Questionnaire
Dear respondent,
I am a final year student
of the above name institution, conducting a research project on the knowledge
of sickle cell disease among married couples from age 24-45 years in Ozoro of
Isoko North Local Government Area.
of the above name institution, conducting a research project on the knowledge
of sickle cell disease among married couples from age 24-45 years in Ozoro of
Isoko North Local Government Area.
I will appreciate your
co-operation in filling out this questionnaire. All information supplied are
merely for academic purpose and will be
treated with confidentiality.
co-operation in filling out this questionnaire. All information supplied are
merely for academic purpose and will be
treated with confidentiality.
Thanks.
Instruction
Answer the following
question appropriately on the correct box space provided by ticking [ √ ] and
supply answer where needed.
question appropriately on the correct box space provided by ticking [ √ ] and
supply answer where needed.
SECTION A
1. Sex: Female [ ],
Male [ ]
Male [ ]
2. Age: 24-29 [ ],
30-34 [ ], 35-39 [ ], 40-45 [
]
30-34 [ ], 35-39 [ ], 40-45 [
]
3. Qualification: WAEC [
], NCE [ ], B.Sc [ ], Msc [
] None [ ]
], NCE [ ], B.Sc [ ], Msc [
] None [ ]
4. Religion: Christianity [
], Islam [ ], Other [ ]
], Islam [ ], Other [ ]
Section B
5. What is your blood genotype? SS [ ], AA [
], AS [ ]
], AS [ ]
6. Have you heard of sickle cell disease before? Yes [ ], No [
]
]
7. If yes
what does sickle cell disease mean? A condition caused by viral micro organism
[ ], A spiritual condition that is sent
upon his/her blood by the gods [ ], A
disease of the blood which affects the blood cell due to marriage of both AS
parents [ ], A disease that metabolizes
tissue and cell of the body [ ]
what does sickle cell disease mean? A condition caused by viral micro organism
[ ], A spiritual condition that is sent
upon his/her blood by the gods [ ], A
disease of the blood which affects the blood cell due to marriage of both AS
parents [ ], A disease that metabolizes
tissue and cell of the body [ ]
8. Did
you and your partner know or did genotype test before getting married? Yes
[ ], No [ ]
you and your partner know or did genotype test before getting married? Yes
[ ], No [ ]
9. How
did you know your genotype? Through marriage counselling [ ], Through hospitalization [ ], Through routine medical checkup [ ], Through a relation [ ], Others [ ]
did you know your genotype? Through marriage counselling [ ], Through hospitalization [ ], Through routine medical checkup [ ], Through a relation [ ], Others [ ]
10. Do you
have children that are of age or matured for marriage? Yes [ ], No [
]
have children that are of age or matured for marriage? Yes [ ], No [
]
11. If yes
do they have knowledge of sickle cell disease and the need for genotypes
testing before marriage? Yes [ ], No
[ ]
do they have knowledge of sickle cell disease and the need for genotypes
testing before marriage? Yes [ ], No
[ ]
12. Can
sickle cell disease be prevented? Yes [
], No [ ]
sickle cell disease be prevented? Yes [
], No [ ]
13. If yes
how can it be prevented? Environmental and personal hygiene [ ], Going for blood screening before marriage
[ ], Adequate diet intake [ ], Not marrying a carrier or individual with
the disease [ ]
how can it be prevented? Environmental and personal hygiene [ ], Going for blood screening before marriage
[ ], Adequate diet intake [ ], Not marrying a carrier or individual with
the disease [ ]
14. Do
children with sickle cell disease go to school in your area? Yes [ ], No [
]
children with sickle cell disease go to school in your area? Yes [ ], No [
]
15. If no,
why are they no given the chance for education?
why are they no given the chance for education?
…………………………………………………………………….……………
16. Which
are the right combination of genotype for intending couple? i. AA and AS,
ii. AA and SS, iii. AA and AA, iv. AS and AS, v. SS and AS, vi. SS and SS
are the right combination of genotype for intending couple? i. AA and AS,
ii. AA and SS, iii. AA and AA, iv. AS and AS, v. SS and AS, vi. SS and SS
(a)
i, ii and v [ ], (b) i, ii and iii
[ ], (c) i, iv and v [ ]
i, ii and v [ ], (b) i, ii and iii
[ ], (c) i, iv and v [ ]
17. Through
what medium did you get to know about sickle cell disease? Through educational
program [ ], Prints and electronic media
[ ], Through parents [ ], School [
], Others …………………………………
what medium did you get to know about sickle cell disease? Through educational
program [ ], Prints and electronic media
[ ], Through parents [ ], School [
], Others …………………………………
18. Are the
media for increasing knowledge of sickle cell disease still available in Ozoro
Community? Yes [ ], No [ ]
media for increasing knowledge of sickle cell disease still available in Ozoro
Community? Yes [ ], No [ ]
19. Does
your culture/religion belief permit blood screening for genotype in early stage
of life and before marriage? Yes [ ],
No [ ].
your culture/religion belief permit blood screening for genotype in early stage
of life and before marriage? Yes [ ],
No [ ].
