The Pave Project Report - Queen's University Belfast

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The PAVE Project Report
Service users questionnaire
Section 1 About yourself
1. What age are you? under 30 years
30-50 years
over 50 years
2. Female Male
3. Is the area you live in: inner city.
outskirts
small town.
country.
4. Are you in paid employment? yes.
no
5. What educational or professional qualifications do you have? -----------------------------
6. Have you any worries
about money? yes.
no
If yes, what are your worries? ---------------------------------------------------------------
7. What are your main sources of financial support at the moment? --------------------------
8. Do you feel you get enough time
for yourself? yes.
no
9. How do you generally spend your free time ------------------------------------------------------------------
10. What is your state of health? good.
fair.
poor.
11. How often have you seen your
doctor in the past 6 months? once.
2-6 times.
more than 6 times.
12. Are you taking any tablets? yes
no.
If yes, what kind?........................................................................................
13. How have you been affected by the Troubles? (Please tick all relevant boxes)
a. An immediate member of the family has been killed
b. Physical injury or disability
c. A close friend or relative has been killed
d. Witnessed a violent event (shooting, bomb explosion)
e. Intimidation
f. Caring for someone injured by the troubles
g. A member of the family has been injured
h. Others (Please specify) -------------------------------------