Life Satisfaction Survey - psych testing

Section 1

Date of Birth____; Gender___; Ethnic Origin___; Diagnosis___

Section 2

In first interview ask all questions 1-9. In a repeat interview, ask first, whether there have been any changes in respondent’s circumstances. If the answer is yes, complete questions 1-9. If answer is no, go straight to section 3 (question 10).

1 Age at leaving full time education___

2 Employment status___

If employed, ask questions 3 and 4, otherwise ask question 5

3 What is your occupation?___

4 How many hours a week do you work?

5 What is your total monthly income after tax?

6 Which if any, state benefits do you receive?

7 How many children if any do you have?

8 Who else (if anybody) do you live with?___

9 In which type of residence do you currently live?___

Part 3

10 How satisfied are you with your life as a whole today?

11 How satisfied are you with your job (or sheltered employment, or training/education as your main occupation)? Or if unemployed or retired, how satisfied are you with being unemployed/retired?

12 How satisfied are you with your financial situation?

13Do you have anyone who you would call a “close friend”? Yes/No

14 In the last week have you seen a friend? (visited a friend, been visited by a friend or met a friend both outside your home and work)? Yes/No

15 How satisfied are you with the number and quality of your friendships?

16 How satisfied are you with your leisure activities?

17 How satisfied are you with your accommodation?

18 In the past year have you been accused of a crime? (Yes/No)

19 In the past year have you been a victim of physical violence? (Yes/No)

20 How satisfied are you with your personal safety?

21 How satisfied are you with the people you live with? Or if alone, How satisfied are you with living alone?

22 How satisfied are you with your sex life?

23 How satisfied are you with your relationship with your family?

24 How satisfied are you with your health?

25 How satisfied are you with your mental health?

Satisfaction Scale

1	2	3	4	5	6	7
Couldn’t be worse	Displeased	Mostly dissatisfied	Mixed	Mostly Satisfied	Pleased	Couldn’t be better