COPY THEN PASTE IN REPLY AND FILL OUT-MARK "X" NEXT TO YOUR ANSWER CHOICE
Swallowing and Feeding Difficulties in a Patient With a Tracheostomy
Directions: To the best of your ability, fill out all four sections completely and honestly.
PART 1 - Background Information
1.) Age: Gender:
2.) College or University:
3.) Status: (a) freshman (b) sophomore (c) junior (d) senior (e) other
4.) What degree are you working towards?
(a) Associates (b) Bachelors (c) Masters (d) Doctorate (e) other
5.) What area would you like to work in?
6.) Do you have any work experience in the hospitals? (a) yes (b) no
In what setting(s) (Emergency, Pediatric, Maternity, etc.)?
7.) Have you ever taken a class that was specific to teaching swallowing disorders and/or
tracheostomies? Yes No What was the class called?
PART 11 - Swallow Overview
1.) What is the appropriate term for a disorder in swallowing?
(a) dysarthria (b) dysphasia (c) dysphagia (d) aphasia (e) dyspnea
2.) What is the optimum position for feeding and swallowing?
(a) standing (b) laying down (c) sitting at 45 degree angle (d) sitting upright
3.) Would you be able to identify signs/symptoms of a swallowing impairment?
If so, please list three symptoms:
1), (2.), (3)
5.) What discipline(s) has a role in swallowing impairments? (Circle all that apply):
(a) Occupational Therapist (c) Speech-Language Pathologist
(b) Certified Nurse Assistant (d) Other
6.) Would you follow instructions given to you by a speech pathologist on the care and
management of a patient with feeding and/or swallowing issues? (Circle)
(a) Yes (b)No (c) Unsure (d) I Don't know what a Speech
PART 111 - Tracheostomy Overview
1.) How does a tracheostomy tube affect a person's speech and swallow?
2.) When eating and drinking, the cuff should be...
(a) Inflated (b) deflated (c) worn on the outside (d) people can only eat with fenestrated tubes
True / False
3.) The main purpose of a cuffed tracheostomy tube is to prevent aspiration. True False
4.) The use of a one-way speaking valve can hinder swallowing. True False
5.) Aspiration is when you exhale. True False
6.) Patients who have a swallowing disorder may not develop early onset pneumonia.
7.) Which is a protective mechanism for airway clearance?
(a) gag reflex (c) choking reflex
(b) cough reflex (d) swallowing reflex
(e) acid reflex
PART 1V - Your Opinion
1.) Do you think you would ever want to specialize in this area of care? (a) yes (b) no
If no please explain:
2.) Do you think university/college programs should focus more on feeding and/or swallowing issues?
(a) yes (b) no (c) unsure
Please Circle the statement that best describes your opinion:
3.) (a) I think higher education institutions who offer nursing programs should dedicate a course specific to tracheostomy care and swallowing management.
(b) If institutions offered a course specific to tracheostomy care and swallowing management, I do not think I would benefit much from it.
(c) Academic programs in nursing are offering sufficient courses to address these issues.
Please Circle the statement that best describes your feeling:
4.) (a) As of right now, I feel confident in caring for this population of patients.
(b) As of right now, I do not feel confident in caring for this population.
(c) As of right now, I am unsure if I am competent to care for this population.
J Thank you for taking your time to complete this survey J