SURVEY QUESTIONNAIRE

Dear Respondents,

You are invited to participate in our data gathering as part of our Research Paper entitled:
“JOB SATISFACTION AND BURNOUT OF RADIOLOGIC TECHNOLOGISTS IN
SELECTED TERTIARY HOSPITALS IN DAVAO CITY.” Rest assured that the data
gathered will be kept strictly confidential and will only be used for the purpose of this research
work.

I. Demographic Profile

Age: [ ] 18 – 23 years old Sex:[ ] Male

[ ] 24 – 29 years old [ ] Female
[ ] 30 – 35 years old
[ ] 36 – 41 years old
[ ] 42 – 47 years old
[ ] 48 – 53 years old
[ ] 54 years old and above

Year of Service:
[ ] less than 1 year
[ ] 1-3 years
[ ] 4-6 years
[ ] 7-10 years
[ ] more than 10 years

II. Direction: Kindly read the items properly and write the scale on the appropriate box that
corresponds to your answer based on the scale below.
Rating Scale Descriptive Rating

5 – Very High This means that the level of job satisfaction is very
high and burnout is always manifested

4 – High This means that the level of job satisfaction is high

and burnout is oftentimes manifested

3 – Moderate This means that the level of job satisfaction is

moderate and burnout is sometimes manifested

2 – Low This means that the level of job satisfaction

is low and burnout is seldom manifested

1 – Very Low This means that the level of job satisfaction is very
low and burnout is never manifested
 I. Level of Job Satisfaction
Pay 5 4 3 2 1
1. Feels being paid a fair amount for the work I do.
2. Raises are regularly implemented.
3. Feels appreciated by the organization when I think about what
they pay me.
4. Feels satisfied with my chances for salary increase.
Supervision 5 4 3 2 1
1. My supervisor is quite competent in doing his/her job
2. My supervisor is fair
3. My supervisor shows great interest in the feelings of
subordinates
4. I like my supervisor.
Communication
1. Communication seems good within this organization.
2. The goals of this organization are clear to me.
3. I often feel that I know what is going on with the organization.
4. Work assignments are fully explained.

II. Level of Burnout

Emotional Exhaustion 5 4 3 2 1
1. I feel emotionally drained by my work.
2. I feel fatigued when I have to get up in the morning to face
another day on the job
3. Working with people all day is really a strain for me.
4. I feel frustrated by my job
Depersonalization 5 4 3 2 1
1. I feel I treat some patients as impersonal "object"
2. I have become more callous towards people since I took this job
3. I feel some patient's blame me for some of their problems
4. In my work, people bother me with personal problem that I don't
want to be bothered with
Personal Accomplishment 5 4 3 2 1
1. I deal ineffectively with problems of my patients.
2. I worry that this job is hardening me emotionally.
3. I feel exhilarated after working with my patients
4. I don't really care what happens to some patients.
Dear Participant,

We invite you to participate in our research study “JOB SATISFACTION AND

BURNOUT OF RADIOLOGIC TECHNOLOGISTS IN SELECTED TERTIARY
HOSPITALS IN DAVAO CITY”. We are currently enrolled in the Bachelor of Science in
Radiologic Technology and we are in the process of writing our undergraduate research. The purpose of
the research is to determine the relationship of job satisfaction and burnout.

The enclosed questionnaire has been designed to collect information. Your participation
in this research study is completely voluntary and will not be given any compensation. You may
decline altogether, or leave blank any questions you don’t wish to answer. There are no known
risks to participation beyond those encountered in everyday life. Your responses will remain
confidential and anonymous. Data from this research will be kept under lock and reported only
as a collective combined total. No one other than the researchers will know your individual
answers to this questionnaire.

If you agree to participate in this study, please answer the questions on the questionnaire
as best as you can. It should take approximately 30 minutes to complete. Also, we will inform
you as soon as there is progress on the study.

If you have any questions about this study, feel free to contact Mr. Vince Alejandrino, the
group leader through his mobile phone number at +63. If there are concerns regarding the
information on the rights of human subjects in research is available through Davao Doctors
College Research Office.

Thank you for your assistance in this important endeavor.

Sincerely yours,

Vince Alejandrino
Group Leader

RESEARCH PARTICIPANT’S CONSENT

I have read the information provided above. I have been given a chance to ask questions.
My questions have been answered to my satisfaction, and I agree to participate in this study. I
have been given a copy of this form. I can withdraw my consent at any time and discontinue
participation without penalty.

_________________
Signature over printed name Date signed