Stress at Work Survey Template

Stress at Work Survey Template
The Health and Safety Executive defines stress as ‘the adverse reaction people have to excessive pressures or other types of demands placed on them”.

We believe that stress may increasingly impact on people at work and we are running a campaign to ensure that your organisation has an action plan in place to combat work-related stress.

Finding out about people’s concerns is the first step. Please could you help by taking 10 minutes or so to fill out this survey form.

The results of this survey will help your representatives understand what is happening in your workplace. The results will be shared with you and will form the basis of discussions with the employer to take this forward.

We are not asking for personal details and will take all steps to guarantee the anonymity of the respondents.

About you

Name of Employer:

Age (please circle your answer): Under 25

25 – 34

35 – 44

45 – 54

55 or over
Gender (please circle your answer): Male

Female

1. 
   I am aware of a stress at work strategy at work
   

Yes / No

2. 
   Do you feel you are stressed by your work?
   

Yes / No

How are you?

Do you generally suffer from symptoms caused by stress in your workplace? (frequent headaches, depression, anxiety attacks, sleeplessness, indigestion, continual tiredness, or other
symptoms)

Yes / No

What makes you stressed at work?

(Please mark 1 for low level of stress, 5 for high level of stress)

1. Demands of the job

a. Long working hours 1 2 3 4 5


b. Too much work 1 2 3 4 5


c. Too little work 1 2 3 4 5


d. Repetitive or monotonous work 1 2 3 4 5

e. Insufficient time to do your job 1 2 3 4 5

f. Not enough rest breaks 1 2 3 4 5

2. Lack of control

a. Lack of control over work 1 2 3 4 5


b. Unrealistic targets 1 2 3 4 5


c. Pace of the work dictated by others 1 2 3 4 5

d. Deadline which are regularly too tight 1 2 3 4 5

e. Unremitting pressures to perform well 1 2 3 4 5

f. Over-harsh discipline 1 2 3 4 5


g. Too much supervision 1 2 3 4 5


h. Too little supervision 1 2 3 4 5


i. Too little job/task specific training 1 2 3 4 5

3. Work-life balance

a. Inflexible working hours
(causing childcare, domestic problems, etc) 1 2 3 4 5

b. Unsympathetic management 1 2 3 4 5


c. Unfair pay system 1 2 3 4 5


d. Failure to recognise achievements 1 2 3 4 5


e. Skills not being fully utilised 1 2 3 4 5

4. Relationships at work

a. Bullying, harassment or
unwanted behaviour 1 2 3 4 5


b. Respect as an employee 1 2 3 4 5

c. Discrimination or prejudice from colleagues or managers 1 2 3 4 5

d. Risk of violence and abuse
from customers or service users 1 2 3 4 5

e. Working alone 1 2 3 4 5


f. Lack of communication
between colleagues 1 2 3 4 5


g. Lack of communication between
staff and management 1 2 3 4 5

5. Change

a. Uncertainty about your future 1 2 3 4 5

b. Lack of job security 1 2 3 4 5


c. Introduction of new
management techniques 1 2 3 4 5

d. Restructuring 1 2 3 4 5


e. Lack of consultation over changes 1 2 3 4 5

6. Conflicting roles

a. Unclear job responsibilities 1 2 3 4 5

b. Conflicting responsibilities 1 2 3 4 5

c. Confused demands 1 2 3 4 5

7. Working environment

a. Overcrowding or cramped work areas 1 2 3 4 5

b. Untidy or unclean working areas 1 2 3 4 5


c. Poor facilities 1 2 3 4 5


d. Badly designed, unsuitable or uncomfortable equipment 1 2 3 4 5

What do you believe are the major causes of your stress at work?

.................................................................................................... .................................................................................................... .................................................................................................... ....................................................................................................

What do you believe your organisation could do to reduce stress at your workplace? .................................................................................................... .................................................................................................... .................................................................................................... ....................................................................................................

I am a union member

Yes / No

I am a union representative

Yes / No

I am interested in getting more involved in this campaign

Yes / No

I am interested in becoming a union representative

Yes / No


If you are interested in becoming a representative or getting more involved in the campaign, please contact ………………………………………………..

If you are interested in joining the union, please contact ………………………………………

Thank you for completing the questionnaire. Please return to ……………….