Survey Questionnaire

Part I. Demographic Profile

Instructions: Fill-in the underlined space provided.

Name (optional):_______________________________________Gender: ________Age:______

Monthly income: _____________________Educational Attainment:_______________________
Marital Status:________________________Tribe:____________________________________

Part II. Question

Instructions: Encircle the number which you feel best of your choice and rate the items using the
scale below. Answer each question as honest as you can.

Descriptive Value Description Commented [TI1]: I took the liberty of changing the likert
type scale to a more suitable descriptive value for this study.
1.00 – 1.90 - Strongly Disagree
1.1 – 2.70 - Disagree
2.71 – 3.30 - Moderately Agree
3.31 – 4.20 - Agree
4.21 – 5.00 - Strongly Agree

A. Nutritional Intake Mean DV 1 2 3 4 5

1. I usually eat saturated and trans fatty 3.14 MA 2 6 15 9 3
food in my diet like cheese, red meats,
butter and margarine.
2. I usually eat foods that rich sources of 3.2 MA 3 7 10 10 5
cholesterol such as organs and egg
yolks.
3. I control eating low protein diet such as 3.08 MA 0 12 12 7 4
lean meats, fish, egg, beans, peas, soy
products, nuts, seeds and red meats.
4. I eat food containing high in fiber such 3.91 A 0 0 11 16 8
as whole grains, fruits like papaya and
banana, etc and green leafy vegetables.
5. I usually eat low in sodium containing 3.2 MA 0 7 17 8 3
food such as fruits like apple, oranges
or banana, vegetables such as spinach,
 carrots, broccoli, radish, beans and
peas.
6. I usually add artificial sweeteners in 2.94 MA 3 11 9 9 3
my diet such as aspartate, saccharin
and suclarose.
7. I usually consume low calories in my 3.31 A 1 4 17 9 4
diet like papaya, watermelon and
potatoes.
8. I only eat food which low in 2.97 MA 0 6 24 5 0
carbohydrates in my healthy diet like
fruits, vegetables, whole grains,
legumes and low-fat milk.
9. I usually eat food that rich sources of 2.69 D 0 17 12 6 0
cholesterol such as shrimp and squid.
10. I add non-saturated and poly-saturated 3.09 MA 0 8 19 5 3
fatty food like fish, olive oil and nuts.
3.15 MA Commented [TI2]: The table shows that the respondents
are moderately agree with the nutritional intake factor with
a 3.15 weighted mean. Further, a mean of 2.69 or a
B. Exercise descriptive value of Disagree was revealed by the
1. I do Yoga as a series of mental, 2.37 D 10 11 6 7 1 respondents saying that they usually do not eat food rich in
physical and spiritual exercise. cholesterol.
2. I do dancing for fun and excitement. 2.8 MA 6 11 7 6 5
3. I usually walk at least 3 times a week. 3.57 A 1 3 12 13 6
4. I do Chinese exercise like Tai Chi. 1.77 SD 11 21 3 0 0
5. I swim at least 3 times a week for at 2.2 D 13 8 9 4 1
least 10 minutes.
2.54 D Commented [TI3]: This data suggests that the
respondents disagreed that they do exercises with a
weighted mean of 2.54. they said that they strongly
C. Stress Management disagree that they do Chinese style exercises like Yoga but
1. I do deep breathing exercise or 3.69 A 0 1 16 11 7 they agree that they usually walk at least three times a
meditation for 5-20 minutes at least week.
once a day.
2. I do regular exercise like circling, 3.77 A 0 4 11 9 11
stretching and shaking parts of my
body.
3. I replace bad thoughts with happy 3.49 A 2 6 10 7 10
ones.
4. I take a nap during siesta time. 3.6 A 2 6 8 7 12
5. I love listening to music while 3.29 MA 2 9 8 7 9
exercising.
3.57 A Commented [TI4]: A descriptive value of Agree and a
weighted mean of 3.54 revealed that the respondents know
how to manage their stress. A high mean score of 3.77
D. Treatment states that the respondents do stretching exercises
1. I take insulin through needle and 2.71 MA 5 16 1 10 3 regularly.
syringe.
 2. I take insulin orally. 2.97 MA 3 14 1 16 1
3. I take insulin orally with a combination 2.68 D 3 18 2 11 1
of other diabetes medicine.
4. I take other forms of medicines like 3.03 MA 4 8 6 17 0
herbal.
5. I don’t take any form of medication at 1.26 SD 26 9 0 0 0
all.
2.53 D Commented [TI5]: On the treatment factor, the table
revealed that the overall mean score of 2.53 has a
descriptive value of Disagree. A weighted mean score of
1.26 with a descriptive value of disagree was gathered for
Ages: item # 5 which states that the respondent’s do not take any
form of medication at all is a positive response from the
40 – 4 participants which revealed that they are taking their
medications or treatment.
41 – 2 Commented [TI6]: Majority of the respondents (60%) are
between the age of 46-50.
42 – 2

43 – 2

44 – 1

45 – 3

46 – 3

47 – 4

48 – 2

49 – 5

50 – 7

Monthly income Commented [TI7]: Meanwhile, 17% of the respondents

shows that their monthly income is either 5,000 and 10,
2,000 – 2 000. While 14% of them has a monthly income of 15,000.

3, 000 – 1

4,000 – 1

5,000 – 9

7,000 – 2

8,000 – 1

9, 000 – 1
10, 000 – 9

13, 000 – 1

15,000 – 5

18,000 – 1

20,000 – 2

Educational Attainment Commented [TI8]: On educational attainment, the data

shows that 43% of the respondents were College graduates,
Elem grad – 8 34% were High School Graduates while 23% are elementary
school graduates.
HS grad – 12

College grad – 15

Marital Status Commented [TI9]: Majority of the respondents (89%) civil

status were Married. Similarly, 71% respondents are
Single: 4 females while 29% are males. Moreover, majority of the
respondents (51%) are coming from the Ilonggo tribal
group.
Married 31

Tribe

Ilonggo – 18

Cebuano: 4

Ilocano: 11

Maguindanaon – 2

Gender

Male – 10

Female – 25