Workplace Well Being Questionnaire (Black Dog Institute)About this form –INSTRUCTIONS: Please answer the following questions by checking the appropriate box. Choose the option which best represents your ‘current’ and most relevant work situation (i.e. the work role where you spend most of your time and with who you have most contact) over the past 30 days using the following scale;First NameOptionalLast NameOptionalCompany or Organisation Name *If not connected to any Company or Organisation Name type – none0 / 100Email Address *Acceptance of Terms and Conditions & Privacy Policy *Yes, I agree with the Workplace Well-being Privacy Policy and Terms & Conditions (click here to read)Is your work fulfilling? *ExtremelyVeryModeratelySlightlyNot at allIn general terms, do you trust the senior people in your organisation? *ExtremelyVeryModeratelySlightlyNot at allDo your daily work activities give you a sense of direction and meaning? *ExtremelyVeryModeratelySlightlyNot at allAt a difficult time, would your boss be willing to lend an ear? *ExtremelyVeryModeratelySlightlyNot at allDoes your work eat into your private life? *ExtremelyVeryModeratelySlightlyNot at allDoes your work bring a sense of satisfaction? *ExtremelyVeryModeratelySlightlyNot at allDo you believe in the principles by which your employer operates? *ExtremelyVeryModeratelySlightlyNot at allIs your boss caring? *ExtremelyVeryModeratelySlightlyNot at allDo you feel stressed in organising your work time to meet demands? *ExtremelyVeryModeratelySlightlyNot at allDoes your work increase your sense of self-worth? *ExtremelyVeryModeratelySlightlyNot at allDo you feel content with the way your employer treats its employees? *ExtremelyVeryModeratelySlightlyNot at allDoes your job allow you to re-craft your job to suit your needs? *ExtremelyVeryModeratelySlightlyNot at allDo you feel that your boss is empathic and understanding about your work concerns? *ExtremelyVeryModeratelySlightlyNot at allDo you feel excessively pressured at work to meet targets? *ExtremelyVeryModeratelySlightlyNot at allDoes your work make you feel that, as a person, you are flourishing? *ExtremelyVeryModeratelySlightlyNot at allDo you feel that your employer respects staff? *ExtremelyVeryModeratelySlightlyNot at allDoes your boss treat you as you would like to be treated? *ExtremelyVeryModeratelySlightlyNot at allAfter work, do you find it hard to wind down? *ExtremelyVeryModeratelySlightlyNot at allDo you feel capable and effective in your work on a day-to-day basis? *ExtremelyVeryModeratelySlightlyNot at allHow satisfied are you with your work’s value system? *ExtremelyVeryModeratelySlightlyNot at allDoes your boss shoulder some of your worries about work? *ExtremelyVeryModeratelySlightlyNot at allDo you find yourself thinking negatively about work outside work hours? *ExtremelyVeryModeratelySlightlyNot at allDoes your work offer challenges to advance your skills? *ExtremelyVeryModeratelySlightlyNot at allCompared with your organisation’s ‘ideal values’, to what degree re actual work values positive? *ExtremelyVeryModeratelySlightlyNot at allDo you feel your transactions with your boss are, in general, positive? *ExtremelyVeryModeratelySlightlyNot at allDo you feel that you can separate yourself easily from your work when you leave for the day? *ExtremelyVeryModeratelySlightlyNot at allDo you feel you have some level of independence at work? *ExtremelyVeryModeratelySlightlyNot at allDo people at your work believe in the worth of the organisation? *ExtremelyVeryModeratelySlightlyNot at allDo you believe that your employer cares about their staff’s well being? *ExtremelyVeryModeratelySlightlyNot at allDoes your work impact negatively on your self-esteem? *ExtremelyVeryModeratelySlightlyNot at allDo you feel personally connected to your organisation’s values? *ExtremelyVeryModeratelySlightlyNot at allWork Satisfaction (WS)Work Satisfaction Scoring (WS): Low = 0-11; Medium = 12-30; High = 31-40 This measure indicates the degree to which you view your work as fulfilling, and whether it increases your sense of self-worth, provides life with some purpose and meaning, and advances your skills. Low scores may signify low levels of work satisfaction.Organisational Respect for the Employee (ORE)Organisational Respect for the Employee Scoring: Low = 0-7; Medium = 8-21; High = 22-28 This measured whether you judge senior people in your organization as trustworthy and having ethical values, as well as whether the organization values its staff and treats you well. High scores indicate high levels of organisational respect for the employee.Employer Care (EC)Employer Care Scoring: Low = 0-7; Medium = 8-21; High = 22-28 This measure is specific to how well your boss treats you. It looks at whether he/she is caring, willing to lend an ear, be understanding about work concerns and treats you as you wish to be treated. Low scores may indicate low levels on that care dimension.Intrusion of Work into Private Life (IWPL)Intrusion of Work into Private Life Scoring: Low = 0-5; Medium = 6-17; High = 18-26 High scores on this scale indicate greater intrusion of work into your private life. It measured whether you feel stressed and pressured at work to meet targets, find it hard to ‘wind down’ after work and judge that your work eats into your private life and impacts negatively on your self- esteem.Submit Form
INSTRUCTIONS: Please answer the following questions by checking the appropriate box. Choose the option which best represents your ‘current’ and most relevant work situation (i.e. the work role where you spend most of your time and with who you have most contact) over the past 30 days using the following scale;
Yes, I agree with the Workplace Well-being Privacy Policy and Terms & Conditions (click here to read)
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