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Informed Consent Form
This study is being conducted by Yibeltal Arega for a research externship at Mercy College. The study is under the supervision of Dr. Claudia Fenderson, a professor in the Doctor of Physical Therapy Program at Mercy College. It compares the stress levels between Doctor of Physical Therapy students enrolled in weekend classes (currently in 1st year and 3rd year) vs. Masters in Communication Disorder students enrolled in weekday classes (currently in 1st year and 2nd year) in the past one month of current semester/trimester.
If you agree to participate, you will be asked to complete a survey about yourself. Included in the survey will be some general questions about your stress level, and the sources of your stress. The survey should only take about ten minutes. Please be assured that at no time will your name be reported along with any of your responses. Your participation in this study is voluntary and you are free to withdraw from the study before submitting the survey. The responses that you provide will be used by the researcher conducting the study for the purpose of learning about research and methodology. Your response could also be used by school officials to minimize stress levels in the academic sector.
I acknowledge that I am at least 18 years old and that the purpose and procedures of this study have been explained to my satisfaction. I understand that my participation is totally voluntary and that I am free to withdraw before submitting the survey. I understand that by submitting this survey I am providing my informed consent to participate in this study.
Survey questions
Graduate students face a wide variety of stress during their academic years. The aim of this stress questionnaire is to compare the stress levels of students enrolled in a weekday vs. weekend graduate program during their academic years at Mercy College. The research team will be using the perceived stress scale (PSS). The PSS is the most widely used psychological instrument for measuring the perception of stress. It is a measure of the degree to which situations in one’s life are appraised as stressful. The items are easy to understand, and the response alternatives are simple to grasp.
The following questions are general information about you and your past one month of current semester/trimester status. Please answer the following question by marking an X or filling the blank.
Demographic
 
 
 
1.Select the program you are currently enrolled.
 
Doctor of Physical Therapy
 
Masters in Communication Disorders
 
 
 
2. On average, how many hours did you study for school each week?
 
0-4hrs
 
4-6hrs
 
6-10hrs
 
10+ hrs
 
 
 
5.During this time period, were you employed? FORMCHECKBOX Yes FORMCHECKBOX No
 
If yes, proceed to next question if not processed to question 8.
 
 
 
7.Did you have children? FORMCHECKBOX Yes FORMCHECKBOX No
 
If yes, please provide the age of each child separated by a comma.
 
 
 
 
 
8.Please indicate your marital status? ____________
 
Perceived Stress Scale
 
The questions in this scale ask you about your feelings and thoughts during the last month in each case, you will be asked to indicate your choice on how often you felt or thought a certain way on a scale of 0-4.
 
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
 
 
 
1. How often have you been upset because of something
 
that happened unexpectedly? 0 1 2 3 4
 
 
 
2. How often have you felt that you were unable
 
to control the important things in your life? 0 1 2 3 4
 
 
 
4. How often have you felt confident about your ability
 
to handle your personal problems? 0 1 2 3 4
 
 
 
5. How often have you felt that things
 
were going your way? 0 1 2 3 4
 
 
 
6. How often have you found that you could not cope
 
with all the things that you had to do? 0 1 2 3 4
 
 
 
7. How often have you been able
 
to control irritations in your life? 0 1 2 3 4
 
 
 
9. How often have you been angered
 
because of things that were outside of your control? 0 1 2 3 4
 
 
 
10. How often have you felt difficulties
 
were piling up so high that you could not overcome them? 0 1 2 3 4
 
The following questions have been created by the research team to supplement the PSS. The questions ask about different stressors that may affect students in weekend DPT program and weekday CD program. For each question below, select one of the following alternatives:
 
0 = never 1 = almost never 2 = sometimes 3 = often 4 = very often
 
Social Stressor Questionnaire
 
Please answer all questions pertaining to your past one month of current semester/trimester.
 
 
 
1. How often did you feel that your course load has affected your relationships with your family members and friends?
 
0 1 2 3 4
 
 
 
2. How often did you feel the lack of time for relaxation because of school?
 
0 1 2 3 4
 
 
 
3. How often did you feel that marital/relationship problems have affected your education?
 
0 1 2 3 4
 
 
 
4. How often did you feel that financial problems have affected your education?
 
0 1 2 3 4
 
 
 
5. How often did you feel that your physical health has affected your school work?
 
0 1 2 3 4
 
 
 
6. How often do you get the support of your family while pursuing your studies?
 
0 1 2 3 4
 
For each question below, choose one of the following alternatives:
 
0 = never 1 = almost never 2 = sometimes 3 = often 4 = very often
 
Academics Stressor Questionnaire
 
Please answer all questions pertaining to your past one month of current semester/trimester.
 
 
 
7. How often did you feel that the amount of assigned coursework was too heavy?
 
0 1 2 3 4
 
 
 
8. How often did you find the coursework to be difficult?
 
0 1 2 3 4
 
 
 
9. How often did you feel that there was a competition among classmates?
 
0 1 2 3 4
 
 
 
10. How often did examinations and your grades worry you?
 
0 1 2 3 4
 
 
 
11. How often did completing the graduation requirements worry you?
 
0 1 2 3 4
 
 
 
12. How often did you experience the fear of failing a course?
 
0 1 2 3 4
 
For each question below, choose one of the following alternatives:
 
0 = never 1 = almost never 2 = sometimes 3 = often 4 = very often
 
Work Stressor Questionnaire
 
If you were employed in the past one month of current semester/trimester, please answer the following questions. If you were not employed, you have completed the survey.
 
 
 
13. How often did you feel that your workload interfered with school?
 
0 1 2 3 4
 
 
 
14. How often did you feel that that your workload has affected your study during exams?
 
0 1 2 3 4
 
 
 
15. How often were you able to take time off from work to accommodate your school work?
 
0 1 2 3 4
 
 
 
16. How often did you feel that your grades were affected because of work?
 
0 1 2 3 4
 
 
 
17. How often did you feel that the amount of hours you worked has affected your school work?
 
0 1 2 3 4
 
Thank you for your participation in this study.
 
If you have any questions or concerns please contact
 
Yibeltal Arega
 
Candidate for the Doctor of Physical Therapy
 
 
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