Sample Work Positive CI Survey

Thank you for taking this survey. Your individual responses will be completely anonymous, and will be used to create anonymised reports helping to identify ways to improve the physical, social and mental wellbeing of employees in your organisation.

Please note that your anonymised responses may be used to improve how we score the work positive survey or to conduct research on employee wellbeing within the workplace. No individual survey respondent or company will be identifiable during this activity.

 

About you

Please indicate your gender
Does your role involve any remote working?
Remote working is a work arrangement in which you do not commute or travel to a central place of work, such as an office building, rather you work from your home or an alternative appropriate location.
Has remote working had a positive impact on you?
If yes, what impact has this had on you? (select any impacts that apply)
If no, what impact has this had on you? (select any impacts that apply)

 

Your work

I am clear in what is expected of me at work
I can decide when to take a break.
Different groups at work demand things from me that I find hard to combine
I know how to go about getting my job done
I am subject to personal harassment in the form of unkind words or behaviour at work
I have unachievable deadlines
If work gets difficult, my colleagues will help me if I ask
I am given supportive feedback on the work I do by my line manager
I have to work very intensively
I have enough control over the pace of my work
I am clear in what my duties and responsibilities are
I have to neglect some tasks because I have too much work to do
I am clear about the goals and objectives for my department/work group
There is friction or anger between colleagues
I have a choice in deciding how I do my work
I feel I cannot take enough break time
I understand how my work fits into the overall aim of the organisation
I am pressured to work long hours
I have a choice in deciding what tasks I do at work
I have to work too fast
I am subject to bullying at work
For this question we define workplace bullying as: repeated inappropriate behaviour, direct or indirect, whether verbal, physical or otherwise, conducted by one or more persons against another or others at the place of work and/or in the course of employment, which could be reasonably be regarded as undermining the individual's right to dignity at work.
I have unrealistic time pressures
I can rely on my line manager to help me out with a work-related problem if I ask
I get the help and support I need from my colleagues if I ask
I have some say over the way I work
I have sufficient opportunities to question management about change at work
Colleagues generally treat me respectfully at work
Staff are always consulted about change at work
I feel I can talk to my line manager about something that has upset or annoyed me about work
My working time can be flexible
I feel I can talk to my colleagues to solve work-related issues
When changes are made at work, it is explained how they will work in practice
I feel I would be supported by management if I had emotionally demanding work
Relationships at work are strained
My line manager encourages me at work

 

Your wellbeing (part 1)

The following statements have been designed by the World Health Organisation (WHO) to find out your current state of wellbeing. Please indicate for each of the five statements which response is closest to how you have been feeling over the last two weeks.

I have felt cheerful and in good spirits
I have felt calm and relaxed
I have felt active and vigorous
I woke up feeling fresh and rested
My daily life has been filled with things that interest me

© Psychiatric Research Unit, WHO Collaborating Center for Mental Health, Frederiksborg General Hospital, DK-3400 Hillerød

 

Your wellbeing (part 2)

Over the last 2 weeks, how often have you been bothered by the following problems?

Feeling nervous, anxious or on edge
Not being able to stop or control worrying
Little interest or pleasure in doing things
Feeling down, depressed, or hopeless

 

Exposure to Critical Incidents

A Critical Incident has been defined by the World Health Organisation (WHO) as an event out of the range of normal experience, one that is sudden and unexpected, makes you lose control, involves the perception of a threat to life and can include elements of physical or emotional loss’. 

Reflecting back over the last twelve months:       

Have you been involved in an incident(s) which you found to be particularly distressing or hard to cope with?

Definitions

  • Witnessed – to see, hear (an event/critical incident), or know by personal presence and perception
  • Injury – includes any disease and any impairment of a person’s physical or mental condition, including minor injuries. Bodily injury includes accidental bodily injury, death, disease, illness, mental injury, mental anguish or shock.
  • An adverse event is an incident where a patient/ client/ service user had an unexpected outcome due to unforeseen circumstances or due to an error in the delivery of their care.
  • An unusually long period of time – spent longer than normal or necessary at scene with a patient/service use due to circumstances out of your control
  • A peer is someone from the same profession, who shares a similar background as the group members and who is trained to provide an empathic listening ear; low level psychological support to their colleagues and facilitate pathways to professional help (i.e. EAP, Occupational health).

 

Please indicate the number of incidents, over the past twelve months, that involved the following:

 

 

Based on the incident that was most stressful for you within the last twelve months - did any of the following apply:

You personally knew the patient/client/service user personally.
You had significant “hands on” contact with human remains (e.g. a severely burned or dismembered or a badly decomposed body).
The incident had a profound significance for you due to being able to personally relate to the individual(s) and/or situation.
You spent an unusually long period of time with a patient/client service user.
The incident involved high media coverage.
What sort of ‘work-related’ support would be helpful in this situation? (you may select more than one option):