Thanks for responding. Just copy and delete
all but your answers.
1. Do you/the patient have a medical condition which requires airway clearance therapy?
A. Yes B. No
2. Have you/the patient been diagnosed with Cystic Fibrosis?
A. Yes B. No
3. Have you/the patient been prescribed airway clearance therapy?
A. Yes B. No
4. How often do you/the patient have ACT performed by a professional?
A. Never
B. Weekly
C. Monthly
D. Yearly
5. How often do you/the patient perform ACT at home? ¬¬¬¬¬¬
A. Never
B. 1-2 times a day
C. 3-4 times a day
D. 5 or more times a day
6. How is your/the patient's at home therapy performed? Please indicate all that apply.
A. By yourself/themselves
B. By a friend or family member
C. By a medical professional
D. By an automated airway clearance device
7. How would you rate the comfort level of your/the patient's home airway clearance therapy?
A. Very comfortable
B. Comfortable
C. Uncomfortable
D. Very uncomfortable
8. How would you rate the comfort level of your/the patient's professional airway clearance therapy?
A. Very comfortable
B. Comfortable
C. Uncomfortable
D. Very uncomfortable
9. Which of the following factors would most influence you to change your home therapy?
A. Comfort
B. Cost
C. Mobility of device
D. Effectiveness of treatment
E. Other ________________
10. What factors would prevent you from switching to a more effective therapy?
A. Large space requirement
B. Low mobility of device
C. High Cost
D. Longer treatment time
E. None of the above
11. Do you have any other reactions or comments?
all but your answers.
1. Do you/the patient have a medical condition which requires airway clearance therapy?
A. Yes B. No
2. Have you/the patient been diagnosed with Cystic Fibrosis?
A. Yes B. No
3. Have you/the patient been prescribed airway clearance therapy?
A. Yes B. No
4. How often do you/the patient have ACT performed by a professional?
A. Never
B. Weekly
C. Monthly
D. Yearly
5. How often do you/the patient perform ACT at home? ¬¬¬¬¬¬
A. Never
B. 1-2 times a day
C. 3-4 times a day
D. 5 or more times a day
6. How is your/the patient's at home therapy performed? Please indicate all that apply.
A. By yourself/themselves
B. By a friend or family member
C. By a medical professional
D. By an automated airway clearance device
7. How would you rate the comfort level of your/the patient's home airway clearance therapy?
A. Very comfortable
B. Comfortable
C. Uncomfortable
D. Very uncomfortable
8. How would you rate the comfort level of your/the patient's professional airway clearance therapy?
A. Very comfortable
B. Comfortable
C. Uncomfortable
D. Very uncomfortable
9. Which of the following factors would most influence you to change your home therapy?
A. Comfort
B. Cost
C. Mobility of device
D. Effectiveness of treatment
E. Other ________________
10. What factors would prevent you from switching to a more effective therapy?
A. Large space requirement
B. Low mobility of device
C. High Cost
D. Longer treatment time
E. None of the above
11. Do you have any other reactions or comments?