QUESTIONARIE
CONSENT FORM
The study you are about to participate is “Frequency of Musculoskeletal discomfort and its
Association with Quality of life and Stress level among Professional Drivers.” The study has
no potential harm to participants. All data collected from you will be coded in order to protect
your identity, and should not be disclosed to anyone. Following the study there will be no way to
connect your name with your [Link] additional information about the study results will be
provided to you at its conclusion, upon your request.
You are free to withdraw from the study at any time. You agree to participate, indicating that you
have read and understood the nature of the study and that all your inquiries concerning the
activities have been answered to your satisfaction
Demographic Data:
Name: Age:
Gender: Residence:
Years of Driving Experience:
Type of Vehicle Driven:
[ ] Van
[ ] Cab
Average hours of driving per day:
Do you experience musculoskeletal discomfort (e.g., back, neck pain)?
[ ] Yes
[ ] No
NORDIC MUSCULOSKELETAL QUESTIONNAIRE
Nordic Musculoskeletal Questionnaire (NMQ), This is a tool used to assess musculoskeletal pain and
discomfort across various body regions, including the neck, shoulders, back, and limbs. We are interested
in knowing the presence of pain over specific time periods. It will help to identify the location, frequency,
and duration of symptoms, as well as their impact on daily activities.
Instructions
We are interested in knowing whether you are having any difficulty in different regions listed above for
which you are currently seeking attention. Please provide an answer for each [Link] is valuable in
evaluating Musculoskeletal health, identifying patterns of pain, and to reduce discomfort and improve
function.
SF-12 HEALTH SURVEY
This survey asks for your views about your [Link] information will help keep track of how
you feel and how well you are able to do your usual activities. Answer each question by
choosing just one answer. If you are unsure how to answer a question, please give the best
answer you can.
1. In general, would you say your health is:
□ Excellent □ Very good □ Good □ Fair □ Poor
The following questions are about activities you might do during a typical day. Does
your health now limit you in these activities? If so, how much?
YES, NO, not
YES,
limited limited
limited
a little at all
a lot
2. Moderate activities such as moving a table, pushing □ □ □
a vacuum cleaner, bowling, or playing golf.
3. Climbing several flights of stairs. □ □ □
During the past 4 weeks, have you had any of the following problems with your work
or other regular daily activities as a result of your physical health?
YES NO
4. Accomplished less than you would like. □ □
5. Were limited in the kind of work or other activities. □ □
During the past 4 weeks, have you had any of the following problems with your work
or other regular daily activities as a result of any emotional problems (such as
feeling depressed or anxious)?
YES NO
6. Accomplished less than you would like. □ □
7. Did work or activities less carefully than usual. □ □
8. During the past 4 weeks, how much did pain interfere with your normal work (including work
outside the home and housework)?
□ Not at all □ A little bit □ Moderately □ Quite a bit
□ Extremely
These questions are about how you have been feeling during the past 4 weeks.
For each question, please give the one answer that comes closest to the way
you have been feeling. How much of the time during the past 4 weeks.
All of Most A good Some A little None
the of the bit of of the of the of the
time time the time time time time
9. Have you felt calm & peaceful? □ □ □ □ □ □
10. Did you have a lot of energy? □ □ □ □ □ □
11. Have you felt downhearted and □ □ □ □ □ □
blue?
12. During the past 4 weeks, how much of the time has your physical health or
emotional problems interfered with your social activities (like visiting
friends, relatives, etc.)?
□ All of the time □ Most of the time □ Some of the time □ A little of the time
□ None of the time
The SF-12 Health Survey is a tool used to assess an individual’s physical and mental health status
through 12 questions. It generates two summary scores: the Physical Component Summary (PCS),
which reflects physical health, and the Mental Component Summary (MCS), which reflects
mental health. Both scores are standardized with a mean of 50 and a standard deviation of 10, with
higher scores indicating better health. The SF-12 is useful for tracking overall health, evaluating
treatment outcomes, and guiding healthcare interventions by highlighting areas of physical and
mental well-being.
PERCIEVED STRESS QUESTIONNAIRE
