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Singer S, Roick J, Gose A, Oeken J, Herzog M, Pabst F, Plontke SK, Boehm A, Dietz A, Büntzel J, Vogel HJ, Fabian A, Wollenberg B, Taylor K, Gouveris H, Busch CJ, Guntinas-Lichius O. Patients' Reflections on Treatment Decision After Surgery for Laryngeal Cancer. JAMA Otolaryngol Head Neck Surg 2024:2820030. [PMID: 38935397 PMCID: PMC11211990 DOI: 10.1001/jamaoto.2024.1422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/29/2024] [Indexed: 06/28/2024]
Abstract
Importance Clinicians should understand how patients who were treated with laryngeal cancer surgery think about this later on and what factors may be related with regretting surgery. Objective To assess variables associated with a positive attitude toward laryngeal cancer surgery. Design, Setting, and Participants This combination of 2 cohorts, based on patient interviews and questionnaires, was studied in 16 hospitals in Germany. Participants scheduled for laryngeal cancer surgery were enrolled before surgery and followed up until 1 year after surgery. Data collection began on November 28, 2001, and ended on March 15, 2015. Statistical analysis was performed from August 21, 2023, to January 19, 2024. Main Outcomes and Measures The attitude toward surgery was measured with the Psychosocial Adjustment After Laryngectomy Questionnaire (scores range from 0 to 100, with high scores representing a positive attitude toward the surgery) at 1 year after surgery. In multivariate regression analysis, the following variables were investigated: type of surgery, number of surgeries to the larynx, receipt of radiotherapy and chemotherapy, quality of life, speech intelligibility (objectively measured), age, sex, educational level, employment status, having a partner or not, counseling by patient association, and shared decision-making. Results Patients (n = 780; mean [SD] age, 60.6 [10.4] years; 701 [90%] male) who had received counseling from the patient association reported a more positive attitude toward surgery (adjusted B = 8.8; 95% CI, 1.0-16.6). Among patients after total laryngectomy, those with a university degree had a less positive attitude toward their surgery (adjusted B = -50.8; 95% CI, -84.0 to -17.6); this result was not observed in patients after partial laryngectomy (adjusted B = -4.8; 95% CI, -15.1 to 5.4). Among patients after partial laryngectomy, the attitude toward surgery was most positive in those who had experienced shared decision-making (mean [SD] questionnaire score, 84 [20] in those without a wish and 83 [20] in those with a wish for shared decision-making). Those who had wished they could decide together with the physician but where this eventually was not experienced expressed the most regret toward surgery (mean [SD] score, 71 [22]). There was no association between attitudes toward surgery and type of surgery (total vs partial laryngectomy) and all other variables tested. Conclusion and Relevance In this cohort study, most patients with head and neck cancer reported a positive attitude toward surgery, suggesting low levels of decision regret. Counseling by members of patient associations as well as individualized shared decision-making prior to surgery may have a positive impact on decision regret and is advisable in daily practice.
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Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
- University Cancer Center Mainz, Mainz, Germany
| | - Julia Roick
- Division of Social Determinants of Health, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Annegret Gose
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jens Oeken
- Department of Otorhinolaryngology, Hospital Chemnitz, Chemnitz, Germany
| | - Michael Herzog
- Department of Otorhinolaryngology and Head and Neck Surgery, Carl-Thiem-Klinikum Cottbus gGmbH, Cottbus, Germany
| | - Friedemann Pabst
- Department of Otorhinolaryngology and Head and Neck Surgery, Community Hospital Dresden, Dresden, Germany
| | - Stefan K. Plontke
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center of Martin-Luther-University, Halle, Germany
| | - Andreas Boehm
- Department of Otorhinolaryngology, St Georg Hospital, Leipzig, Germany
| | - Andreas Dietz
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center of Leipzig University, Leipzig, Germany
| | - Jens Büntzel
- Department of Otorhinolaryngology, Südharz-Krankenhaus Nordhausen, Nordhausen, Germany
| | - Hans-Joachim Vogel
- Department of Otorhinolaryngology, Sana-Klinikum Remscheid, Remscheid, Germany
| | - Alexander Fabian
- Department of Radiotherapy, University Medical Center Schleswig-Holstein Kiel, Kiel, Germany
| | - Barbara Wollenberg
- Department of Otorhinolaryngology and Head and Neck Surgery, Technical University of Munich, Munich, Germany
| | - Katherine Taylor
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
- University Cancer Center Mainz, Mainz, Germany
| | - Haralampos Gouveris
- University Cancer Center Mainz, Mainz, Germany
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Chia-Jung Busch
