very uncomfortable
Uncomfortable
Neutral
Comfortable
Very comfortable
16) What changes would most improve your ability to manage stress?
17) How often do you disconnect from work or responsibilities during your personal time?
Never
Rarely
Sometimes
Often
Always
18) During the past month, how frequently have you experienced the following?
Never
Rarely
Sometimes
Often
Always
Feeling optimistic
Feeling anxious
Feeling productive
Feeling emotionally drained
Feeling engaged in daily activities
19) Is there anything else you would like to share about your experiences with stress or burnout?
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