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Socio - Demographic - and - Clinical - Variables English

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Lakshmi Rj
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21 views3 pages

Socio - Demographic - and - Clinical - Variables English

Uploaded by

Lakshmi Rj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Section - A

Demographic Variables

Please read the following and make a tick (√) mark in a appropriate one

1) Age (Years)
a) 21 - 24 ( )
b) 25 - 28 ( )
c) 29 - 32 ( )
d) 33 - 36 ( )
e) Above 36 ( )
2) Education
a) Primary school ( )
b) High school ( )
c) Higher secondary school ( )
d) Graduate ( )
3) Occupation
a) Home maker ( )
b) Daily wages ( )
c) Private job ( )
d) Government job ( )
4) Religion
a) Hindu ( )
b) Christian ( )
c) Muslim ( )
5) Family Monthly Income
a) Upto Rs. 10,000 ( )
b) Rs. 10,001 - 20,000 ( )
c) Rs. 20,001 – 30,000 ( )
d) Rs. 30,001 – 40,000 ( )
e) Above Rs. 40,000 ( )
6) Type of Family
a) Nuclear ( )
b) Joint ( )
7) Source of Awareness
a) Mass media ( )
b) Health personnel ( )
c) Friends ( )
8) Performance of Household Activities
a) Alone ( )
b) With others ( )
SECTION - B

Clinical Variables

Please read the following and make a tick (√) mark in a appropriate one

1) Gestational Weeks
a) 13 - 21 weeks ( )
b) 22 - 30 weeks ( )
c) Above 30 weeks ( )
2) Parity Status

a) Primi ( )
b) Multi ( )
3) BMI

a) <18.5 ( )
b) 18.5 - 24.9 ( )
c) 25 - 29.9 ( )
d) 30 - 39.9 ( )
e) 35 - 39.9 ( )
f) above 40 ( )
4) Past History of Low Back Pain
a) Yes ( )
b) No ( )
5) Hours of Rest at day time

a) Nil ( )
b) 1 – 2 hours ( )
c) 3 – 4 hours ( )

6) Duration of Sleep

a) 2 – 5 hours ( )
b) 5 – 8 hours ( )
c) More than 8 hours ( )

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