Survey Questionnaire
Age: _____ Course & Year: ___________________ Date: ______________
Instructions: Please check the box to indicate your rating on the 5-point scale that follows for each of the
following questions. Kindly provide a truthful response to the questions. Keep all questions answered.
Scale:
4-Very often 3-Quite often 2-Occasionally 1-Very Rarely 0-Never
Respondent's treatment of their respective families SCALE
Productive Conversations
I can easily tell my family how things go with me on a day 4 3 2 1 0
I can open sensitive topics that bother me 4 3 2 1 0
I have the chance to speak and share my opinions with my 4 3 2 1 0
family
I feel that I am heard and respected whenever I talk inside the 4 3 2 1 0
family
I am willing for a discussion and accept my mistakes if ever I 4 3 2 1 0
commit one
Quality time spent together
My parents and I talk about what happened to our day every day 4 3 2 1 0
My parents reach out for help for my schoolwork 4 3 2 1 0
My parents are aware of my interests and find time to do it with 4 3 2 1 0
me
We schedule family downtime or family dates every holiday 4 3 2 1 0
We do not use our gadgets whenever we eat together 4 3 2 1 0
Free time Pleasures
I respect the ways in which my family chooses to relax 4 3 2 1 0
I make an effort to include my family in recreational activities 4 3 2 1 0
I create activities with my families 4 3 2 1 0
Planning ways to bond and spend time with my family is a 4 3 2 1 0
priority of mine
I am conscious of the boundaries that my family has when they 4 3 2 1 0
spend time for themselves
How does the family treat the respondents?
Division of household work
My family burdens me with chores 4 3 2 1 0
Chores are split fairly between the members of the family 4 3 2 1 0
I feel a sense of independence with the tasks my family gives me 4 3 2 1 0
They trust me in giving responsibilities to other family members 4 3 2 1 0
in the division of works
At times my family is inconsiderate of the work they ask of me 4 3 2 1 0
leading to over-exhaustion
Financial support
I receive enough daily allowance 4 3 2 1 0
My family provides me with my basic necessities. 4 3 2 1 0
My parents manage my school fees and budget. 4 3 2 1 0
I rely on my family for medical support. 4 3 2 1 0
I live comfortably in a stable home. 4 3 2 1 0
Emotional support 4 3 2 1 0
My family respects my choices and decisions 4 3 2 1 0
We communicate when misunderstandings arise. 4 3 2 1 0
I can be open with my family when I have problems and burdens 4 3 2 1 0
My family supports my dreams and ambitions 4 3 2 1 0
My family disciplines and corrects me when I am in the wrong 4 3 2 1 0
What values do they uphold?
Public places 4 3 2 1 0
I treat public authorities with respect 4 3 2 1 0
I treat community helpers with respect 4 3 2 1 0
I avoid making other people works hard (like not littering) 4 3 2 1 0
I tend to respect other people's personal spaces 4 3 2 1 0
I follow safety rules in all places 4 3 2 1 0