QUESTIONNAIRE TO IDENTIFY PSYCHOSOCIAL RISK FACTORS IN THE WORKPLACES

To answer the following questions, consider the conditions of your workplace, as well as the amount and
pace of work.
Almost Some Almost Nunc
Always
always times never a

1 My job requires me to exert a lot of physical effort

2 I am worried about having an accident at work

3 I consider the activities I perform to be dangerous.

Due to the amount of work I have to stay additional time

4
after my shift.

Due to the amount of work I have, I have to work non-

5
stop.

I believe it is necessary to maintain an accelerated pace

6
of work.

7 My job requires me to be very focused

8 My job requires me to memorize a lot of information

My job requires me to attend to several issues at the

9 same time.

The following questions are related to the activities you perform in your job and the responsibilities you
have.
Almost Some Almost Nunc
Always
always times never a

10 In my job, I am responsible for things of great value.

I am accountable to my manager for the results of my

11
entire work area.

12 I get contradictory orders at work

I feel that in my job I am asked to do unnecessary things.

13

The following questions are related to your work time and family responsibilities.
Almost Some Almost Nunc
Always
always times never a

14 I work overtime more than three times a week.

My job requires me to work on days off, holidays or

15
weekends.

I consider that the time spent at work is too much and

16
detrimental to my family and personal activities.

I think about family or personal activities when I am at

17
work.

The following questions are related to decisions you can make in your job.
Almost Some Almost
Always Never
always times never

18 My job allows me to develop new skills

19 In my job, I can aspire to a better position.

20 During my workday, I can take breaks when I need them.

I can decide the speed at which I carry out my activities

21
in my job

22 I can change the order of the activities I perform at work.

The following questions are related to the training and information you receive about your job.
Almost Some Almost
Always Never
always times never

23 I am clearly informed of my duties

They clearly explain to me the results that I must obtain

24
in my work

They inform me with whom I can solve problems or work

25
issues.

26 I am allowed to attend training related to my job.

27 I receive useful training to do my job

The following questions refer to your relationships with your co-workers and your boss.
Almost Some Almost
Always Never
always times never

28 My boss takes my views and opinions into account

29 My boss helps solve problems at work.

30 I can trust my coworkers

When we have to carry out teamwork, our colleagues

31
collaborate

32 My coworkers help me when I have difficulties

In my job I can express myself freely without

33
interruption.

34 I receive constant criticism of my person and/or work.

I receive mockery, slander, defamation, humiliation or

35
ridicule.

My presence is ignored or I am excluded from work

36
meetings and decision making.

Work situations are manipulated to make me appear to

37
be a bad worker.

My work successes are ignored and attributed to other

38
workers

They block or impede my opportunities for promotion or

39
improvement in my job.

40 I have witnessed acts of violence in my workplace.

 The following questions are related to customer and user service.
Yes
In my job I have to provide service to customers or users:
No
If you answered "YES", please answer the following questions. If your answer was "NO" skip to the
questions in the next section.
Almost Some Almost
Always Never
always times never

41 I attend to very angry customers or users

My job requires me to take care of people in need of

42
help or who are ill.

To do my job I must demonstrate feelings other than

43 my own.

Yes
I am the boss of other workers:
No
If your answer was "YES", answer the following questions. If your answer was "NO", you have completed
the questionnaire.
The following questions are related to the attitudes of the workers you supervise.
Almost Some Almost
Always Never
always times never

44 Late communication of work issues

45 hinder the achievement of work results

46 They ignore suggestions to improve their work