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Questionnaire template

Everyday Stress Survey

Measures adults' stress levels, triggers, coping methods, support and the effects of stress on health, work and quality of life.

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Healthcare · Mental health. All Healthcare templates

Questions in this template

Your Stress Level

  1. Thank you for taking part. This survey looks at what causes you stress at home and at work and how you deal with it. It takes about 10 minutes.

  2. How stressed do you feel at the moment, overall?

    Choose one:

    • Not at all stressed
    • Slightly stressed
    • Moderately stressed
    • Very stressed
    • Extremely stressed
  3. How much does each of these areas of your life add to your stress?

    • Work or career
    • Family
    • Finances
    • Health
    • Social relationships

    For each row: choose one:

    • Not at all
    • Slightly
    • Moderately
    • Very much
    • Extremely
  4. In the past month, how often have you felt overwhelmed by stress?

    Choose one:

    • Never
    • Rarely
    • Sometimes
    • Often
    • Always

What Triggers Your Stress

  1. Which of these situations regularly cause you stress?

    Choose any that apply:

    • Work deadlines
    • Conflict with colleagues or managers
    • Balancing work and personal life
    • Money worries
    • Worries about health
    • Family problems
    • Other
    • None of these
  2. What other situation causes you stress?

    Condition: Only when Other was selected

    Open answer

  3. Over the past year, how has each of these affected your stress?

    • Workload
    • Job security
    • Financial stability
    • Physical health
    • Emotional wellbeing
    • Social contact

    For each row: choose one:

    • Increased my stress
    • No change
    • Reduced my stress

Coping and Support

  1. How do you mainly cope with stress?

    Choose any that apply:

    • Exercise
    • Meditation or mindfulness
    • Talking with friends or family
    • Hobbies
    • Therapy or counselling
    • Relaxing activities such as reading or music
    • Other
    • None of these
  2. What other way of coping do you use?

    Condition: Only when Other was selected

    Open answer

  3. How well do these ways of coping help you manage your stress?

    Condition: Only when at least one coping method was selected

    Choose one:

    • Not at all effective
    • Slightly effective
    • Moderately effective
    • Very effective
    • Extremely effective
  4. Do you get enough help with stress from each of these groups?

    • Family
    • Friends
    • Colleagues

    For each row: choose one:

    • Yes
    • Not sure
    • No

Effects on Your Life and Work

  1. How, if at all, does stress affect your work?

    Choose any that apply:

    • I get less done
    • I miss work
    • I find it hard to concentrate
    • I make more mistakes
    • My motivation drops
    • Other
    • None of these
  2. In what other way does stress affect your work?

    Condition: Only when Other was selected

    Open answer

  3. How often does stress give you physical symptoms such as headaches or tiredness?

    Choose one:

    • Never
    • Rarely
    • Sometimes
    • Often
    • Always
  4. To what extent does stress lower your overall quality of life?

    Choose one:

    • Not at all
    • Slightly
    • Moderately
    • Very much
    • Extremely