Support for P2, M2 & D1

BTEC National - Sport

Unit 14: Exercise, Health & Lifestyle

Activity 8 – Can you assess Kelvin’s lifestyle?

Imagine you have conducted a lifestyle questionnaire with the person below and have to give them feedback on their strengths and areas for improvement.

What would you say? How could you explain their strengths & areas for improvement? Could you evaluate their lifestyle and prioritise areas for change?

Well here is your chance! Have a go…..remembering that:

  • A description paints a picture in words
  • An explanation shows a good understanding of a topic and gives a reason or reasons to support comment(s)
  • An evaluation lays out the essential strengths and weaknesses of an issue and investigates them in detail

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There is space for you to make notes at the end of the questionnaire. Use them to verbally describe, explain and evaluate the person’s lifestyle and the possible effect it may be having on their health & fitness.

Lifestyle Questionnaire - Personal Details

Title:

Mr Mrs Miss Ms Dr

Name:

Address:


DOB:

Marital Status:

Single Married Separated Divorced Widow/Widower Cohabiting

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Smoking Status

Non Smoker

Cigarettes Per Day:

1-9 10-19 20-39 40+

Ex Cigarette Smoker Date Ceased:

Alcohol Status

Teetotaller

Trivial Drinker:

Less Than 1 Unit Daily 1 - 6 Units Weekly

Light Drinker:

1 - 2 Units Daily 7 - 14 Units Weekly

Moderate Drinker:

3 - 6 Units Daily 21 - 42 Units Weekly

Heavy Drinker:

7 - 9 Units Daily 49 - 63 Units Weekly

Very Heavy Drinker:

9+ Units Daily 64+ Units Weekly

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Exercise Status

No Exercise:

Avoids Even Trivial Exercise Unable to exercise due to health

Exercise:

Light Exercise Moderate Exercise Heavy Exercise Competitive Athlete

Height:

Weight:

Dietary Status

Diet:

  • Normal Diet
  • Weight Reducing
  • Low Fat
  • Diabetic
  • Vegetarian
  • High Fibre
  • Low Salt
  • Low Carbohydrate
  • High Protein
  • Gluten Free
  • Low Cholesterol

Other:

Avoidance of any food due To allergy (please state):

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Family History Status

Family History: / Relationship:
 Heart Disease Aged 60 Or Under /
 Heart Disease Aged Over 60 /
 Diabetes /
 Hypertension/High Blood Pressure /
 Stroke/TIA /
 Hyperlipidaemia/High Cholesterol /
 Cancer
Type Of Cancer:
/

Employment details

Type of job

Clerical

Manual

Otherx

Key points for description…
Key points for explanation…
Key points for evaluation and priorities for change…