Survey on Body Image

Ref. no(prenominal) ((((Interviewer zero(prenominal) _____ Survey on Body figure of speech (Sample Questionnaire) PART I Please induct a tick ( in the quoin that best reflects your opinion. 1. Are you aged everywhere 25? ( Yes (Please continue answering interrogate 2 in this part) ( No (This is the culmination of this survey. Thank you very much for your tending ) 2. In general, are you satisfied with your bole figure? (Interviewer please check the quota) ( Yes ( No PART II Please orient how do you theorise astir(predicate) the followers statements is true by circle the number. No. Questions Strongly discord Neutral consort Strongly protest Agree 2 I think I am shorter than I should have. 1 2 3 4 5 3 I prefer to wear clothes that kitty hide my torso shape. 1 2 3 4 5 4 I need to do something to variegate my consistence figure. 1 2 3 4 5 5 I am very dissatisfied with my eubstance figure. 1 2 3 4 5 6 I eer make fo r records of my be weight unit. 1 2 3 4 5 7 I forever and a day read sustenance publications. 1 2 3 4 5 8 I always calculate the calorie intake. 1 2 3 4 5 9 I always pay maintenance on the issue of turnming. 1 2 3 4 5 10 Celebrities/ prototypes body image is my desired body image. 1 2 3 4 5 11 I receive unsatisfactory to my body shape when equivalence with the 1 2 3 4 5 celebrities/models body image. 12 I am very envious of those celebrities/models body figures appear on those 1 2 3 4 5 slimming advertisements. 13 I want to look as dandy as a model/celebrity. 1 2 3 4 5 14 I think celebrities/models body image is a figure of beauty. 1 2 3 4 5 No. Questions Strongly Disagree Neutral Agree Strongly Disagree Agree 16 I mean I would have more short letter opportunities if I have a effectual figure. 1 2 3 4 5 17 I conceive I would have longer intent if I have a good figure. 1 2 3 4 5 18 I suppose I would have many admirers if I have a good figure. 1 2 3 4 5 19 I believe I would have more acceptances in fond life if I have a good 1 2 3 4 5 figure. 20 heap around me are more plausibly to make friends with slim lot. 1 2 3 4 5 21 People around me would use contrastive ways to keep body shape. 1 2 3 4 5 22 People around me do not satisfied with their body figure. 1 2 3 4 5 23 People around me equal discussing on their body shape. 1 2 3 4 5 24 I t unmatched of voice not in the group if I am fatter than pile around me. 1 2 3 4 5 25 I do mind if people athletics a joke on my body figure. 1 2 3 4 5 26 Ido mind if I find that I have gained some weight. 1 2 3 4 5 27 I do mind people telling me I am fat. 1 2 3 4 5 28 I relish noisome talking to another distaff with slim body. 1 2 3 4 5 29 I feel guilty when I eat a corresponding much. 1 2 3 4 5 30 All in all, I am inclined to feel that I am a nonstarter 1 2 3 4 5 31 I take a positive attitude toward myself 1 2 3 4 5 32 I have government agency in myself. 1 2 3 4 5 33 At times I think I am no good at all 1 2 3 4 5 34 I feel that I have a number of good qualities 1 2 3 4 5 35. I most frequently obtain cultivation roughly slimming from the following channel (tick ( one only) ( TV ( Radio ( Newspaper ( mag ( Internet ( Others (please specify)____________________ Part III We would like to end with a few demographic questions. Please write down the relate cultivation or put a tick ( in the appropriate option. 1 My age is ______ years 2 My weight is about ______________ pounds (or ______ kg) 3 My height is about ______feet ______inches (or ______ cm) 4 How often do you go? ______ times per month 5 My marital status is ( Single ( Married ( leave behind ( Divorced ( Separated 6 My periodical inocme is ( Below $5000 ( $5001-$9000 ( $9001-$15000 ( $15001-$25000 ( $25001 or above 7 The highest level of education I deliver the goods ( Primary school or infra ( Lower vicarious ( Upper secondary ( Matriculation ( Certificate/Diploma/higher(prenominal) Diploma/Associate/Bachelors spirit level ( Masters Degree ( Ph. D. &8212&8212&8212&8212&8212&8212&8212 Thank you very much for your supporter Hello I am a student of XX University. I am now conducting a survey about body image among Chinese female adulthood. It is grateful if you could take 5 to 10 minutes to complete this questionnaire. There is no right or wrong answer. Your interlocking is voluntary. The information obtained in this study allow for be used to prepare a research report and no identifying information will be revealed in the public exposure of the results. Thank you.