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PCOS Survey Questionnaire

This document is a survey questionnaire designed to assess women's knowledge, awareness, and attitudes towards Polycystic Ovary Syndrome (PCOS). It includes sections on demographic information, knowledge about PCOS, awareness levels, and attitudes towards the condition. The survey aims to gather data that can inform educational initiatives and support for women affected by PCOS.

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Roselle Marie Tayo
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257 views4 pages

PCOS Survey Questionnaire

This document is a survey questionnaire designed to assess women's knowledge, awareness, and attitudes towards Polycystic Ovary Syndrome (PCOS). It includes sections on demographic information, knowledge about PCOS, awareness levels, and attitudes towards the condition. The survey aims to gather data that can inform educational initiatives and support for women affected by PCOS.

Uploaded by

Roselle Marie Tayo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Survey Questionnaire

Research Study: Knowledge, Awareness, and Attitude of Women About


PCOS

Part I: Demographic Information


1. Age: _______

2. Civil Status: ☐ Single ☐ Married ☐ Separated ☐ Widowed

3. Educational Attainment:
☐ High School Graduate ☐ College Level ☐ College Graduate ☐ Postgraduate

4. Occupation: ___________________________

5. Have you been diagnosed with PCOS? ☐ Yes ☐ No

6. Do you know someone with PCOS? ☐ Yes ☐ No

Part II: Knowledge About PCOS


Please indicate whether the following statements are True, False, or Don’t Know.

Statement True False Don’t Know

PCOS is a hormonal ☐ ☐ ☐
disorder affecting
women of
reproductive age.

Irregular menstrual ☐ ☐ ☐
cycles are a
symptom of PCOS.

PCOS can cause ☐ ☐ ☐


infertility.

Obesity increases ☐ ☐ ☐
the risk of PCOS.

There is a cure for ☐ ☐ ☐


PCOS.

PCOS only affects ☐ ☐ ☐


overweight women.
Acne and excessive ☐ ☐ ☐
hair growth can be
symptoms of PCOS.

Birth control pills ☐ ☐ ☐


are sometimes used
to manage PCOS
symptoms.

Part III: Awareness of PCOS


1. Have you ever heard of PCOS before? ☐ Yes ☐ No

2. If yes, how did you learn about PCOS? (You may check more than one)

☐ Social Media ☐ Television/Radio ☐ School ☐ Healthcare Provider ☐ Friends/Family


☐ Other (Please specify): _______________

3. How would you rate your current awareness of PCOS?

☐ Very Aware ☐ Moderately Aware ☐ Slightly Aware ☐ Not Aware

Part IV: Attitudes Toward PCOS


Please indicate the extent to which you agree with the following statements:

Statement Strongly Agree Neutral Disagree Strongly


Agree Disagree

Women ☐ ☐ ☐ ☐ ☐
should be
educated
about PCOS
at an early
age.

PCOS is a ☐ ☐ ☐ ☐ ☐
serious
health issue.

I am willing ☐ ☐ ☐ ☐ ☐
to undergo
screening
for PCOS.

I believe ☐ ☐ ☐ ☐ ☐
lifestyle
changes can
help manage
PCOS.

I would ☐ ☐ ☐ ☐ ☐
support a
friend or
family
member
who has
PCOS.

Talking ☐ ☐ ☐ ☐ ☐
about PCOS
is still taboo
in society.

I am ☐ ☐ ☐ ☐ ☐
interested in
learning
more about
PCOS.

Women with ☐ ☐ ☐ ☐ ☐
PCOS may
feel
ashamed or
embarrasse
d to talk
about their
condition.

Society ☐ ☐ ☐ ☐ ☐
tends to
judge
women with
PCOS based
on their
physical
appearance
(e.g., weight,
acne, body
hair).

I believe ☐ ☐ ☐ ☐ ☐
PCOS is
unfairly
stigmatized
in the
community.

I feel ☐ ☐ ☐ ☐ ☐
comfortable
discussing
PCOS openly
with others.

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