Well-being Questionnaire (adapted after Ryff’s Psychological Well-Being Scales)
Completing the form is taking around 20 minutes. There are no good or bad answers. It is designed as a process to help you reflect about your well-being (it's not only focusing on physical health, but it's "a journey of unfolding the unique potential by developing the mental, emotional, physical aspects, in relation to oneself, the others and the environment."- adapted from Learning For Well-being definition).
Please feel free to be as honest as possible. We respect confidentiality and your answers will be used strictly in order to create the project and design the training course “Being Well-Being You”.
Organization
Your answer
Username
It will remain anonymous, but please remember it
Your answer
Gender
1. I am not afraid to voice my opinions, even when they are in opposition to the opinions of most people.
strongly disagree
strongly agree
2.In general, I feel I am in charge of the environment in which I live.
strongly disagree
strongly agree
3.I am interested in activities that will expand my horizons.
strongly disagree
strongly agree
4.I believe most people enjoy my communication style.
strongly disagree
strongly agree
5.I live my life one day at a time and I don't really think about the future of the society.
strongly disagree
strongly agree
6. When I look at the story of my life, I am pleased with how things have turned out.
strongly disagree
strongly agree
7. My decisions are often influenced by what everyone else is doing.
strongly disagree
strongly agree
8. Bad news about events happening in the society often get me down.
strongly disagree
strongly agree
9. I think it is important to have new experiences that challenge how I think about myself and the world.
strongly disagree
strongly agree
10. Maintaining close relationships is difficult and frustrating for me.
strongly disagree
strongly agree
11. I have a sense of direction and purpose in life.
strongly disagree
strongly agree
12. In general, I feel confident and positive about myself.
strongly disagree
strongly agree
13. I tend to worry about what other people think of me.
strongly disagree
strongly agree
14. I do not feel very comfortable in the community around me.
strongly disagree
strongly agree
15. When I think about it, I haven't really improved much as a person over the years.
strongly disagree
strongly agree
16. I often feel lonely because I have few close friends with whom to share my concerns.
strongly disagree
strongly agree
17. I often think that my daily activities are trivial and unimportant for my contribution to the society/world.
strongly disagree
strongly agree
18. I feel like many of the people I know have gotten more out of life than I have.
strongly disagree
strongly agree
19. I tend to be influenced by people with strong opinions.
strongly disagree
strongly agree
20. I am quite good at identifying and managing my emotions in my daily life.
strongly disagree
strongly agree
21. I have the sense that I have developed a lot as a person over time.
strongly disagree
strongly agree
22. I enjoy personal and mutual conversations with my family/friends.
strongly disagree
strongly agree
23. I don't have a good sense of what it is I'm trying to accomplish in life.
strongly disagree
strongly agree
24. I like most aspects of my personality.
strongly disagree
strongly agree
25. I tend to accept other peoples' requests even when I wouldn't like to.
strongly disagree
strongly agree
26. I often feel overwhelmed by my responsibilities.
strongly disagree
strongly agree
27. I dislike being in new situations that require me to change my old familiar ways of doing things.
strongly disagree
strongly agree
28. People would describe me as a giving person, willing to share my time with others.
strongly disagree
strongly agree
29. I enjoy making plans for the future and working to make them a reality.
strongly disagree
strongly agree
30. In many ways, I feel disappointed about my achievements in life.
strongly disagree
strongly agree
31.It's difficult for me to voice my own opinions on controversial matters.
strongly disagree
strongly agree
32. I have difficulty arranging my life in a way that is satisfying to me.
strongly disagree
strongly agree
33. For me, life has been a continuous process of learning, changing, and growth.
strongly disagree
strongly agree
34. I have not experienced many warm and trusting relationships with others.
strongly disagree
strongly agree
35. Some people wander aimlessly through life, but I am not one of them.
strongly disagree
strongly agree
36. My attitude about myself is probably not as positive as most people feel about themselves.
strongly disagree
strongly agree
37. Most often I judge myself by what I think is important, not by what others think is important.
strongly disagree
strongly agree
38. I have been able to build a home and a lifestyle for myself that is much to my liking.
strongly disagree
strongly agree
39. I seek to make changes in my life in order to learn new things.
strongly disagree
strongly agree
40. I know that I can trust my friends, and they know they can trust me.
strongly disagree
strongly agree
41. I believe there is a special contribution I can bring to what I do in my life.
strongly disagree
strongly agree
42. When I compare myself to friends and acquaintances, it makes me feel good about who I am.
strongly disagree
strongly agree
43. I am generally satisfied with my health.
strongly disagree
strongly agree
44. I feel good in my body.
strongly disagree
strongly agree
45. My physical state is sometimes affecting my ability to carry on with my life.
strongly disagree
strongly agree
46. Mention at least 3 things you think a participant should learn about in the training course “Being Well-Being You”:
Your answer
47. If you want you can add why you are interested in the project.
Your answer
Becoming a partner in Being Well-Being You
*Note In order for your organization to apply to become a partner, please:
-fill and send the partnership form
-ask at least 2 potential participants from the organization to submit the questionnaire,
-fulfill the criteria described in the call,
-send us the mandate at lecs.romania@gmail.com,
-send these before the 19th of January, first on e-mail and then by post.

For any questions please contact us at lecs.romania@gmail.com.

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