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  2. 2014
  3. January
  4. C
  5. College life
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Questions marked with an * are required Exit Survey
 
Please read and answer yes or no to the informed consent. You may save a copy for your files
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Informed consent
 
Yes
 
No
 
 
 
STUDENT DEMOGRAPHICS

Please answer the following questions about yourself to assist in better interpretation of the information being collected. All responses are confidential.

Please check the appropriate box or fill in the blanks with the correct response.
An example is presented below
E.g. Length of time in the university

(a) 1 yr. [ ]

(b) 2yrs. [ ]

(c) 3yrs. [ ]

(d) 4 or more yrs [* ]
In this case my response is (d) 4 or more years.
 
 
 
1. GENDER


 
(a) Male [ ]
 
(b) Female [ ]
 
 
 
2. AGE

 
(a) 18-22 [ ]
 
 
(b) 23-28 [ ]
 
 
(c) 29-34 [ ]
 
 
(d) 35 and over [ ]
 
 
 
3. RESIDENCE


 
(a) On-campus [ ]
 
(b) Off Campus [ ]
 
 
 
4. ARE YOU A FIRST GENERATION COLLEGE STUDENT

 
(a) Yes
 
(b) No
 
 
 
5. What is your grade point average?
 
(a) A (3.5 - 4.0) [ ]
 
 
(b) B (2.5 - 3.4) [ ]
 
 
(c) C (1.5 - 2.4) [ ]
 
 
(d) D (0.5 - 1.4) [ ]
 
 
(e) F (0.0 – 0.4) [ ]
 
 
 
6. WHAT IS YOUR ACADEMIC STANDING

 
(a) Freshman [ ]
 
(b) Sophomore [ ]
 
(c) Junior [ ]
 
(d) Senior [ ]
 
(e) Graduate [ ]
 
 
 
7. Island of origin
   
 
 
 
8. Number of years in America
   
 
 
 
Student Life Stress Inventory (1991)

In this section you will first indicate the perception of your stress level (mild, moderate, or severe), then respond to the inventory by rating each item in the SSI using a 5-point scale in Likert format with 1 = never, 2 = seldom, 3 = occasionally, 4 = often, 5 = most of the time.

The SSI consists of 43 items listed under eight categories. Categories A - E measures stressors and categories F - G measures reactions to the stressors.

It is very important that you complete all the items. Please note that there is no wrong answer. All that is required is your honest response to each statement.
 
 
 
What is your current stress level?
 
Mild
 
Moderate
 
Severe
 
 
A. As a student (frustrations):
1-never 2-seldom 3-occasionally 4-often 5-most of the time
1. I have experienced frustrations due to delays in reaching my goals.
2. I have experienced daily hassles which affected me in reaching my goals.
3. I have experienced lack of sources (money for auto, books etc.).
4. I have experienced failure in accomplishing the goals I set.
5. I have not been accepted socially (became a social outcast).
6. I have experienced dating frustration.
7. I feel I was denied opportunities in spite of my qualifications.
 
 
B. I have experienced conflicts which were:
1-never 2-seldom 3-occasionally 4-often 5-most of the time
8. Produced by two or more desirable alternatives.
9. Produced by two or more undesirable outcomes.
10. Produced when a goal had both negative and positive alternatives.
 
 
C. I experienced pressures:
1-never 2-seldom 3-occasionally 4-often 5-most of the time
11. As a result of competition (on grades, work, relationships with spouse and/or friends).
12. Due to deadlines (papers due, payments to be made, etc).
13. Due to an overload (attempting too many things at one time).
14. Due to interpersonal relationships (family and /or friends, expectations, work responsibilities).
 
 
D. I have experienced (change):
1-never 2-seldom 3-occasionally 4-often 5-most of the time
15. Rapid unpleasant changes.
16. Too many changes occurring at the same time.
17. Change that disrupted my life and /or goals.
 
 
E. As a person (self imposed).
1-never 2-seldom 3-occasionally 4-often 5-most of the time
18. I like to compete and win.
19. I like to be noticed and be loved by all.
20. I worry a lot about everything and everybody.
21. I have a tendency to procrastinate (put off things that have to be done).
22. I feel I must find a perfect solution to the problems I undertake.
23. I worry and get anxious about taking tests.
 
 
F. During stressful situations, I have experienced the following (physiological):
1-never 2-seldom 3-occasionally 4-often 5-most of the time
24. Sweating (sweaty palms, etc.).
25. Stuttering (not being able to speak clearly).
26. Trembling (being nervous, biting fingernails, etc).
27. Rapid movements (moving quickly, from place to place).
28. Exhaustion (worn out, burn out).
29. Irritable bowels, peptic ulcers, etc.
30. Asthma, bronchial spasm, hyperventilation.
31. Backaches, muscle tightness (cramps), teeth-grinding.
32. Hives, skin itching, allergies.
33. Migraine headaches, hypertension, rapid heartbeat.
34. Arthritis, overall pains.
35. Viruses, cold, flu.
36. Weight loss (can’t eat).
37. Weight gain (eat a lot).
 
 
G. When under stressful situations, I have experienced (emotional):
1-never 2-seldom 3-occasionally 4-often 5-most of the time
38. Fear, anxiety, worry.
39. Anger.
40. Guilt.
41. Grief, depression.
 
 
H. With reference to stressful situations, I have (cognitive appraisal).
1-never 2-seldom 3-occasionally 4-often 5-most of the time
42. Thought about and analyzed how stressful the situations were.
43. Thought and analyzed whether the strategies I used were most effective.