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. 2022 Oct 14;11(9):5072–5076. doi: 10.4103/jfmpc.jfmpc_1081_21

Table 1.

Questionnaire

Questions Options
Do you agree to participate in this questionnaire? Yes/No
Age
Gender
Education
State of origin
Have you ever been sexually abused at any point in your life?. Yes/No
Sexual abuse consists of any of the following:
 a) look at his/her private parts?
 b) undress and show him/her your private parts?
 c) watch someone arouse sexual pleasure on their own ?
 d) undress with another child and fondle each other in front of him/her ?
 e) be a victim of bad touch (caresses, rubs, kisses) on the whole body and/or your private parts?
 f) look at pornographic pictures, drawings, films, videotapes or magazines ?
 g) be naked and to expose your private parts for picture taking or filming ?
 h) submit to sexual intercourse ?
What was your age at the first instance of sexual abuse? Yes/No
Have your parents spoken to you about good touch and bad touch? Yes/No
Do you consent to answer the following questions?
Which situation affected you more than others?
What was your age at the last instance of sexual abuse?
What was the age of the perpetrator?
Were you advised to inform an adult in case of such an event? Yes or no
Who did you talk to about these events?
How was the person who got you into this situation related to you? Family member friend stranger
How old were you when you were abused for the first time?
What was the gender of the person (or people) who got you in this (or these) situation/s (multiple answers possible)? Male
Female
Which situation affected you more than the others?
If you were subjected to one or more situations described, how many times did it happen to you?
If not, how old were you the last time it happened to you?
How old would you say he/she was (the abuser)? *multiple answers possible <30
>30
Did you ever talk to anyone about this (or these) event/s? Yes/No