MIND WELLNESS SCREENING
This is a confidential mental health screening assessment. This is a self report scale designed to measure the negative emotional states of depression, anxiety and stress. 
This link also provides a self-report burnout inventory score in relation to work. 

Ini adalah penilaian pemeriksaan kesihatan mental yang sulit. Ini ialah skala laporan diri yang direka untuk mengukur keadaan emosi negatif kemurungan, kebimbangan dan tekanan.
Pautan ini juga menyediakan skor inventori keletihan lapor diri berkaitan dengan kerja.

All information and patient data are strictly protected by the Malaysian Medical Council Guidelines 2011 
Semua maklumat dan data pesakit dilindungi dengan ketat oleh Garis Panduan Majlis Perubatan Malaysia 2011


0 - NEVER: Did not apply to me at all 
     Tidak langsung menggambarkan keadaan saya
1 - SOMETIMES: Applied to me to some degree, or some of the time
     Sedikit atau jarang-jarang menggambarkan keadaan saya
2 - OFTEN: Applied to me to a considerable degree, or a good part of time
     Banyak atau kerapkali menggambarkan keadaan saya
3 - ALMOST ALWAYS: Applied to me very much, or most of the time 
     Sangat banyak atau sangat kerap menggambarkan keadaan saya
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Email / Emel *
Name / Nama *
Handphone Number / Nombor Telefon Bimbit *
Number of years in service with current company / Bilangan tahun berkhidmat dengan syarikat semasa *
I found it hard to wind down /  Saya dapati diri saya sukar ditenteramkan *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I was aware of dryness of my mouth /  Saya sedar mulut saya terasa kering *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I couldn’t seem to experience any positive feeling at all /  Saya tidak dapat mengalami perasaan positif sama sekali *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I experienced breathing difficulty (eg, excessive rapid breathing, breathlessness in the absence of physical exertion) /  Saya mengalami kesukaran bernafas (contohnya pernafasan yang laju, tercungap-cungap walaupun tidak melakukan senaman fizikal) *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I found it difficult to work up the initiative to do things (difficult to start a certain task when given , but still able to finish it even if last minute) /  Saya sukar untuk mendapatkan semangat bagi melakukan sesuatu perkara *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I tend to over-react to situations (sometimes even small things irritate you) /  Saya cenderung untuk bertindak keterlaluan dalam sesuatu keadaan *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I experienced trembling (eg, in the hands) /  Saya rasa menggeletar (contohnya pada tangan) *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I felt that I was using a lot of 'nervous' energy (you constantly feel nervous when going through day to day routines, feel easily exhausted afterwards) /  Saya rasa saya menggunakan banyak tenaga dalam keadaan cemas  *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I was worried about situations in which I might panic and make a fool of myself /  Saya bimbang keadaan di mana saya mungkin menjadi panik dan melakukan perkara yang membodohkan diri sendiri *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
 I felt that I had nothing to look forward to (feeling hopeless/worthless) /  Saya rasa saya tidak mempunyai apa-apa untuk diharapkan *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I found myself getting agitated /  Saya dapati diri saya semakin gelisah *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I found it difficult to relax /  Saya rasa sukar untuk relaks *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I felt down-hearted and blue /  Saya rasa sedih dan murung *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I was intolerant of anything that kept me from getting on with what I was doing (you feel that you dont like to be disturbed or interrupted whenever you are already focused on doing something) /  Saya tidak dapat menahan sabar dengan perkara yang menghalang saya meneruskan apa yang saya lakukan *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I felt I was close to panic (the feeling of panic; excessive worry, increased heart rate, unable to think straight) /  Saya rasa hampir-hampir menjadi panik/cemas *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I was unable to become enthusiastic about anything /  Saya tidak bersemangat dengan apa jua yang saya lakukan *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I felt I wasn’t worth much as a person /  Saya rasa tidak begitu berharga sebagai seorang individu *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
 I felt that I was rather touchy (feeling over sensitive about things, or when spoken to) /  Saya rasa saya mudah tersentuh *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I was aware of the action of my heart in the absence of physical exertion (eg, sense of heart rate increase, heart missing a beat , heart beating strongly) /  Saya sedar tindakbalas jantung saya walaupun tidak melakukan aktiviti fizikal (contohnya kadar denyutan jantung bertambah, atau denyutan jantung berkurangan) *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I felt scared without any good reason /  Saya berasa takut tanpa sebab yang munasabah *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
I felt that life was meaningless /  Saya rasa hidup ini tidak bermakna *
Did not apply to me at all – NEVER
Applied to me very much , or most of the time - ALMOST ALWAYS
Is your work emotionally exhausting? / Adakah kerja anda meletihkan secara emosi?  *
Do you feel burnt out because of your work? / Adakah anda berasa letih kerana kerja anda? *
Does your work frustrate you? / Adakah kerja anda mengecewakan anda? *
Do you feel worn out at the end of the working day? / Adakah anda berasa letih pada penghujung hari bekerja? *
Are you exhausted in the morning at the thought of another day at work? / Adakah anda keletihan pada waktu pagi memikirkan hari lain di tempat kerja? *
Do you feel that every working hour is tiring for you? / Adakah anda rasa setiap waktu bekerja memenatkan anda? *
Do you have enough energy for family and friends during leisure time? / Adakah anda mempunyai tenaga yang mencukupi untuk keluarga dan rakan-rakan semasa masa lapang? *
Do you think your current workplace has a good mental health environment? / Adakah anda fikir tempat kerja anda sekarang mempunyai persekitaran kesihatan mental yang baik? *
Do you feel you will work better if there was an initiative to aid in work related mental health problems? / Adakah anda rasa anda akan bekerja lebih baik jika terdapat inisiatif untuk membantu dalam masalah kesihatan mental yang berkaitan dengan kerja? *
Should mental health be taken seriously at your current workplace? / Sekiranya kesihatan mental dipandang serius di tempat kerja anda sekarang? *
Are there some days when you just do not feel like working , and want to take an off day from work? / Adakah terdapat beberapa hari yang anda rasa tidak mahu bekerja dan ingin mengambil cuti dari kerja? *
Which of the following do you think will help you and your colleagues out more in regards to mental health? / Antara berikut, yang manakah anda fikir akan membantu anda dan rakan sekerja anda lebih lanjut berkaitan kesihatan mental? *
Required
If a private consult with a doctor regarding your mental health was offered, do you think you/your colleagues would benefit from it? / Jika rundingan peribadi dengan doktor mengenai kesihatan mental anda ditawarkan, adakah anda fikir anda/rakan sekerja anda akan mendapat manfaat daripadanya? *
How do you think workplace mental health can be improved? / Pada pendapat anda, bagaimanakah kesihatan mental di tempat kerja boleh dipertingkatkan? *
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