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center of Greifswald University, Greifswald, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology and Head and Neck Surgery, Jena University Hospital, Jena, Germany
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Iwai M, Ando S, Sato K. The process of reacquiring new vocalization in total laryngectomy patients with head and neck cancer: A qualitative study. Asia Pac J Oncol Nurs 2024; 11:100362. [PMID: 38433771 PMCID: PMC10904916 DOI: 10.1016/j.apjon.2023.100362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/03/2023] [Indexed: 03/05/2024] Open
Abstract
Objective Speech rehabilitation significantly contributes to the enhanced quality of life for patients who have undergone laryngectomy due to head and neck cancer. The initiation of tracheoesophageal speech early in the rehabilitation process has been associated with improved speech quality. Despite this, voice changes can carry a stigma due to communication challenges, even after successful voice restoration, potentially limiting the overall improvement in quality of life. Thus, our aim was to gain a profound understanding of the transition process from the selection to the adaptation of tracheoesophageal speech in patients with head and neck cancer. Methods Participants, who had undergone laryngectomy for head and neck cancer, were recruited from peer support groups in Japan, resulting in the identification of thirteen tracheoesophageal speakers. The data were analyzed using grounded theory methodology, incorporating open, axial, and selective coding. Semi-structured interviews delved into tracheoesophageal speakers' perceptions of their voices and the adaptive strategies employed for their preferred alternative communication methods. Results During the adaptation process, participants underscored the importance of communicating with their own voices. However, they also experienced anxiety about losing their natural voice, confronted the reality of living without a voice, and coped with their new voice. Eventually, participants came to recognize the changed voice as their own. Conclusions The personal conviction associated with the notion of "communicating with one's own voice" is integral to the adaptation process for patients with head and neck cancer who undergo laryngectomies and utilize tracheoesophageal speech. Some aspects of tracheoesophageal speech can evoke feelings of hopelessness, emphasizing the importance of comprehensive support for professional speech rehabilitation.
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Affiliation(s)
- Miyoko Iwai
- Nursing for Advanced Practice, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya City, Aichi, Japan
| | - Shoko Ando
- Department of Nursing, Ichinomiya Kenshin College, Ichinomiya City, Aichi, Japan
| | - Kazuki Sato
- Nursing for Advanced Practice, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya City, Aichi, Japan
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3
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Leemans M, Longobardi Y, Dirven R, Honings J, D'Alatri L, Galli J, van den Brekel M, Parrilla C, van Sluis KE. Improving Hands-Free Speech Rehabilitation in Laryngectomized Patients with a Moldable Adhesive. Laryngoscope 2023; 133:2965-2970. [PMID: 36883657 DOI: 10.1002/lary.30636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/24/2023] [Accepted: 02/15/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE This study aims to assess the product performance of a new moldable peristomal adhesive with corresponding heating pad designed to facilitate and improve automatic speaking valve (ASV) fixation for hands-free speech in laryngectomized patients. METHODS Twenty laryngectomized patients, all regular adhesive users with prior ASV experience, were included. Study-specific questionnaires were used for data collection at baseline and after two weeks of moldable adhesive use. The primary outcome parameters were adhesive lifetime during hands-free speech, use and duration of hands-free speech, and patient preference. Additional outcome parameters were satisfaction, comfort, fit, and usability. RESULTS The moldable adhesive enabled ASV fixation adequate for hands-free speech in the majority of participants. Overall, the moldable adhesive significantly increased adhesive lifetime and duration of hands-free speech compared to participants' baseline adhesives (p < 0.05), regardless of stoma depth, skin irritation, or regular use of hands-free speech at baseline. The participants who preferred the moldable adhesive (55% of participants) experienced a significant increase in the adhesive lifetime (median of 24 h, range 8-144 h) and improved comfort, fit, and ease of speech. CONCLUSION The moldable adhesive's lifetime and functional aspects, including the ease of use and custom fit, are encouraging outcomes and enable more laryngectomized patients to use hands-free speech more regularly. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2965-2970, 2023.
