backache sabiha
Post on 07-Apr-2018
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8/6/2019 Backache Sabiha
1/7
In the following questionnaire, I am going to ask you a variety of questions.
Some are concerned with you and some are general. There are Five (5) options
for every single question, Agree strongly Agree Neither Agree Nor disagree
Disagree Disagree strongly. Please tick () mark only to the answer to
which you feel to. Tick () mark to only one answer of each question.
I am simply interested in knowing your interest and perception of your life.
Please complete all the questions carefully as possible.
All your answers in the questionnaire will be treated in strict confidence.
May I thank you very much for your co-operation.
Sabiha Hakeem(Research Investigator)
PGDRP Student
Name: .
Age: Sex: (Male / Female)
Education: . (Illiterate/ Literate)
If Literate, mention qualification:
Occupation:
Monthly Income:
Family Status: (Nuclear/Joint) ..
Address:
Rural / Urban:
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8/6/2019 Backache Sabiha
2/7
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8/6/2019 Backache Sabiha
3/7
6. My back pain is such an achey feeling?Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
7. There are activities that can temporarily or permanently to ease back pain?Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
8. Is medication or doing special exercise essential for back pain?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
9. Do you usually feel low back pain?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
10. Do you usually have over weight? Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
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8/6/2019 Backache Sabiha
4/7
11. The medication is usually effective for treatment of back pain?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
12. I am not getting time to look after5 my child because of back pain?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
13.I think eating fatty and oily things create back ache trouble among women?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
14.I think that the heavy activities might be a cause of back trouble?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
15.I feel vertigo?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
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8/6/2019 Backache Sabiha
5/7
16.Ifeel over confident in my work?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
17. I do not take a proper concentration on my job?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
18.I often do not sleep properly?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
19.The back agony always creates a problem on my way?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
20.I feel helpless ?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
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8/6/2019 Backache Sabiha
6/7
21. I prefer to make cook by taking help of others?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
22.I cannot sit properly?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
23.I cannot walk properly?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
24.I stand with support?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
25.I usually feel weakness in my legs?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
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8/6/2019 Backache Sabiha
7/7
26.I usually have a problem of headache?
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
27.I often have a feeling of depression? Agree strongly
Agree strongly
Agree
Neither Agree Nor Disagree
Disagree
Disagree Strongly
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