Questionnaire on Work Life Balance
1) Age:-
2) Gender: - Male/ Female
3) Designation:-
4) Nature of Org: - IT/ITES
5) How many days in a week do you normally work?
a) Less than 5 days
b) 5 days
c) 6 days
d) 7 days
6) How many hours in a day do you normally work?
a) 7-8 hours
b) 8-9 hours
c) 9-10 hours
d) 10-12 hours
e) More than 12 hours
7) How many hours a day do you spend traveling to work?
a) Less than half an hour
b) Nearly one hour
c) Nearly two hours
d) More than two hours
8) Do you work in shifts?
a) General shift/day shift
b) Night shift
c)Alternative
9) I) Are you married?
a) Yes
b)No
II) If yes, is your partner employed?
a) Yes
b) No
10) I) Do you have children?
a) Yes, no. of children____________.
b)No
II) Being an employed man/woman who is helping you to take care of your children?
a) Spouse
b) In-laws
c) Parents
d) Servants
e) Crèche/day care centers
III) How many hours in a day do you spend with your child/children?
a) Less than 2 hours
b) 2-3 hours
c) 3-4 hours
d) 4-5 hours
e) More than 5 hours
IV) Do you regularly meet your child/children teachers to know how your child is progressing?
a) Once in a week
b) Once in two weeks
c) Once in month
d) Once in 6 months
e) Once in a year.
11) I) Do you take care of?
a) Older people
b) Dependent adults
c) Adults with disabilities
d) Children with disabilities
e) none
II) If yes, how many hours do you spend with them?
a) Less than 2 hours
b) 2-3 hours
c) 3-4 hours
d) 4-5 hours
e) More than 5 hours
12) Do you generally feel you are able to balance your work life?
a) Yes
b) No
13) How often do you think or worry about work (when you are not actually at work or traveling to work)?
a) Never think about work
b) Rarely
c) Sometimes
d) Often
e) Always
14) How do you feel about the amount of time you spend at work?
a) Very unhappy
b) Unhappy
c) Indifferent
d) Happy
e) Very happy
15) Do you ever miss out any quality time with your family or your friends because of pressure of work?
a) Never
b) Rarely
c) Sometimes
d) Often
e) Always
16) Do you ever feel tired or depressed because of work?
a) Never
b) Rarely
c) Sometimes
d) Often
e) Always
17) How do you manage stress arising from your work?
a) Yoga
b) Meditation
c) Entertainment
d) Dance
e) Music
f) Others, specify_________.
18) I) Does your company have a separate policy for work-life balance?
a) Yes
b) No
c) Not aware
II) If, yes what are the provisions under the policy?
a) Flexible starting time
b) Flexible ending time
c) Flexible hours in general
d) Holidays/ paid time-off
e) Job sharing
f) Career break/sabbaticals
g) Others, specify________.
19) Do you personally feel any of the following will help you to balance your work life?
a) Flexible starting hours
b) Flexible finishing time
c) Flexible hours, in general
d) holidays/paid time offs
e) Job sharing
f) Career break/sabbaticals
g) time-off for family engagements/events
h) Others, specify_________
20) Do any of the following hinder you in balancing your work and family commitments?
a) Long working hours
b) Compulsory overtime
c) Shift work
d) meetings/training after office hours
e) Others, specify_________________
21) Do any of the following help you balance your work and family commitments?
a) Working from home
b) Technology like cell phones/laptops
c) Being able to bring Children to work on occasions
d) Support from colleagues at work
e) Support from family members
f) Others, specify___________.
22) Do any of the following hinder you in balancing your work and family commitments?
a) Technology such as laptops/cell phones
b) Frequently traveling away from home
c) Negative attitude of peers and colleagues at work place
d) Negative attitude of supervisors
e) Negative attitude of family members
c) Others, specify___________
23) Does your organization provide you with following additional work provisions?
a) Telephone for personal use
b) Counseling services for employees
c) Health programs
d) Parenting or family support programs
e) Exercise facilities
f) Relocation facilities and choices
g) Transportation
h) Others, specify______________.
24) Does your organization encourage the involvement of your family members in work- achievement reward functions?
a) Yes, specify the name of such program__________
b) No
25) Does your organization have social functions at times suitable for families?
a) Yes, specify the name of such programs____________
b) No.
26) Does your organization provide you with yearly Master health check up?
a) Yes
b) No
27) Do you suffer from any stress-related disease?
a) hypertension
b) obesity
c) diabetes
d) frequent headaches
e) none
f) Others, specify______.
28) I) Do you take special initiatives to manage your diet?
a) Yes
b) No
II) What is your preference for food?
a) Carrying home made food
b) Dieting on vegetables and fruits
c) Choosing less calorific food
d) Choosing organic food
e) Food from the organizations cafeteria
f) Spicy/Junk food
g) Others, specify__________.
III) How often will you have refreshment drinks/snacks in a day?]
a) None
b) Once
c) Twice
d) Thrice
e) More than three times
29) I) Do you spend time for working out?
a) Yes
b) No
II) If yes, how many hours?
a) less than half an hour
b)half an hour
c) half an hour to one hour
d) more than 1 hour
III) Where do you usually prefer to do your workouts?
a) In your organizations health centers
b) Residence
c) Nearby Gym
d)Walking
e) Others, specify_____________.
30) Do you feel work life balance policy in the organization should be customized to individual needs?
a) Strongly agree
b) Agree
c) Indifferent
d) Disagree
e) Strongly disagree
31) Do you think that if employees have good work-life balance the organization will be more effective and successful?
a) Yes
b) No
If so how?