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Affiliation(s)
- Maartje Leemans
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Ylenia Longobardi
- UOC di Otorinolaringoiatria, Dipartimento di Scienza dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Richard Dirven
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Jimmie Honings
- Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lucia D'Alatri
- UOC di Otorinolaringoiatria, Dipartimento di Scienza dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Jacopo Galli
- UOC di Otorinolaringoiatria, Dipartimento di Scienza dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Michiel van den Brekel
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Institute of Phonetic Sciences, University of Amsterdam, Amsterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center (AUMC), Amsterdam, The Netherlands
| | - Claudio Parrilla
- UOC di Otorinolaringoiatria, Dipartimento di Scienza dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Klaske E van Sluis
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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Weidlich S, Pfeiffer J, Kugler C. Self-management of patients with tracheostomy in the home setting: a scoping review. J Patient Rep Outcomes 2023; 7:101. [PMID: 37823948 PMCID: PMC10570259 DOI: 10.1186/s41687-023-00643-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023] Open
Abstract
PURPOSE The aim of this study was to create a model of patient-centered outcomes with respect to self-management tasks and skills of patients with a tracheostomy in their home setting. METHODS A scoping review using four search engines was undertaken (Medline, CINAHL, PsycINFO, Cochrane Library) to identify studies relevant to this issue and published since 2000. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statements for Scoping Reviews (PRISMA-ScR), the Joanna Briggs Institute (JBI) approach of conducting and reporting a scoping review, and the Participants, Concept, Context (PCC) scheme were employed. The following elements of the framework synthesis study data were screened, and presented based on the self-management model of Lorig and Holman. RESULTS 34 publications from 17 countries met the criteria for study inclusion: 24 quantitative, 8 qualitative and 2 mixed methods designs. Regarding the dimensions of self-management, 28 articles reported on "managing the therapeutic regimen", 27 articles discussed "managing role and behavior changes", and 16 articles explored "managing emotions". A model of self-management of patients with tracheostomy was developed, which placed the patient in the center, since it is this individual who is completing the tasks and carrying out his or her skill sets. CONCLUSION This scoping review represents the first comprehensive overview and modeling of the complex self-management tasks and skills required of patients with tracheostomy in their home setting. The theoretical model can serve as a cornerstone for empirical intervention studies to better support this patient-centered outcome for this population in the future.
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Affiliation(s)
- Sandra Weidlich
- Faculty of Medicine, Department of Oto-Rhino-Laryngology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Jens Pfeiffer
- Center for Oto-Rhino-Laryngology (HNO Center am Theater), Freiburg, Germany
| | - Christiane Kugler
- Faculty of Medicine, Institute of Nursing Science, University of Freiburg, Breisacher Str. 153, Freiburg, 79110, Germany.
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Bickford J, Hersh D, Israel M. "I won't be able to speak for three days after": Ethical and practical considerations in qualitative research involving people with a laryngectomy. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:746-756. [PMID: 36263463 DOI: 10.1080/17549507.2022.2115553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Purpose: A laryngectomy impacts communication, swallowing and breathing. It is disfiguring and can disrupt quality of life, one's sense of identity, and relationships. It can increase dependence on others, trigger social stigma, avoidant coping and suicidal risk. Qualitative research has the potential to enable greater understanding of these consequences. However, almost nothing has been written about the specific ethical issues that can arise when carrying out research with people with laryngectomy (PWL). This paper builds on the experiences of the authors in the field and seeks to examine and explain these research ethics considerations and how they impact research design, data collection, data analysis and dissemination.Method: Using a framework based on the values underpinning the Australian National Statement on Ethical Conduct in Human Research, respect, merit and integrity, justice and beneficence, we have highlighted key issues relevant to this particular population.Main contribution: Different practical approaches are provided to address the ethical concerns that arise when conducting research with PWL. These include access to participants and ensuring diverse representation; balancing harm and benefit; achieving accurate interpretation, analysis and representation of the data generated through the research; research as a partnership that is respectful, empowering and fosters collaboration.Conclusion: This paper breaks new ground in discussing the ethical considerations and practical challenges relevant to researching the experiences of PWL.
