The goal of the study is to address the clinical problem of poor education outcome from the current practice of teaching tracheostomy care by providing them with a pictographic education handout to assist their learning. The study seeks to establish face validity and preliminary efficacy of a pictographic education handout with patients and identify factors associated with lower self-efficacy level on tracheostomy care.

Inclusion Criteria:

• 18 years of age or older
• Had a tracheostomy as part of head and neck cancer treatment, and who is not on mechanical ventilation
• His or her date of the related tracheostomy surgery was within the past 6 months
• Have received the discharge tracheostomy care education from the clinical nurse

Exclusion Criteria:

• Documented major physical or cognitive disabilities that would limit the ability to give informed consent or answer survey questions