COMPARATIVE STUDY OF URBAN AND RURAL HOUSEHOLDS WITH 
SPECIAL REFERENCE TO QUALITY OF LIFE 
QUESTIONNAIRE 
Note: 
Strongly Dissatisfied- 
1 
Dissatisfied- 
2 
Neutral- 
3 
Satisfied- 
4 
Strongly Satisfied- 
5 
A. PERSONAL INFORMATION 
General information (this information will be kept confidential) 
Name……………………………………………………………… Age …………… 
Sex Male  Female  Residential Address ……………………………… 
………………………………………………………………… Pin Code………………. 
Marital Status Married  Unmarried  
Number of members in the family ……………….. 
Average monthly income (in rupees.)..…………………………………………..……… 
Job Profile...………………………………………………………………………………. 
Area you live in Rural  Urban  
What is your education? 
 Cannot read 
 Without any degree 
 Less than primary school 
 Primary school/ similar 
 Secondary education/ middle school/ high school 
 University/ similar 
 Other, please specify………………………………………………. 
Have you often worried about the daily expenses? 
 Never 
 Quite often 
 Often 
 Always 
B. PHYSICAL WELL-BEING 
How satisfied or dissatisfied you are with 
1 2 3 4 5 
Life overall 
Food 
Housing 
Income 
Health 
Work 
Local Security Level 
Friends
Family 
Education 
Free Choice & control over life 
Dignity 
Locality to yard 
C. FAMILY LIFE 
1 2 3 4 5 
I get proper time to spend with my family & friends 
I get proper time for households chores such as 
cleaning, cooking etc 
My family members are satisfied with my routine 
D. ECONOMIC LIFE 
1 2 3 4 5 
I am satisfied with my economic stand 
I spend on fruits 
I go for outing with my family 
I go usually for dinner with my family & friends 
I affected by sales of departmental stores 
I have a car/ expensive vehicle 
I buy new cloths on every festival 
I often buy branded cloths 
E. PERSONAL LIFE 
1 2 3 4 5 
I am satisfied with my personal health & well-being 
I am psychologically healthy & stress free 
I manage meals properly that is in proper amount 
and at a proper time 
I am getting ample amount of time for leisure 
activities 
I am perfectly satisfied with my lifestyle 
Have you felt that you do everything badly? 
Have you felt sad? 
Have you felt so bad that you didn’t want to do 
anything? 
Have you felt that everything in your life goes 
wrong? 
Have you felt fed up? 
Have you felt lonely? 
Have you felt under pressure?
F. SELF - PERCEPTION 
1 2 3 4 5 
I am happy with the way I am 
I am happy with my clothes 
I am worried about the way I look 
I felt jealous of the way other girls and boys look 
I would like to change something about my body 
G. SELF-RULE 
1 2 3 4 5 
Have I had enough time for myself 
I have been able to do the things that I want to do in 
my free time? 
I have had enough opportunity to be outside 
I had enough time to meet friends 
I have been able to choose what to do in my free 
time 
H. PSYCHOLOGICAL WELL-BEING 
1 2 3 4 5 
My life has been enjoyable 
I had felt pleased that I am alive 
I had felt satisfied with my life 
I have been in a good mood 
I felt cheerful? 
I had fun in my life 
I. MOODS AND EMOTIONS 
1 2 3 4 5 
I felt that I can do everything badly 
I felt sad 
I felt so bad that I didn’t want to do anything 
I felt that everything in your life goes wrong 
I felt fed up 
I felt lonely 
I felt under pressure 
J. SOCIAL LIFE AND SUPPORT 
1 2 3 4 5 
I possess proper well- being in terms of social 
interaction 
I am able to manage social circles and parties 
I often get indulge in welfare services 
I have good social status and esteem
I participated in religious functions 
I spent time with my friends 
I had fun with my friends 
I often do help of my friends 
I have been able to talk about everything with my 
friends 
K. FINANCIAL RESOURCES 
1 2 3 4 5 
I had enough money to do the same things as my 
friends do 
I have enough money for my expenses 
I have enough money to do things with my friends?

Project questionnaire

  • 1.
    COMPARATIVE STUDY OFURBAN AND RURAL HOUSEHOLDS WITH SPECIAL REFERENCE TO QUALITY OF LIFE QUESTIONNAIRE Note: Strongly Dissatisfied- 1 Dissatisfied- 2 Neutral- 3 Satisfied- 4 Strongly Satisfied- 5 A. PERSONAL INFORMATION General information (this information will be kept confidential) Name……………………………………………………………… Age …………… Sex Male  Female  Residential Address ……………………………… ………………………………………………………………… Pin Code………………. Marital Status Married  Unmarried  Number of members in the family ……………….. Average monthly income (in rupees.)..…………………………………………..……… Job Profile...………………………………………………………………………………. Area you live in Rural  Urban  What is your education?  Cannot read  Without any degree  Less than primary school  Primary school/ similar  Secondary education/ middle school/ high school  University/ similar  Other, please specify………………………………………………. Have you often worried about the daily expenses?  Never  Quite often  Often  Always B. PHYSICAL WELL-BEING How satisfied or dissatisfied you are with 1 2 3 4 5 Life overall Food Housing Income Health Work Local Security Level Friends
  • 2.
    Family Education FreeChoice & control over life Dignity Locality to yard C. FAMILY LIFE 1 2 3 4 5 I get proper time to spend with my family & friends I get proper time for households chores such as cleaning, cooking etc My family members are satisfied with my routine D. ECONOMIC LIFE 1 2 3 4 5 I am satisfied with my economic stand I spend on fruits I go for outing with my family I go usually for dinner with my family & friends I affected by sales of departmental stores I have a car/ expensive vehicle I buy new cloths on every festival I often buy branded cloths E. PERSONAL LIFE 1 2 3 4 5 I am satisfied with my personal health & well-being I am psychologically healthy & stress free I manage meals properly that is in proper amount and at a proper time I am getting ample amount of time for leisure activities I am perfectly satisfied with my lifestyle Have you felt that you do everything badly? Have you felt sad? Have you felt so bad that you didn’t want to do anything? Have you felt that everything in your life goes wrong? Have you felt fed up? Have you felt lonely? Have you felt under pressure?
  • 3.
    F. SELF -PERCEPTION 1 2 3 4 5 I am happy with the way I am I am happy with my clothes I am worried about the way I look I felt jealous of the way other girls and boys look I would like to change something about my body G. SELF-RULE 1 2 3 4 5 Have I had enough time for myself I have been able to do the things that I want to do in my free time? I have had enough opportunity to be outside I had enough time to meet friends I have been able to choose what to do in my free time H. PSYCHOLOGICAL WELL-BEING 1 2 3 4 5 My life has been enjoyable I had felt pleased that I am alive I had felt satisfied with my life I have been in a good mood I felt cheerful? I had fun in my life I. MOODS AND EMOTIONS 1 2 3 4 5 I felt that I can do everything badly I felt sad I felt so bad that I didn’t want to do anything I felt that everything in your life goes wrong I felt fed up I felt lonely I felt under pressure J. SOCIAL LIFE AND SUPPORT 1 2 3 4 5 I possess proper well- being in terms of social interaction I am able to manage social circles and parties I often get indulge in welfare services I have good social status and esteem
  • 4.
    I participated inreligious functions I spent time with my friends I had fun with my friends I often do help of my friends I have been able to talk about everything with my friends K. FINANCIAL RESOURCES 1 2 3 4 5 I had enough money to do the same things as my friends do I have enough money for my expenses I have enough money to do things with my friends?