______________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Thank You for your time.
Name:
Mobile No:
Name of your Organization:
1) Age:-
2) Gender: - Male/ Female
3) Designation:-
4) Nature of Org: - IT/ITES
5) How many days in a week do you normally work?
a) Less than 5 days
b) 5 days
c) 6 days
d) 7 days
6) How many hours in a day do you normally work?
a) 7-8 hours
b) 8-9 hours
c) 9-10 hours
d) 10-12 hours
e) More than 12 hours
7) How many hours a day do you spend traveling to work?
a) Less than half an hour
b) Nearly one hour
c) Nearly two hours
d) More than two hours
8) Do you work in shifts?
a) General shift/day shift
b) Night shift
c)Alternative
9) I) Are you married?
a) Yes
b)No
II) If yes, is your partner employed?
a) Yes
b) No
10) I) Do you have children?
a) Yes, no. of children____________.
b)No
II) Being an employed man/woman who is helping you to take care of your children?
a) Spouse
b) In-laws
c) Parents
d) Servants
e) Crèche/day care centers
III) How many hours in a day do you spend with your child/children?
a) Less than 2 hours
b) 2-3 hours
c) 3-4 hours
d) 4-5 hours
e) More than 5 hours
IV) Do you regularly meet your child/children teachers to know how your child is progressing?
a) Once in a week
b) Once in two weeks
c) Once in month
d) Once in 6 months
e) Once in a year.
11) I) Do you take care of?
a) Older people
b) Dependent adults
c) Adults with disabilities
d) Children with disabilities
e) none
II) If yes, how many hours do you spend with them?
a) Less than 2 hours
b) 2-3 hours
c) 3-4 hours
d) 4-5 hours
e) More than 5 hours
12) Do you generally feel you are able to balance your work life?
a) Yes
b) No
13) How often do you think or worry about work (when you are not actually at work or traveling to work)?
a) Never think about work
b) Rarely
c) Sometimes
d) Often
e) Always
14) How do you feel about the amount of time you spend at work?
a) Very unhappy
b) Unhappy
c) Indifferent
d) Happy
e) Very happy
15) Do you ever miss out any quality time with your family or your friends because of pressure of work?
a) Never
b) Rarely
c) Sometimes
d) Often
e) Always
16) Do you ever feel tired or depressed because of work?
a) Never
b) Rarely
c) Sometimes
d) Often
e) Always
17) How do you manage stress arising from your work?
a) Yoga
b) Meditation
c) Entertainment
d) Dance
e) Music
f) Others, specify_________.
18) I) Does your company have a separate policy for work-life balance?
a) Yes
b) No
c) Not aware
II) If, yes what are the provisions under the policy?
a) Flexible starting time
b) Flexible ending time
c) Flexible hours in general
d) Holidays/ paid time-off
e) Job sharing
f) Career break/sabbaticals
g) Others, specify________.
19) Do you personally feel any of the following will help you to balance your work life?
a) Flexible starting hours
b) Flexible finishing time
c) Flexible hours, in general
d) holidays/paid time offs
e) Job sharing
f) Career break/sabbaticals
g) time-off for family engagements/events
h) Others, specify_________
20) Do any of the following hinder you in balancing your work and family commitments?
a) Long working hours
b) Compulsory overtime
c) Shift work
d) meetings/training after office hours
e) Others, specify_________________
21) Do any of the following help you balance your work and family commitments?
a) Working from home
b) Technology like cell phones/laptops
c) Being able to bring Children to work on occasions
d) Support from colleagues at work
e) Support from family members
f) Others, specify___________.
22) Do any of the following hinder you in balancing your work and family commitments?
a) Technology such as laptops/cell phones
b) Frequently traveling away from home
c) Negative attitude of peers and colleagues at work place
d) Negative attitude of supervisors
e) Negative attitude of family members
c) Others, specify___________
23) Does your organization provide you with following additional work provisions?
a) Telephone for personal use
b) Counseling services for employees
c) Health programs
d) Parenting or family support programs
e) Exercise facilities
f) Relocation facilities and choices
g) Transportation
h) Others, specify______________.
24) Does your organization encourage the involvement of your family members in work- achievement reward functions?
a) Yes, specify the name of such program__________
b) No
25) Does your organization have social functions at times suitable for families?
a) Yes, specify the name of such programs____________
b) No.
26) Does your organization provide you with yearly Master health check up?
a) Yes
b) No
27) Do you suffer from any stress-related disease?
a) hypertension
b) obesity
c) diabetes
d) frequent headaches
e) none
f) Others, specify______.
28) I) Do you take special initiatives to manage your diet?
a) Yes
b) No
II) What is your preference for food?
a) Carrying home made food
b) Dieting on vegetables and fruits
c) Choosing less calorific food
d) Choosing organic food
e) Food from the organizations cafeteria
f) Spicy/Junk food
g) Others, specify__________.
III) How often will you have refreshment drinks/snacks in a day?]
a) None
b) Once
c) Twice
d) Thrice
e) More than three times
29) I) Do you spend time for working out?
a) Yes
b) No
II) If yes, how many hours?
a) less than half an hour
b)half an hour
c) half an hour to one hour
d) more than 1 hour
III) Where do you usually prefer to do your workouts?
a) In your organizations health centers
b) Residence
c) Nearby Gym
d)Walking
e) Others, specify_____________.
30) Do you feel work life balance policy in the organization should be customized to individual needs?
a) Strongly agree
b) Agree
c) Indifferent
d) Disagree
e) Strongly disagree
31) Do you think that if employees have good work-life balance the organization will be more effective and successful?
a) Yes
b) No
If so how?
______________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Thank You for your time.
Name:
Mobile No:
Name of your Organization:
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