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Questionnaire Example

This questionnaire was contructed for my MSc Public Health dissertation titled "Assessing the level of knowledge of Hepatitis C among Pakistani students at the University of Bedfordshire" This document also explains following steps: 1) What is this questionnaire about. 2) Who can be the participants. 3) Why participate. 4) How long will the questionnaire take 5) About privacy and confidentiality 6) About consent 7) Any risk of participation 8) Who developed questionnaire 9)

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Muhammad Khurram Shahzad
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133 views5 pages

Questionnaire Example

This questionnaire was contructed for my MSc Public Health dissertation titled "Assessing the level of knowledge of Hepatitis C among Pakistani students at the University of Bedfordshire" This document also explains following steps: 1) What is this questionnaire about. 2) Who can be the participants. 3) Why participate. 4) How long will the questionnaire take 5) About privacy and confidentiality 6) About consent 7) Any risk of participation 8) Who developed questionnaire 9)

Uploaded by

Muhammad Khurram Shahzad
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Title: Assessing the level of knowledge of hepatitis C among Pakistani students at University of Bedfordshire.

You are kindly invited to take a part in a research study and you are required to fill up a questionnaire regarding your knowledge about hepatitis C. Before making any decision whether or not to take a part, please read the following information. If you are not clear about anything in this participant information sheet please do not hesitate to contact the researcher. The contact details of the researcher are at the end of this participant information sheet. Please read this participant information sheet and then complete the consent form. Please read all the information in this participant information sheet carefully. Researcher: Muhammad Khurram Shahzad (Muhammad.Shahzad1@study.beds.ac.uk ) Research Supervisor: Gurch Randhawa (Gurch.Randhawa@beds.ac.uk ) What is the questionnaire about?

This questionnaire is a part of my MSc research project to assess the level of knowledge of hepatitis C among Pakistani students at University of Bedfordshire. The main aim of this study is to get an insight into the knowledge of Pakistani students and to find out if hepatitis C education is needed for Pakistani students at University of Bedfordshire. This questionnaire is prepared in order to find answers to general questions about hepatitis C. Who can be the participants?

If you are overseas Pakistani student studying at University of Bedfordshire and you are between 1865 years of age, then you can be the participant Why participate?

Since the main aim of this study is to get an insight into the level of knowledge of hepatitis C among Pakistani students at University of Bedfordshire. If the researcher is able to get responses, this study will help to arrange hepatic C related educational activities in the university for the future students. How long will the questionnaire take?

The questionnaire has 12 questions in total. The questions 1-10 have sub-categories. Questions 1-3 are about general knowledge regarding hepatitis C, questions 3-8 are about transmission, question 9 is about vaccine for hepatitis C and questions 11-12 are about prevalence of hepatitis C. At the end of the questionnaire there are some personal questions about the participants. This will take about 5-10 minutes to answer all questions.

About privacy and confidentiality:

The researcher will keep your personal information confidential. Only the researcher and the research supervisor will have an access to your personal details. Your name and personal details will not appear on the research paper. About consent and change of mind to withdraw from participation.

If you fill this questionnaire up and hand it back to the researcher, this would be taken as your consent for participation. To participate in this study is of voluntary nature and everyone has a right to freely take part or withdraw from the study at any time and can inform me about withdrawal from this study by sending me an email at Muhammad.Shahzad1@study.beds.ac.uk. Any risk in participation?

This doesnt mean to judge your intelligence levels or knowledge about hepatitis C. if you feel yourself distressed at any point of filling questionnaire, the researcher recommends stopping filling in the questionnaire and handing it back to the researcher. Who developed the questionnaire?

This questionnaire has been developed by Muhammad Khurram Shahzad, pursuing Master in Public Health at University of Bedfordshire. The questionnaire has been reviewed by Professor Gurch Randhawa (University of Bedfordshire).

Questionnaire
Name: . Sex: Age: . City/Village of birth: Education level: . Please encircle appropriate option below each question. 1. Have you ever heard of hepatitis C? a) Yes 2. Do you know, what is hepatitis C? a) Yes b) No c) Not sure b) No c) Not sure

3. Do you know what symptoms appear when someone is exposed to hepatitis C? a) Yes If yes, then which of the followings: a) Skin and white part of eyes get yellowish coloured b) Flu c) Pains in the abdomen d) Loss of appetite e) Generalised body pains f) Bleeding from the gums Yes Yes Yes Yes Yes Yes No No No No No No b) No c) Not sure

Others 4. Please write at least one cause of spread of hepatitis C a) .. b) Dont know 5. Do you think one can get hepatitis C through close contact with HCV positive patients? a) Yes b) No c) Not sure

If yes, then what about following options? a) Kissing b) Sharing eating utensils c) Coughing Yes Yes Yes No No No

Others 6. Can hepatitis C spread through? a) Stagnant water b) Blood c) Mosquito Yes Yes Yes No No No Dont know Dont know Dont know

Others . 7. Can hepatitis C be transmitted by? a) Sharing tooth brushes b) Unprotected sex c) Surgical instruments d) Contaminated shaving blades e) Blood transfusion f) Contaminated needles Others 8. Can mother transmit hepatitis C virus to her baby? a) Yes 9. Is there any vaccine for hepatitis C? a) Yes b) No c) Not sure b) No c) Not sure Yes Yes Yes Yes Yes Yes No No No No No No Dont know Dont know Dont know Dont know Dont know Dont know

10. Which of the following is correct about hepatitis C patient? a) Has a long period of illness b) Has short period of illness c) Dies on the spot after exposure to HCV 11. Prevalence of hepatitis C infection is highest in a) Asia b) Africa c) Europe d) Dont know Yes Yes Yes No No No Dont know Dont know Dont know

12. Which country has highest prevalence of hepatitis C of the following? a) Nigeria b) Egypt

c) Pakistan d) Kenya e) South Africa f) Dont know. I am really thankful to you for completing this questionnaire. If you wish to receive the results of this survey, then you are required to fill in the following spaces, the information provided here would be kept confidential. Name .. Age . Sex House No Road .. Town County . Post Code Email address ..

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