The following questions relate to stress caused by different stresses within the 
workplace.  Please circle the box that most accurately reflects how you feel about 
your job at the moment.  Please only circle one box for each question.  
1. 
I am clear what is expected of me at work  
Never 
Seldom 
Sometimes 
Often 
Al
2. 
I can decide when to take a break 
Never 
Seldom 
Sometimes 
Often 
Al
3. 
Different groups at work demand things from me  Never Seldom 
Sometimes 
Often 
 
Al
that are hard to combine 
4. 
I know how to go about getting my job done 
Never 
Seldom 
Sometimes 
Often 
Al
5. 
I am subjected to personal harassment in the 
Never Seldom 
Sometimes 
Often 
Al
form of unkind words or behaviour 
6. 
I have unachievable deadlines 
Never 
Seldom 
Sometimes 
Often 
Al
7. 
If work gets difficult, my colleagues will help 
Never Seldom 
Sometimes 
Often 
Al
me 
8. 
I am given supportive feedback on the work I do 
Never 
Seldom 
Sometimes 
Often 
Al
9. 
I have to work very intensively 
Never 
Seldom 
Sometimes 
Often 
Al
10.  I have a say in my own work speed 
Never 
Seldom 
Sometimes 
Often  
Al
11.  I am clear what my duties and responsibilities 
Never Seldom 
Sometimes 
Often 
Al
are  
12.  I have to neglect some tasks because I have too 
Never Seldom 
Sometimes 
Often 
Al
much work to do 
13.  I am clear about the goals and objectives for my 
Never Seldom 
Sometimes 
Often 
Al
department 
14.  There is friction or anger between colleagues Never 
Seldom 
Sometimes 
Often 
Al
15.  I have a choice in deciding HOW I do my work  
Never 
Seldom 
Sometimes 
Often 
Al
16.  I an unable to take sufficient breaks 
Never 
Seldom 
Sometimes 
Often 
Al
17.  I understand how my work fits into the overall 
Never  
Seldom 
Sometimes 
Often  
Al
aim of the organisation  
18.  I am pressured to work long hours 
Never 
Seldom 
Sometimes 
Often 
Al
19.  I have a choice in deciding WHAT I do at work 
Never  
Seldom 
Sometimes 
Often 
Al
20.  I have to work very fast 
Never 
Seldom 
Sometimes 
Often  
Al
21.  I am subject to bullying at work 
Never 
Seldom 
Sometimes 
Often  
Al
22.  I have unrealistic time pressures 
Never 
Seldom 
Sometimes 
Often  
Al
23.  I can rely on my line manager to help me out 
Never Seldom 
Sometimes 
Often 
Al
with a work problem 
24 
I get help and support I need from my colleagues  Strongly
Disagree Neutral 
Agree  St
disagree 
ag
25.  I have some say over the way I work. 
Strongly  Disagree Neutral 
Agree  St
disagree 
ag
26.  I have sufficient opportunities to question 
Strongly  Disagree Neutral 
Agree  St
managers about change at work 
disagree 
ag
27.  I receive the respect at work I deserve from my 
Strongly  Disagree Neutral 
 
Agree  St
colleagues 
disagree 
ag
CONTINUED OVER……….. 
 
 
28.  Staff are always consulted about change at work 
Strongly  Disagree Neutral  Agree  St
disagree 
ag
29.  I can talk to my line manager about something that 
Strongly  Disagree   Neutral  Agree 
St
has upset or annoyed me about work 
disagree 
ag

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30.  My working time can be flexible 
Strongly  Disagree Neutral  Agree  St
disagree 
ag
31.  My colleagues are willing to listen to my work-
Strongly  Disagree Neutral  Agree  St
related problems 
disagree 
ag
32.  When changes are made at work, I am clear about 
Strongly  Disagree Neutral  Agree  St
how they will work out in practice 
disagree 
ag
33.  I am supported through emotionally demanding 
Strongly  Disagree Neutral  Agree  St
work 
disagree 
ag
34.  Relationships at work are strained 
Strongly  Disagree Neutral  Agree  St
disagree 
ag
35.  My line manager encourages me at work 
Strongly  Disagree Neutral  Agree  St
disagree 
ag
 
 
Thank you for completing this questionnaire.  Please return to Occupational 
Health Department in the envelope provided by the date requested on the 
covering letter. 
 

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