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Affiliation(s)
- Jane Bickford
- Speech Pathology, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| | - Deborah Hersh
- Speech Pathology, Curtin School of Allied Health Curtin University, Bentley, Western Australia
- Adjunct Associate Professor, Edith Cowan University, Joondalup, Australia
- Adjunct Associate Professor, University of Adelaide, Adelaide, Australia
| | - Mark Israel
- Australasian Human Research Ethics Consultancy Services, AU Adjunct Professor, School of Social Sciences, University Western Australia, Perth, Western Australia
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6
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Ghirotto L, Catania G, Camera H, D'Adamo C, Ignone D, Rizzuto A, Stevanin S, Losi E, Pedroni C, Peretti G, Bagnasco A, Sasso L, Bressan V. Surviving cancer following total laryngectomy: a phenomenological study. Support Care Cancer 2023; 31:457. [PMID: 37432600 DOI: 10.1007/s00520-023-07931-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/05/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE Total laryngectomy followed by radiotherapy is a life-preserving treatment for patients with locally advanced laryngeal cancer. This study explored how persons who had undergone total laryngectomy perceived themselves as cancer survivors in the follow-up phase. METHODS A descriptive phenomenological approach was adopted. We employed a purposive sampling strategy to collect data through interviews at the otorhinolaryngology outpatient clinics of two research hospitals in northern Italy. The interviews were transcribed verbatim and analysed, following the seven analytical steps of Colaizzi's descriptive analysis. RESULTS The final sample included 19 patients. The following main themes were identified: (i) accepting a life with the "without" to survive; (ii) feeling unpleasant emotions; (iii) getting the hang of communication again; and (iv) reclaiming one's role. Together, they highlight the lived experiences of laryngectomised patients during the follow-up phase and how they perceived themselves as cancer survivors. CONCLUSION Laryngectomised patients are a uniquely vulnerable population. This study provides insights into how surgical procedures change and affect their lives over time to improve care models, patient education, and support systems. Survivors must be adequately prepared to transition from treatment and return to the community. This preparation should begin before treatment is started. Functional education, accurate information, and psychological support must be arranged and provided before surgery. Regarding the post-treatment phase, it is essential to support voice rehabilitation and peer support, and improve the family network, to ensure these patients' reintegration into society and social recognition.
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Affiliation(s)
- Luca Ghirotto
- Qualitative Research Unit, Azienda USL-IRCCS di Reggio Emilia, Viale Umberto I, 50, 42123, Reggio Emilia, Italy.
| | - Gianluca Catania
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Helena Camera
- Azienda Sanitaria Locale di Alessandria, Castelnuovo Scrivia, Italy
| | | | - Danilo Ignone
- Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Antonio Rizzuto
- Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Simone Stevanin
- Health Professions Direction, Padova University Hospital, Padua, Italy
| | - Elisabetta Losi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | | | - Giorgio Peretti
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
- Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Annamaria Bagnasco
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Loredana Sasso
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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Longobardi Y, Savoia V, Libero R, Marenda ME, Proietti I, Picciotti PM, Mari G, Parrilla C, D'Alatri L. Rehabilitation After Total Laryngectomy: An Integrated Protocol Remotely Delivered During COVID-19. Int J Telerehabil 2023; 15:e6548. [PMID: 38046556 PMCID: PMC10687949 DOI: 10.5195/ijt.2023.6548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
The aim of this paper was to evaluate the results of an integrated treatment delivered remotely to laryngectomized patients with voice prosthesis. Eighteen laryngectomized patients were treated remotely in groups co-led by a speech therapist and a psychologist ("Online Group"). The results were compared with those of 17 patients ("In-Person Group") previously studied. The two groups obtained comparable results on all parameters of the INFVo perceptual rating scale, in the DEP, ANX, PHO and HOS areas of the Symptom Check List-90-Revised questionnaire, and in the areas investigated by the WHOQOL-B questionnaire. The "In-Person Group" obtained statistically better results on the Italian Self-Evaluation of Communication Experiences after Laryngeal Cancer questionnaire. Although the in-person treatment favored the acceptance of the new voice and the development of conversational skills, telerehabilitation guaranteed an adequate level of assistance in terms of voice acquisition, prevention of anxiety and depression, and recovery of a good QoL.
