SURVEY QUESTIONNAIRE

Polytechnic University of the Philippines

Graduate School

Dear: Respondents,

Good Day!

I ‘am a student of Polytechnic University of the Philippines (PUP) Graduate School in Sta. Mesa Campus
taking up Master of Science in Information Technology with specialization in Management Information
Systems

As an enrolled graduate student of PUP, I ‘am pursuing my thesis subject as a prerequisite for graduation.
The study I'm proposing is entitled "A PSYCHOLOGICAL ASSESSMENT TOOL USING RETE
ALGORITHM FOR PERSON WITH CHEMICAL IMBALANCE ON SUBSTANCE ABUSE ". I
would like to respectfully request for your permission to allow me to conduct my data gathering in your
respective institution.. Rest assured that any information that will be involved with this data gathering will
be treated with confidentiality and will be used for studying purposes only.

This study aims to benefit psychologists, professors and student practitioners in serving as an aid in the
aspects of psychological assessment. This will also serve as an enhancement and introduce innovative
approaches in having an initial assessment for a potential patient as this study proposes an integration of
technologies such as knowledge based expert systems utilizing an algorithm that would accurately present
real time results.

Again, I’m humbly requesting for your permission to allow me to collaborate with the experts of your
institution in the field of psychology.

Hoping for your favorable response.

Thank you so much and God bless!

Sincerely,

MIKAEL FLORENZ P. NUESTRO

Researcher
I. Respondent’s Profile

1. Name (Optional): __________________________________________________

2. Type of respondent

Psychology Professor Psychology Expert

II. Questionnaire Proper

Directions: Choose scales form 1 to 5 by putting a check in the box provided for your answer on your

perception about the study.

5 – Strongly Agree 2 - Disagree

4 - Agree 1 – Strongly Disagree
3 – Moderately Agree

1. What are the challenges encountered by the respondents with the psychologist for evaluating
a person with chemical imbalances on substance abuse? (Please check the items that are
applicable.)

Hectic process for patient assessment

Consumes time and effort for reviewing and manually checking the assessment forms
Inadequate technological tool for monitoring/treatment plan recommendation
Excessive documents to review leading to inconveniency
Lack of systematic and usage of technology in patient assessment terms of decision
making
Lack of convenient assessment tools
Others (Please specify) ___________________________________

2. What are the features of the proposed application to address the challenges that occur in the current
system?

Criteria YES NO
Convenient assessment diagnosis with treatment plan for person with
3.1 chemical imbalances

Quick and accurate recommendation of treatment plan based on the

3.2
diagnosis
Minimal subjectivity while maintaining consistency in assessment
3.3
 3. What is the respondent’s level of acceptance towards the proposed psychological
assessment tool using Rete algorithm for person with chemical imbalance on substance
abuse in terms of:

Strongly Agree Partly Disagree Strongly

Criteria Agree Agree Disagree
(5) (4) (3) (2) (1)
1.Functionality

1.1 Modules are well organized and easily understood

1.2 Availability of data are present whenever needed

1.3 Patient’s treatment is easily understood

1.4 Patient’s treatment plan is properly suggested

1.5 Assessments are easily managed in terms of

organizing information
2. Reliability

2.1 Patient’s data are secured and confidentiality is

preserved
2.2 Treatment and symptoms are accurately retrieved
and matched
2.3 Treatment and symptoms are valid and suggested
depending on patient’s assessment
3.Usability

3.1 Interface is user friendly and easy to navigate

3.2 Modules are consistent all throughout the system

3.3 Statistical results and representations are

understandable
4.Efficiency

4.1 Patient’s assessment is quickly generated and

reports are accurately presented
4.2 Results are easily retrieved and consistent

4.3 Assessment tool has the capability to line up with

the standards and requirements of the process

4. What are the recommendation of respondents with the proposed assessment tool?

Include other psychological assessments aside from substance abuse

Include report generation modules.
Integrate voice recognition features
Integrate graphical representations of treatment plan
Others: (Please specify ) ____________________________