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participate in the study conducted by Ms. Anjali Bagh, Ms. Kalika Bhawre and Mr. Sandeep
Uikey of IVth year B.Sc. Nursing titled “ A Study to Assess Knowledge Regarding Life Style
Jabalpur (MP)” I will also co-operate with the researcher in providing necessary information. I
was explained that the information provided would be kept in confidential and used only for
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QUESTIONNAIRE
Section A
DEMOGRAPHIC DATA
(1). Age in years-
a. 19-21 yeas
b. 22-24 years
c. 25-27 years
d. More than 28 years
(2).Gender-
a. Male
b. Female
(3). Religion-
a. Hindu
b. Muslim
c. Christian
d. Shikh
e. Others
(4). Education-
a. 12th
b. Undergraduate
c. Others (Specify ………………..)
(5) Type of family-
a. Nuclear
b. Joint
c. Extended
(9). Do your parents are having any Life Style Diseases like Diabetes
Mellitus, HTN,CAD, Cancer etc.
a. Yes
b. No
If yes then specify………………
Section - B
1. Disease occur because of changes in Life Style Disease pattern is called-
a. Acute disease b) Life Style Disease c) Chronic disease d) None of these above
20.Which type of diet should not give to patient with Coronary Artery Disease?
a. Spicy food
b. High fat diet
c. Junk / street food
d. All of these above
Section B
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