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Affiliation(s)
- Ylenia Longobardi
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia
| | - Vezio Savoia
- Unità Operativa Semplice di Psicologia Clinica-Governo Clinico, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia
| | - Rosa Libero
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia
| | - Maria Elisabetta Marenda
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia
| | - Ilaria Proietti
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia
| | - Pasqualina Maria Picciotti
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia
- Sezione di Otorinolaringoiatria, Dipartimento Testa-Collo e Organi di Senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giorgia Mari
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia
| | - Claudio Parrilla
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia
| | - Lucia D'Alatri
- Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia
- Sezione di Otorinolaringoiatria, Dipartimento Testa-Collo e Organi di Senso, Università Cattolica del Sacro Cuore, Rome, Italy
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Tang JA, McCarroll L, Schmalbach CE. Voice Restoration and Quality of Life in Larynx Cancer. Otolaryngol Clin North Am 2023; 56:361-370. [PMID: 37030948 DOI: 10.1016/j.otc.2022.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2023]
Abstract
Voice restoration following laryngectomy has a significant influence on quality of life (QOL). Three main techniques exist to provide voice: esophageal speech (ES), artificial larynx (electrolarynx [EL]), and tracheoesophageal puncture (TEP). Although the EL was historically the most used technique, TEP has quickly become the gold standard. ES remains the least frequently used technique in developed countries. Technique selection must be made on an individual basis, considering the patient's cancer history and comorbidities. Ultimately, the choice in voice-restoration technique requires joint decision making with the surgeon, speech pathologist, and patient.
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Affiliation(s)
- Jessica A Tang
- Department of Otolaryngology Head and Neck Surgery, Johns Hopkins Hospital, 601 N. Caroline Street, Baltimore, MD 21287, USA
| | - Liane McCarroll
- Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA
| | - Cecelia E Schmalbach
- Department of Otolaryngology-HNS, Lewis Katz School of Medicine at Temple University, Temple Head & Neck Institute, Fox Chase Cancer Center, 3440 North Broad Street, Kresge West 309, Philadelphia, PA 19140, USA.
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Bodd MH, McCammon SD. Laryngeal Cancer and the End of Life (As We Know It). Otolaryngol Clin North Am 2023; 56:403-412. [PMID: 37030951 DOI: 10.1016/j.otc.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Patients with laryngeal cancer undergo life-changing interventions that impact their individual and social well-being. There remains to be an in-depth characterization of the multidimensional symptom burden faced by patients with laryngeal cancer at the end of life. Care at end of life must attend to symptoms that manifest earlier in the course of illness. This article characterizes the suffering experienced by patients with laryngeal cancer, including societal shame, poor mental health, and inequitable outcomes. For patients with advanced laryngeal cancer, surgical palliative care provides a necessary and helpful paradigm for caregiver support, goals-of-care conversations, and treatment counseling.
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Balaguer M, Pinquier J, Farinas J, Woisard V. Development of a holistic communication score (HoCoS) in patients treated for oral or oropharyngeal cancer: Preliminary validation. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:39-51. [PMID: 36043497 PMCID: PMC10087239 DOI: 10.1111/1460-6984.12766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In head and neck cancer, many tools exist to measure speech impairment, but few evaluate the impact on communication abilities. Some self-administered questionnaires are available to assess general activity limitations including communication. Others are not validated in oncology. These different tools result in scores that does not provide an accurate measure of the communication limitations perceived by the patients. AIM To develop a holistic score measuring the functional impact of speech disorders on communication in patients treated for oral or oropharyngeal cancer, in two steps: its construction and its validation. METHODS & PROCEDURES Patients treated for oral/oropharyngeal cancer filled six self-questionnaires: two about communicative dynamics (ECVB and DIP), two assessing speech function (PHI and CHI) and two relating to quality of life (EORTC QLQ-C30 and EORTC QLQ-H&N35). A total of 174 items were initially collected. A dimensionality reduction methodology was then applied. Face validity analysis led to eliminate non-relevant items by surveying a panel of nine experts from communication-related disciplines (linguistics, medicine, speech pathology, computer science). Construct validity analysis led to eliminate redundant and insufficiently variable items. Finally, the holistic communication score was elaborated by principal component factor and validated using cross-validation and latent profile analysis. OUTCOMES & RESULTS A total of 25 patients filled the questionnaires (median age = 67 years, EIQ = 12; 15 men, 10 women; oral cavity = 14, oropharynx = 10, two locations = 