My PIP is a look into the social and emotional effect acne plays upon self-esteem and the ability to feel confident in your own skin. Self-esteem takes into account a person’s self-image, body image, attractiveness and the way they fit in with their peers.
My name is Samantha Adlard and I am currently completing Year 12. I have structured this questionnaire as part of a Personal Interest Project for a subject called Society and Culture. The information that you provide me with will contribute towards the primary research that I am required to complete as part of the project, allowing me to turn the data that I obtain into measurable statistics.
Identity will remain confidential.
What is your gender? (Please circle)
Male Female
Age _____ Nationality _______________
Religion _______________ Suburb/City _______________
1. Do you believe having acne is associated with being dirty and unclean? (Please circle)
Yes No
2. Have you ever had a negative experience as a result of your acne? (Please circle)
Yes No
3. Please describe a situation where you have experienced discrimination because of your acne.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. How did this make you feel? Why?
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5. Are you likely to face limitations in your life due to your acne? (Please circle)
Yes No
6. If yes, what limitations would this include?
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
7. Please indicate how you feel (strongly agree agree unsure disgaree or strongly disagree) about the following statements.
a)My acne will last a short time
b)My acne is likely to be permanent rather than temporary
c)My acne will last for a long time
d)My acne will pass quickly
e)I expect to have this acne for the rest of my life
f)My acne is a serious condition
g)My acne has major consequences in my life
h)My acne does not have much effect on my life
i)My acne strongly effects the way others see me
8. What comments have been made about your acne?
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
9. How do you deal with the comments said about your acne?
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
10. How does having acne make you feel?
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
11.
a)As a result of having acne, have you been aggressive, frustrated or embarrassed? (all the time, alot, a little, not at all)
b)Do you think that having acne has at all interfered with your daily social life, social events or relationships with members of the opposite sex? (affecting all activities, moderately in activities, occasionally, not at all)
c)How would you describe your feelings about your acne over the last month? (the worst it could ever be, a major problem, a minor problem, not at all a problem)
My name is Samantha Adlard and I am currently completing Year 12. I have structured this questionnaire as part of a Personal Interest Project for a subject called Society and Culture. The information that you provide me with will contribute towards the primary research that I am required to complete as part of the project, allowing me to turn the data that I obtain into measurable statistics.
Identity will remain confidential.
What is your gender? (Please circle)
Male Female
Age _____ Nationality _______________
Religion _______________ Suburb/City _______________
1. Do you believe having acne is associated with being dirty and unclean? (Please circle)
Yes No
2. Have you ever had a negative experience as a result of your acne? (Please circle)
Yes No
3. Please describe a situation where you have experienced discrimination because of your acne.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. How did this make you feel? Why?
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
5. Are you likely to face limitations in your life due to your acne? (Please circle)
Yes No
6. If yes, what limitations would this include?
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
7. Please indicate how you feel (strongly agree agree unsure disgaree or strongly disagree) about the following statements.
a)My acne will last a short time
b)My acne is likely to be permanent rather than temporary
c)My acne will last for a long time
d)My acne will pass quickly
e)I expect to have this acne for the rest of my life
f)My acne is a serious condition
g)My acne has major consequences in my life
h)My acne does not have much effect on my life
i)My acne strongly effects the way others see me
8. What comments have been made about your acne?
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
9. How do you deal with the comments said about your acne?
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
10. How does having acne make you feel?
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
11.
a)As a result of having acne, have you been aggressive, frustrated or embarrassed? (all the time, alot, a little, not at all)
b)Do you think that having acne has at all interfered with your daily social life, social events or relationships with members of the opposite sex? (affecting all activities, moderately in activities, occasionally, not at all)
c)How would you describe your feelings about your acne over the last month? (the worst it could ever be, a major problem, a minor problem, not at all a problem)
, but it's just to show the different views everyone has