FAMILY AND FRIENDS |
My communication with others is open, honest and clear |
almost always |
Sometimes |
Almost never |
2 |
|
I give and receive affection |
almost always |
Sometimes |
Almost never |
2 |
|
I get the emotional support that I need |
almost always |
Sometimes |
Almost never |
2 |
|
ACTIVITY |
Active exercise (30 min, e.g., Running, cycling, fast walk) |
More than 4 times/week |
2 times/week |
Almost never |
2 |
|
Relaxation and enjoyment of leisure time |
almost always |
Sometimes |
Almost never |
2 |
|
NUTRITION |
Balanced meals |
almost always |
Sometimes |
Almost never |
2 |
|
Breakfast daily |
almost always |
Sometimes |
Almost never |
2 |
|
Excess sugar, salt, animal fats, or junk food |
Almost never |
Sometimes |
Almost daily |
2 |
|
Ideal weight |
± 4 kg |
±8 kg |
> ± 8 kg |
2 |
|
TOBACCO AND TOXINS |
Tobacco use |
None in the past 5 years |
None in the past 6 months |
More than 10 times/week |
2 |
|
Abuse of drugs, prescribed and unprescribed |
Almost never |
Sometimes |
Almost daily |
2 |
|
Coffee, tea, cola |
never |
3–6 daily |
>6 daily |
2 |
|
ALCOHOL |
Average intake per week. |
<2 |
2 |
>2 |
2 |
|
Alcohol and driving |
never |
Only occasional |
Often |
2 |
|
SLEEP, SEABELTS AND STRESS |
7–9 h sleep per night |
almost always |
Sometimes |
Almost never |
2 |
|
Frequency of seat belt use |
always |
almost always |
Almost never |
2 |
|
Major stressful events in past year |
none |
1–2 |
>3 |
2 |
|
TYPE OF PERSONALITY |
Sense of time urgency: impatience |
Almost never |
Sometimes |
almost always |
2 |
|
Competitive and aggressive |
Almost never |
Sometimes |
almost always |
2 |
|
Feeling of anger and hostility |
Almost never |
Sometimes |
almost always |
2 |
|
INSIGHT |
Positive thinker |
almost always |
Sometimes |
Almost never |
2 |
|
Anxiety, worry |
Almost never |
Sometimes |
almost always |
2 |
|
Depression |
Almost never |
Sometimes |
almost always |
2 |
|
CAREER |
Satisfied in job or role |
almost always |
Sometimes |
Almost never |
2 |
|
Good relationships with those around |
almost always |
Sometimes |
Almost never |
2 |
|
|
|
|
|
TOTAL |
50 |
|