1). After face validity analysis, 44 items were retained (κ > 0.80). Four additional items were excluded because of a very high correlation (r > 0.90) with other items presenting a better dispersion. A total of 40 items were finally included in the factor analysis. A post-analysis score prediction was performed (mean = 100; SD = 10). A total of 24 items are finally retained for the construction of the holistic communication score (HoCoS): 19 items from questionnaires assessing communicative dynamics (13 from the ECVB and six from the DIP), four items from a perceived speech impairment questionnaire (PHI) and one from a quality-of-life questionnaire (EORTC QLQ-H&N35). The reliability is good (five-fold cross-validation: rs = 0.91) and the complementary latent profile analysis shows a good validity of the HoCoS, clustering subjects by level of communication performance. CONCLUSIONS & IMPLICATIONS A global score allowing a measure of the impact of the speech disorder on communication was developed. It fills the lack of this type of score in head and neck oncology and allows the better understanding of the functional and psychosocial consequences of the pathology in the patients' follow-up. WHAT THIS PAPER ADDS What is already known on the subject Because of their anatomical location, head and neck cancer degrades the speech abilities. Few tools currently allow the assessment of the impact of the speech disorder on communication abilities. In ENT oncology, self-administered questionnaires are available to assess activity limitations and participation restrictions (International Classification of Functioning (ICF)-WHO). Other tools from the field of neurology allow an evaluation of communication dynamics. But these different tools, constructed by items, give global additive or averaged scores. This implies an identical weighting of each item, resulting in global scores that are not very representative of the communication limitations really perceived by the patients. What this paper adds to existing knowledge A new global holistic score allowing a measurement of the impact of speech impairment on communication after treatment of oral or oropharyngeal cancer has been developed. The methodology of its construction allows a better reflection of the symptomatological, pragmatic and psychosocial elements leading to a degradation of communication abilities. What are the potential or actual clinical implications of this work? The developed HoCoS score fills the gap in the absence of this type of tool in head and neck oncology. It may allow a better understanding of the factors involved in the functional and psychosocial limitations of these patients, and better customize their follow-up.
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Affiliation(s)
- Mathieu Balaguer
- IRITUniversité de Toulouse, CNRS, Toulouse INP, UT3ToulouseFrance
- Hôpital LarreyHôpitaux de ToulouseToulouseFrance
| | - Julien Pinquier
- IRITUniversité de Toulouse, CNRS, Toulouse INP, UT3ToulouseFrance
| | - Jérôme Farinas
- IRITUniversité de Toulouse, CNRS, Toulouse INP, UT3ToulouseFrance
| | - Virginie Woisard
- Hôpital LarreyHôpitaux de ToulouseToulouseFrance
- Laboratoire de Neuro‐Psycho‐Linguistique LNPLUniversité Toulouse IIToulouseFrance
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11
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Ding Y, Xu J, Ning Y, Wang Q, Chang Z. Nurse-led telephone follow-up according to the revised nursing outcomes classification for laryngeal carcinoma surgery patients: a randomized controlled trial. BMC Nurs 2022; 21:281. [PMID: 36253750 PMCID: PMC9578269 DOI: 10.1186/s12912-022-01054-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/13/2022] [Accepted: 09/29/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study used the revised nursing outcomes classification (NOC) outlined in our previous study, "Core nursing outcomes for otorhinolaryngology head-neck," for telephone follow-up of patients who had laryngeal carcinoma surgery in China. This randomized controlled trial aimed to compare nurse-led telephone follow-up according to the revised NOC with traditional telephone follow-up. METHODS A total of 100 postoperative patients were recruited from March 2018‒March 2020. Patients were randomly assigned to nurse-led telephone follow-up groups as either revised NOC follow-up (n = 51) or traditional follow-up (n = 49). The investigated outcomes included nursing outcomes, quality of life, and self-care abilities. RESULTS The baseline characteristics of patients were well balanced. We noted that improvements in nursing outcomes in the intervention group were significantly better than for those in the control group (P = 0.018), primarily regarding psychosocial health (P < 0.001) and health knowledge and behavior (P < 0.001). Moreover, patient outcomes in the intervention group were associated with greater improvements in quality of life than those in the control group (P < 0.001), especially for social conditions (P < 0.001), emotional health (P < 0.001), functional status (P < 0.001), and additional attention (P = 0.001). Finally, compared with the control group, significant improvements were observed in self-care abilities in the intervention group (P = 0.002), mainly regarding general self-care abilities (P = 0.016) and development self-care abilities (P < 0.001). CONCLUSION This study found that nurse-led telephone follow-up according to the revised NOC improved nursing outcomes, quality of life, and self-care abilities. TRIAL REGISTRATION ChiCTR2100045941.
