Significant others of vision care - Myopia prevention context
English Version
This questionnaire contains items that are related to your experience with others who have talked about eye protection to you. We would like to know more about how you have felt about your encounters with them. Your responses are confidential. Please be honest and candid.
* If a number of people have talked to you about how to protect your eye, please refer the questions to the one who is most important to you. Please tick one of the box below to indicate who you refer to.
Optician | Physician | Parents | Siblings | Friend | Teacher/ Lecturer | Classmate | Others | None |
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* If you haven’t met anyone who has talked to you about how to protect your eye, please skip this section.
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In regards to the person who talked to me about eye protection, … |
Strongly Disagree |
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Strongly Agree |
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1 |
I feel that he/ she provides me choices and options about how to protect my eyes. |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
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2 |
I feel understood by him/ her for my personal issues related to eye protection. |
1 |
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4 |
5 |
6 |
7 |
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3 |
He/ she conveyed confidence in my ability to protect my eyes. |
1 |
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5 |
6 |
7 |
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4 |
He/ she encouraged me to ask questions about how to protect my eyes. |
1 |
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7 |
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5 |
He/ she listens to how I would like to protect my eyes. |
1 |
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5 |
6 |
7 |
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6 |
He/ she tries to understand how I see things before suggesting a new way for me to protect my eyes. |
1 |
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6 |
7 |
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The Simplified Chinese Version
1. 以下问题是关于曾经对你提议过预防近视眼的人。请阅读每项陈述，然后圈出最能代表你的想法的数字。
a. 如曾经有很多人向你提过预防近视眼，请你以对你最重要的一个人作出回答。
请指出那个人是谁：
视光师（✔） | 医生（✔） | 父母（✔） | 兄弟姐妹（✔） | 朋友（✔） | 老师（✔） | 同学（✔） | 其他 （请写出） | 没有（✔） |
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如果没有人曾经对你提过预防近视眼， 请略过下面6题。
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对于那个曾经对我提过预防近视眼的人，… |
完全 不同意 |
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非常 同意 |
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1 |
我感觉到他已经给予我选择的权利与机会去如何预防近视眼。 |
1 |
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5 |
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7 |
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2 |
我感觉到他了解我个人如何预防近视眼的事。 |
1 |
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4 |
5 |
6 |
7 |
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3 |
他在我的能力上，给予我信心去预防近视眼。 |
1 |
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7 |
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4 |
他鼓励我对如何预防近视眼提出问题。 |
1 |
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7 |
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5 |
他听我想如何去预防近视眼。 |
1 |
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6 |
他在建议一个新的预防近视眼方法前，会尝试了解我的看法。 |
1 |
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6 |
7 |
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Notes. Only the simplified Chinese version of the scale was tested in the study
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Citation: |
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Chan, D. K. C., Fung, Y. K., Xing, S., & Hagger, M. S. (2014). Myopia prevention, near work, and visual acuity of college students: Integrating the theory of planned behavior and self-determination theory. Journal of Behavioral Medicine, 37(3), 369-380. doi: 10.1007/s10865-013-9494-9 |