WELLNESS SELF-PERCEPTIONS

NAME: EAZEL DONN O. VILLAMATER GRADE AND SECTION: 12 - FAITH DATE: 09/24/21

To assess self-perceptions of welness

Procedures
1. Place an X over the appropriate box for each questions.
2. Write the number found in that circle in the box to the right.
3. Sum three boxes for each wellness dimension to get your wellness dimension totals.
4. Sum all wellness dimension totals to get your comprehensive wellness total.
5. Use the rating chart to rate each wellness area.
6. Complete the results section and the conclusions and implications section.

Question Strongly Agree Disagree Strongly

Agree Disagree
4 3 2 1 Score
1. I am happy most of the
☒ ☐ ☐ ☐ 4
time.
2. I have good self-
☒ ☐ ☐ ☐ 4
esteem.
3. I do not generally feel
☐ ☒ ☐ ☐ 3
stressed.
Emotional Wellness Total = 11
4. I am well informed
☐ ☒ ☐ ☐ 3
about current events
5. I am comfortable
expressing my view and ☒ ☐ ☐ ☐ 4
opinions.
6. I am interested in my
☒ ☐ ☐ ☐ 4
career development
Intellectual Wellness Total = 11
7. I am physically fit
☐ ☒ ☐ ☐ 3
8. I am able to perform the
☒ ☐ ☐ ☐ 4
physical tasks of my work.
9. I am physically able to
☒ ☐ ☐ ☐ 4
perform leisure activities
Physical Wellness Total = 11
10. I have many friends
☒ ☐ ☐ ☐ 4
and am involved socially.
11. I have close ties with
☒ ☐ ☐ ☐ 4
my family
12. I am confident in social
☒ ☐ ☐ ☐ 4
situations.
Social Wellness Total = 12
 13. I am fulfilled spiritually.
☒ ☐ ☐ ☐ 4
14. I feel connected to the
☒ ☐ ☐ ☐ 4
world around me
15. I have sense of
☒ ☐ ☐ ☐ 4
purpose in my life
Spiritual Wellness Total = 12
Comprehensive Wellness
57
(Sum of all five wellness)

In the results, record your scores then determine your ratings for each score using the
Wellness Rating Chart. Record your ratings in the results section.

Results
Wellness Dimension Score Rating
Emotional-mental 11 High-level Wellness
Intellectual 11 High-level Wellness
Physical 11 High-level Wellness
Social 12 High-level Wellness
Spiritual 12 High-level Wellness
Comprehensive 57 High-level Wellness

Wellness Rating Chart

Rating Wellness Dimension Comprehensive Wellness
Scores Scores
High-level Wellness 10-12 50-60
Good Wellness 8-9 40-49
Marginal Wellness 6-7 30-39
Low level of Wellness Below 6 Below 30
CONCLUSIONS AND IMPLICATIONS: Use several paragraphs to describe your
current state of wellness. DO you think the ratings are indicative of your true state of
wellness? Are there areas in which there is room for improvement?
- In my opinion, I don’t really think that I have any problem with my healthy habits
on my daily routine. In emotional and intellectual wellness, I know in myself that
I am truly happy in my heart and in my mind and I don’t really include myself
with things that will just bring me sadness and stress. I could also say that I am
physically fit with all of the physical activities that I accomplish everyday such
as Zumba, jogging, badminton training, and many more. When it comes to
social and spiritual wellness, I am a member of the Parish Youth Committee in
Lucban or PYC wherein I socialize with other people deeply serving for God.
Therefore,I conclude that the ratings I’ve got in this questionnaire are absolutely
the true state of my wellness.