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Affiliation(s)
- Yongxia Ding
- Nursing College of Shanxi Medical University, No. 98, University Street, 030600, Jinzhong, China. .,Shanxi Key Laboratory of Otolaryngology, Head and Neck Cancer, NO.85 Jiefang South Road, 030001, Taiyuan, China.
| | - Jinxia Xu
- Shanxi Cancer Hospital, No.3 Xincun Street, 030013, Taiyuan, China
| | - Yan Ning
- Nursing College of Shanxi Medical University, No. 98, University Street, 030600, Jinzhong, China
| | - Qian Wang
- Nursing College of Shanxi Medical University, No. 98, University Street, 030600, Jinzhong, China
| | - Zhaojie Chang
- Nursing College of Shanxi Medical University, No. 98, University Street, 030600, Jinzhong, China
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12
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Álvarez-Marcos C, Vicente-Benito A, Gayol-Fernández Á, Pedregal-Mallo D, Sirgo-Rodríguez P, Santamarina-Rabanal L, Llorente JL, López F, Rodrigo JP. Voice outcomes in patients with advanced laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy. ACTA OTORHINOLARYNGOLOGICA ITALICA 2022; 42:243-249. [PMID: 35880365 PMCID: PMC9330749 DOI: 10.14639/0392-100x-n1992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/14/2022] [Indexed: 11/23/2022]
Abstract
Objective Patients with locally advanced laryngeal and hypopharyngeal cancer (LHC) are often treated with chemo-radiotherapy to avoid total laryngectomy, although voice problems may occur even if not markedly manifest. We sought to evaluate the impact of chemoradiation on voice and quality of life. Methods We studied 21 patients with locally advanced LHC with tumour control at least two years after chemo-radiotherapy. None manifested clinical symptoms related to the treatment and maintained an activity considered as within normal limits. All patients had a voice handicap index (VHI) of less than 15. Voice function was evaluated by perceptual vocal analysis (CAPE-V) and aerodynamic and acoustic study. Quality of life was assessed with the EORTC-H&N35 (voice items 46, 53 and 54). Results Voice changes were frequent, with alterations in all CAPE-V attributes, and predominantly type II and III spectrograms in acoustic analysis (78%). The EORTC-H&N35 scale showed a reduction in scores in 10-40% of items related to voice. Conclusions Subclinical voice disorders are common after chemo-radiotherapy. Although patients consider vocal impairment to be very minor and to not interfere with their daily life, it may contribute to a reduced quality of life.
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13
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Dahl KL, Bolognone RK, Childes JM, Pryor RL, Graville DJ, Palmer AD. Characteristics associated with communicative participation after total laryngectomy. JOURNAL OF COMMUNICATION DISORDERS 2022; 96:106184. [PMID: 35091361 DOI: 10.1016/j.jcomdis.2022.106184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/04/2022] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to identify individual characteristics that are associated with communicative participation after total laryngectomy (TL). METHODS This study was a single-institution investigation of individuals who had undergone TL. Data were collected at a single timepoint via patient self-report and medical record review. Thirty-five participants completed a questionnaire containing a communication survey as well as several published, validated instruments. Independent variables included characteristics related to demographics, health and medical history, social network composition, and communication. The dependent variable was communicative participation, which was assessed using the Communicative Participation Item Bank (CPIB). Correlations between the independent variables and CPIB scores were calculated to assess the influence of these characteristics on communicative participation. The study participants were subdivided into three distinct groups based on whether their primary method of communication was spoken or non-spoken and the frequency of using alternate methods of communication. Outcomes across the three groups were then compared. A follow-up survey was also conducted to examine the impact of "stay at home" orders during the COVID-19 pandemic of 2020-21. RESULTS There were significant correlations between communicative participation and some non-communication-related characteristics. Reduced communicative participation was associated with younger age, less time since TL, a history of reconstructive surgery, poorer self-rated health, more depressive symptoms, worse quality of life, and a weaker social network of friends. Several communication-related characteristics were also associated with CPIB scores. Increased communicative participation was associated with using fewer non-spoken communication methods, higher levels of satisfaction with speech and communication, and better communicative effectiveness. There were significant differences between the three groups for communicative effectiveness and satisfaction with speech. The three groups did not differ significantly for satisfaction with communication or communicative participation. There were no significant differences in CPIB scores measured before and during the pandemic. CONCLUSIONS Communicative participation is a complex measure that may be affected by a variety of factors related to demographics, health, social network status, and communication. Despite poorer communicative effectiveness and lower levels of satisfaction, individuals who use non-spoken methods of communication after TL did not demonstrate worse communicative participation than those using spoken methods. Surprisingly, CPIB scores did not decline as a result of social distancing.
