questionnaire on tb2

8/11/2019 Questionnaire on TB2

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APPENDIX

SURVEY QUESTIONNAIRE

PART IPROFILE OF THE RESPONDENT

Direction : Please put a check mark (/) on the appropriate box corresponding to

your answer for each item below or give the required information by filling out the

blanks.

1. Name (Optional ) : _____________________________________________

2. Age :

( ) 1544 years

( ) 45 - 60 years

( ) above 60 years

3. Highest Level of Education:

( ) Elementary Level ( ) College Level

( ) Elementary Graduate ( ) College Graduate

( ) High School Level ( ) Postgraduate

( ) High school Graduate

Part II-A. Knowledge about Airborne Transmitted Disease: cause and nature,

mode of transmission and prevention of infection and/or transmission.

Please read each statement carefully and rate each one in terms of your

agreement (Yes) or disagreement (No) by putting a check mark (/) on the box

corresponding to your answer.

Airborne Transmitted Diseases refer to the following:

(a)Tuberculosis, pulmonary 2 weeks

(b)Influenza. 1-4 days

(c)Pneumonia.. 7-10 days

(d)Chicken pox with pulmonary

involvement 14-15 days


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Period of transmission (incubation) common |SSx, effectivity period of

treatment

Statements about Airborne Transmitted Diseases

Agreement or

Disagreement

YES NO

1.Airborne transmitted disease (ATD) can kill.

2. A person who is having cough is immediately a

suspect for ATD

3. ATD causative organisms are spread through the airwhenever a person with the disease coughs and

sneezes.

4. A person sick with ATD must cover his mouth andnose with an appropriate mask to prevent expulsion of

the germs into the air when he sneezes or coughs.

5. ATD is not preventable nor curable.

6. A person with productive cough for a week or twotwo weeks is sick with ATD.

7. Smoking cigarettes is not among the predisposingfactors for ATD.

8. To protect oneself from getting ATD one must

practice or adhere to a healthy lifestyle.

9. ATD is an infection of the respiratory system.

10. ATD infected person may also have any or a

combination of the following symptoms: chest pains,

body malaise (weakness) and weight loss in addition

to productive cough and low grade fever of 2 weeks

duration. SSX?

11. A person suspected to be sick with ATD mustimmediately consult or seek the help of a health

worker (nurse, doctor).

12. A person who was given proper treatment for atleast two weeks will still spread the TB germs or

bacilli.


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13. A child diagnosed to have weak lungs (primary

complex) has tuberculosis.

14. Drinking liquor and other alcoholic drinks

increases the likelihood of getting infected with ATD.

15. A person who has fully recovered from ATD is

protected against the disease even if there is constant

exposure to a person with ATD.

16. A gap of at least one foot away from anotherperson is a safe distance when isolating an

infectiousATD.

B. Attitude including perceptions of social stigma towards Tuberculosis:

Statements about ATD

Agreement or

Disagreement

YES NO

1. A person sick with ATD cannot work or beamong a group of people even when proper

treatment has been started.2. ATD patient must not be seen in public places.

3. It is better not to receive anti-ATD treatment thanreceive improper treatment.

4.

It is better to be sick with cancer than ATD

5. A person diagnosed to have ATD may be treatedas an out-patient and allowed to go home.

6.

The fact that one has ATD must be kept strictlyconfidential.

7. A person diagnosed to have ATD must beconfined in a hospital until he fully recovers from

the illness.

8. A fully recovered ATD patient can do things anormal and healthy person does.


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C. Practices Perceived to be Effective Against TB disease Spread and Infection:

Statements about Tuberculosis

Agreement orDisagreement

YES NO

1. One can stay in poorly ventilated rooms even ifoccupied by An ATD suspect or infected person.

2.

ATD suspect must immediately submit himself

or herself for diagnostic examination.

3. It is okay for adults diagnosed to have ATD to

stay close to his/her children.4.

One must keep the DOH cough etiquette a habit.

5.

One must avoid spitting whether in public or

private places.

6. It is okay to discontinue ATD treatment beforethe requisite 6 month or 8-month period.

7.

It is not necessary for ATD infected person to

cover his mouth and nose with an appropriate

mask.8.

Proper body nourishment, enough periods of rest

and sleep keep a person less susceptible toATDinfection.

Thank you for your time and cooperation.


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TB as a disease (Question number 1,5-.9-,13)

Signs and symptoms & Risk factors (Question number 2-,6-,10,14)

Disease Transmission(Question number 3,7-,11,15-)

Preventive and health promotive practices(Question number 4,8,12-,16-)

Attitude (Question number 1-,3,5,7-)

Social stigma(Question number 2-,4-,6-,8)

Practices Perceived to be Effective Against TB disease Spread: (Questionnumber 1-,2,3-,4,5,6-,7-,8)

questionnaire on tb2

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