[中州航空] 飞行员身心健康状态调查问卷
Central Airlines Pilot Mental and Physical Health Survey

尊敬的飞行员：

您好！为更好地了解您的心理健康状态，并提供更有针对性的健康支持，现诚邀您填写本次问卷，填写时长预计7分钟。本问卷旨在了解您近期的身心状态，以及收集您对公司员工支持项目的意见。请您根据实际情况和真实感受作答，题目没有对错之分。

您填写的全部内容将严格保密，仅限经授权的心理健康专业人员用于分析评估，不会向其他无关人员披露，结果不作为飞行资质评定依据。问卷提交后即可查看您的分数报告及建议。测评结果主要用于健康管理和自我了解参考，不能替代专业诊断。

感谢您的信任与参与！


Dear Pilot,

Hello! To better understand your psychological health and provide more targeted health support, we sincerely invite you to complete this questionnaire, which should take about 7 minutes. This survey aims to understand your recent physical and mental state, as well as to gather your feedback on the company's Employee Assistance Program. Please answer based on your actual circumstances and genuine feelings — there are no right or wrong answers.

All information you provide will be kept strictly confidential and will only be used for analysis by authorized mental health professionals; it will not be disclosed to any unrelated parties. The results will not be used as a basis for flight fitness determinations. Once you submit the questionnaire, you will be able to view your score report and recommendations. The assessment results are intended for health management and self-awareness purposes only, and are not a substitute for professional diagnosis.

Thank you for your trust and participation!
*
您的姓名 Your Name:
*
您的年龄段：
18~25
26~30
31~40
41~50
51~60
60以上

请根据您过去两周内的实际情况作答，如实反映您的感受。答案没有对错之分。

Please answer based on how you have actually been feeling over the past two weeks. Please answer honestly. There are no right or wrong answers.

*

在过去两个星期，你有多常被以下问题困扰？

1、做任何事都觉得沉闷或不想做任何事 

Little interest or pleasure in doing things 

完全没有/Not at all
几天/Several days
一半以上的天数/More than half the days
近乎每天/Nearly every day
*

2、感到情绪低落、心情不好或对未来感到失望

Feeling down, depressed, or hopeless 

完全没有/Not at all
几天/Several days
一半以上的天数/More than half the days
近乎每天/Nearly every day
*

3、难以入睡，半夜会醒；或相反地，睡觉时间过多

Trouble falling or staying asleep, or sleeping too much 

完全没有/Not at all
几天/Several days
一半以上的天数/More than half the days
近乎每天/Nearly every day
*

4、觉得疲倦或活力不足

Feeling tired or having little energy

完全没有/Not at all
几天/Several days
一半以上的天数/More than half the days
近乎每天/Nearly every day
*

5、胃口极差或进食过量

Poor appetite or overeating 

完全没有/Not at all
几天/Several days
一半以上的天数/More than half the days
近乎每天/Nearly every day
*

6、对自己感到不满意，觉得自己做得不够好，或觉得自己让自己或家人失望

Feeling bad about yourself — or that you are a failure or have let yourself or your family down

完全没有/Not at all
几天/Several days
一半以上的天数/More than half the days
近乎每天/Nearly every day
*

7、难以集中精神做事，例如看报纸或看电视

Trouble concentrating on things, such as reading the newspaper or watching television

完全没有/Not at all
几天/Several days
一半以上的天数/More than half the days
近乎每天/Nearly every day
*

8、他人是否注意到您说话或行动比平时缓慢？或者相反，是否比平时更加坐立不安、活动增多？

Moving or speaking so slowly that other people could have noticed?

Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual 

完全没有/Not at all
几天/Several days
一半以上的天数/More than half the days
近乎每天/Nearly every day
*

9、是否曾出现过觉得自己不如不存在，或想要伤害自己的念头？

Thoughts that you would be better off dead or of hurting yourself in some way

完全没有/Not at all
几天/Several days
一半以上的天数/More than half the days
近乎每天/Nearly every day
*

如果你选了以上任何问题，这些问题在你的工作、处理家中事务或与人相处时造成多大困难?

完全没有困难/Not difficult at all
有一些困难/Somewhat difficult
非常困难/Very difficult
极度困难/Extremely
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