Sample Questions from the Wellness Model

The Singer's Wellness Model

© 1996 Dr. Karen Wicklund

This questionnaire will help determine your level of wellness. Your response to these questions will help to give you some ideas for areas in which you might improve your level of wellness. Some questions may touch on personal subjects, and you may feel that you do not want to answer all of the questions. Please be assured that your answers will be kept strictly confidential. The more questions you answer, the more you will learn about your health and its maintenance.

Today's date:

Your age:

M/F:

Please respond to these items using the following responses. If an item does not apply to you, do not mark it.

Almost always (90% or more of the time)
Very often (approx. 75% of the time)
Often (approx. 50% of the time)
Occasionally (approx. 25% of the time)
Almost Never (less than 10% of the time)
Not Applicable

Physical Exercise:

(Measures one's commitment to maintaining physical fitness)

1. I exercise vigorously for at least 20 minutes a minimum of three times per week.

2. I stretch before and after exercising, and cool my body down after exercise.

3. I monitor the rate of my heartbeat while exercising.

4. I avoid excessive muscle tension in the neck by using proper weight lifting techniques on a consistent basis.

Nutrition:

(Measures the degree to which one chooses foods that are consistent with the dietary goals of the United States as published by the Senate Select Committee on Nutrition and Human Needs)

6. I eat at least 5 servings of fresh fruits and vegetables per day.

8. I avoid eating foods with a lot of sodium (more than 3000 mg of sodium per day).

9. I eat breakfast before I warm up my voice.

10. I drink adequate amounts of water on a daily basis (enough to keep urine pale).

11. I include many fiber-rich foods (vegetables, grains, beans, etc.) in my diet on a daily basis.

12. I minimize my intake of fats and oils in my daily diet, and eat less than 30% of my total calories per day as fat calories.

Physical Vocal Wellness:

(Measures singe5's ability to use optimal vocal hygiene efforts with speaking and singing voice)

51. I avoid frequent clearing of the throat or coughing in order to remove mucous.

52. I avoid the use of my habitual speaking pitch/speaking voice on the vocal "fry" (my lowest speaking pitch) and attempt to use my optimal speaking pitch.

53. I avoid the habitual use of vocal idiosyncrasies ("funny" voices) or the mimicking of other people.

54. I avoid habitual whispering.

Technical Vocal Wellness:

(Measures singe5's ability to use optimal technique on a consistent basis)

62. I remember to warm-up my voice methodically before singing.

63. I remember to cool-down my voice after singing.

64. I engage in regular voice study with a teacher.

65. I engage in adequate daily practice of technical exercises, scales and songs.

66. I avoid the overuse of my voice in rehearsals/performances.

90. Circle the arrows next to all the statements that apply to you:
Voice is worse in the morning
Voice is worse later in the day, after it has been used
Perform or rehearse in the morning
Speak extensively (teacher, clergy, attorney, telephone work, etc.)
Cheerleader
Frequent sore throat
Bitter acid taste or bad breath first thing in the morning
Frequent heartburn or hiatus hernia
Frequent yelling or loud talking
Chronic fatigue (insomnia)
Work around extreme dryness
Excessive exercise (more than once per day)
Frequently thirsty, dehydrated
Hoarseness first thing in the morning
Chest cough
Eat late at night
Have used antacids
Under particular stress at present (personal or professional)
Involved in legal action involving problems with your voice
Frequent bad breath
Live, work, or perform around smoke or fumes
Recent travel: When and Where?

Specific vocal technical difficulties, chronic or sporadic?
Trouble singing softly
Trouble singing loudly
Poor pitch control
Support problems
Problems at register transitions
Other (please describe)

Chronic or sporadic problems:
Hoarseness
Breathiness
Fatigue
Loss of range
Change in voice classification
Voice breaks
Pain in singing
Prolonged warm-up time
Tickling or choking sensation while singing
Other (please describe):

Any problems in the past that required a visit to a physician?
Laryngitis
Nodules
Polyps
Hemorrage
Tonsilitis
Cancer
Other (please describe)

How many colds/upper respiratory infections do you have per year, on average?

Have you ever been evaluated by an allergist?
Yes
No

What allergies do you have?
None
Dust
Mold
Trees
Cats
Dogs
Foods
Others:

Emotional Wellness:

(Measures measures the degree to which one has an awareness and acceptance of one's feelings, and engages in effective, related behaviors with a positive and enthusiastic attitude about oneself and life)

91. I feel positive about myself.

92. My emotions are stable and steady.

93. I am aware of my needs.

94. I trust myself and my own judgement.

95. I am not afraid to make mistakes.

Mental/Intellectual Wellness:

(measures the degree to which one engages her/his mind in creative, stimulating mental activities, expanding knowledge, and improving skills)

128. I read more than ten new books yearly.

129. I read the newspaper everyday.

130. I regularly attend museums or art shows (more than three per year).

131. I regularly use my leisure time for hobbies such as photography, gardening, woodworking, sewing, painting, baking, art, music, writing, pottery, etc.

Occupational Wellness:

(Measures the satisfaction gained form one's work and the degree to which one is enriched by that work)

138. I enjoy my work.

139. I am comfortable with the amount of travel involved in a singing career.

140. I feel that I am "called" to having a great career in singing.

141. I feel that a career in singing contributes positively to my well-being.

Social/Environmental Wellness:

(Measures the degree to which one contributes to the common welfare of the community, emphasizing interdependence with others and nature)

154. I have strong family ties.

155. I am well-accepted by my family.

156. I am able to develop and maintain strong friendships.

157. I am able to choose healthy, positive romantic relationnships.

Spiritual Wellness:

(Measures one's ongoing involvement in seeking meaning and purpose in human existence, including an appreciation for the depth and expanse of life and natural forces that exist in the universe)

167. I feel good about my spiritual life.

168. I make time for prayer, meditation, or quiet reflection.

169. I contemplate my purpose in life.

170. I am able to reflect on the meaning of events in life.

171. I feel good about my spiritual life.

If YOU WOULD LIKE TO ARRANGE AN APPOINTMENT TO HAVE A WELLNESS MODEL HEALTH CONSULTATION IN CHICAGO OR KALAMAZOO, OR ON YOUR SITE (FOR GROUPS OF 15 OR MORE), PLEASE CLICK ON THIS ADDRESS:

wicklund@singershealth.com

Important: The information on this website is intended for educational purposes only. It is not provided in order to diagnose, prescribe, or treat any disease, illness, or injured condition of the body. The authors, publisher, printer(s), and distributor(s)/website provider(s) accept no responsibility for such use. Those individuals suffering from any disease, illness, or injury should consult their physician.

Last updated November 19, 1999

Western Michigan University
Webmaster: Chris Fenner
Photos: Rachel Hinsdale

Website hosted by Verio