Q01
メッセージ
すべてのテンプレートIndustry-Specific
Workplace Sleep Deprivation & Fatigue Risk Survey
Assesses how much sleep loss is affecting your workforce's alertness, mood, and safety on the job — built for HR, EHS, and shift-operations teams. An AI follow-up interview digs into the real story behind a recent fatigue-related close call or bad day, surfacing root causes that a checklist alone would miss.
設問の例
テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。
全15問・約8分
Q02
数値必須
On average, how many hours of sleep have you gotten per night over the past 30 days?
Q03
選択式必須
In the past 7 nights, on how many nights did you get less than 6 hours of sleep?
- 0 nights
- 1-2 nights
- 3-4 nights
- 5-6 nights
- 7 nights
Q04
マトリクス必須
In the past month, how often did you experience each of the following?
5行 × 5列
- Trouble falling asleep
- Waking up during the night and struggling to fall back asleep
- Waking up feeling unrested even after a full night in bed
- Using caffeine or energy drinks to stay alert during your shift
- Feeling drowsy while doing safety-sensitive tasks (driving, operating equipment, etc.)
列: Never · Rarely · Sometimes · Often · Always
Q05
選択式必須
What is the single biggest reason you don't get enough sleep on workdays?
- Work schedule or shift timing
- Long or unpredictable hours / overtime
- Stress or worry about work
- Caregiving responsibilities at home
- Screen time or trouble winding down
- A health condition (pain, apnea, etc.)
Q06
評価スケール必須
How manageable is your current work schedule for getting adequate sleep?
範囲: 1 – 5
最小:Not manageable at all最大:Very manageable
Q07
スライダーマトリクス必須
Thinking about days when you're running short on sleep, how much does it affect each of the following?
4行（各行にスライダー1つ）
- Concentration and focus
- Mood or irritability
- Physical safety on the job
- Overall productivity
スライダー 0〜10最小:No effect最大:Severe effect
Q08
選択式必須
In the past 6 months, have you had a near-miss, error, or safety incident that you'd attribute at least partly to being tired or drowsy?
- Yes
- No
- Not sure
Q09
オピニオンスケール必須
Overall, how well-rested do you typically feel when you start your workday?
スケール: 1 – 7
最小:Completely exhausted最大:Fully rested
Q10
AIインタビュー
Reconstruct one specific recent day when the respondent felt notably tired or drowsy at work: what caused the sleep loss the night before, how the fatigue showed up during the shift (mistakes, slowed reactions, mood, near-misses), and what they or their team did about it in the moment. If they reported a near-miss or safety incident tied to drowsiness, get concrete details on what happened and whether it was reported. If they say fatigue rarely affects them, probe what specifically helps them recover sleep despite a demanding schedule.
Q11
メッセージ
Almost done — just a couple of background questions to help us compare results across teams and shifts.
Q12
選択式
Which best describes your typical work schedule?
- Regular daytime hours
- Evening shift
- Night shift
- Rotating or on-call shift
- Prefer not to say
Q13
選択式
What is your age range?
- Under 25
- 25-34
- 35-44
- 45-54
- 55-64
- 65 or older
- Prefer not to say
Q14
選択式
What is your gender?
- Woman
- Man
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q15
メッセージ
Thank you for sharing this with us. Your responses will be combined with your team's (never shared individually with managers) to guide scheduling changes and fatigue-risk programs.
含まれる機能
AIによる深掘り
自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。
注意確認設問
急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。
AIが作成する設問文
文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。
自動レポート
回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。
他ツールとの比較
ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。
このテンプレートを選ぶ理由
- Goes beyond a static questionnaire with an AI follow-up interview that reconstructs one specific recent day the respondent felt dangerously tired, surfacing root causes a checklist can't reach.
- Combines quantitative core questions (average sleep hours, nights under 6 hours, a matrix of fatigue symptoms, and a slider matrix on how sleep loss affects specific job tasks) with that qualitative deep-dive, so you get both prevalence data and the real story.
- Directly ties fatigue to safety outcomes with a dedicated near-miss/error/incident question, plus schedule and demographic questions at the end for benchmarking across teams and shifts.
- Built for HR/EHS/shift-ops workflows with automated per-response quality scoring and auto-generated reports, so results are usable without manual coding of open-ended answers.
Jotform
Sleep Deprivation Survey Form TemplateA fielding-ready static form template covering general sleep deprivation topics rather than a workplace-fatigue-and-safety specific instrument. It's easy to customize and embed within Jotform's broader form ecosystem, but the questions are fixed once deployed.
優れている点
- Simple drag-and-drop customization
- Large existing template library and integrations
- Straightforward embedding/distribution via Jotform's form platform
物足りない点
- No adaptive AI follow-up interview to probe specific fatigue incidents
- No voice AI interview option
- No automated per-response quality scoring or narrative report generation
QuestionPro
Sleep Deprivation Survey + Sample Questionnaire TemplateA sample questionnaire aimed at general sleep deprivation research, presented as a fixed-question template with typical survey-platform analytics behind it. It's positioned more broadly (research/health) than as a workplace safety/EHS-specific fatigue risk tool.
優れている点
- Established survey research platform with mature analytics/reporting
- Sample questionnaire structure to start from
- Supports standard branching/logic for a fixed question set
物足りない点
- No adaptive AI interview that digs into a specific fatigue-related incident
- No transparent prompt-level methodology disclosed
- No built-in automated quality scoring of open-text responses
SurveySparrow
Sleep Deprivation Survey TemplateA conversational-style survey template filed under healthcare, giving a chat-like feel similar to QuestionPunk's interface but with pre-set questions rather than true AI-driven follow-up. It's a ready-to-field template, useful for quick deployment but not tailored to shift-work/safety incident investigation.
優れている点
- Conversational chat-style UI that feels approachable to respondents
- Mobile-friendly template delivery
- Part of a broader healthcare template category
物足りない点
- Fixed conversational flow, not adaptive AI probing of individual incidents
- No voice AI interview capability
- No automated report generation tying fatigue to safety/root-cause analysis
よくあるご質問
「Workplace Sleep Deprivation & Fatigue Risk Survey」テンプレートにはどのような設問が含まれていますか？
すぐに使える設問が15問含まれており、最初の設問は次のとおりです：「Thanks for taking a few minutes for this survey on sleep and fatigue at work. Your answers are confidential and help us…」・「On average, how many hours of sleep have you gotten per night over the past 30 days?」・「In the past 7 nights, on how many nights did you get less than 6 hours of sleep?」。すべての設問は上でプレビューでき、自由に編集できます。
このアンケートの回答にはどのくらい時間がかかりますか？
回答者は通常、15問を約8分で回答し終えます。
テンプレートは編集できますか？
はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。
このテンプレートは無料で使えますか？
はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。
公開の準備はできましたか？
このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。
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