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Affiliation(s)
- Kimberly L Dahl
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
| | - Rachel K Bolognone
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
| | - Jana M Childes
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
| | - Rebecca L Pryor
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
| | - Donna J Graville
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
| | - Andrew D Palmer
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health and Science University, 3181 Mail Code: CH15-E, 3303 SW Bond Ave., SW Sam Jackson Rd., Portland, OR 97239, USA.
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14
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Wulff NB, Dalton SO, Wessel I, Arenaz Búa B, Löfhede H, Hammerlid E, Kjaer TK, Godballe C, Kjaergaard T, Homøe P. Health-Related Quality of Life, Dysphagia, Voice Problems, Depression, and Anxiety After Total Laryngectomy. Laryngoscope 2021; 132:980-988. [PMID: 34490903 DOI: 10.1002/lary.29857] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/11/2021] [Accepted: 08/29/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS The aims were to determine health-related quality of life (HRQoL), including voice problems, dysphagia, depression, and anxiety after total laryngectomy (TL), and investigate the associations between HRQoL and the late effects. STUDY DESIGN Cross-sectional study. METHODS 172 participants having received a TL 1.6 to 18.1 years ago for laryngeal/hypopharyngeal cancer filled in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, Core and Head and Neck module (EORTC QLQ-C30, EORTC QLQ-H&N35), Voice-Related Quality of Life questionnaire (V-RQOL), M.D. Anderson Dysphagia Inventory (MDADI), and Hospital Anxiety and Depression Scale (HADS) questionnaires. RESULTS Participants scored worse than normative reference populations on all scales/items of the EORTC questionnaires, except one, and almost half of the scales/items showed a clinically relevant difference. Moderate/severe dysphagia was present in 46%, moderate/severe voice problems in 57%, depression in 16%, and anxiety in 20%. Decreasing age, increasing numbers of comorbidities, increasing voice problems, increasing dysphagia, and increasing depression symptoms, were associated with a lowered EORTC QLQ-C30 summary score. CONCLUSION A substantial proportion of participants experienced clinically significant late effects and increasing levels of these were associated with a lowered HRQoL. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
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Affiliation(s)
- Nille B Wulff
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Susanne O Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Naestved, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Irene Wessel
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Beatriz Arenaz Búa
- Division of Ear, Nose and Throat Diseases, Head and Neck Surgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Helena Löfhede
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eva Hammerlid
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Trille K Kjaer
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Christian Godballe
- Research Unit for ORL-Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Thomas Kjaergaard
- Department of Otorhinolaryngology-Head and Neck Surgery, Aarhus University, Aarhus, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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15
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Parrilla C, Almadori A, Longobardi Y, Lattanzi W, Salgarello M, Almadori G. Regenerative Strategy for Persistent Periprosthetic Leakage around Tracheoesophageal Puncture: Is It an Effective Long-Term Solution? Cells 2021; 10:cells10071695. [PMID: 34359865 PMCID: PMC8305158 DOI: 10.3390/cells10071695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/18/2021] [Accepted: 06/29/2021] [Indexed: 02/07/2023] Open
Abstract
Autologous tissue-assisted regenerative procedures have been considered effective to close different types of fistula, including the leakage around tracheoesophageal puncture. The aim of this study was to retrospectively review 10 years of lipotransfer for persistent periprosthetic leakage in laryngectomized patients with voice prosthesis. Clinical records of patients who experienced periprosthetic leakage from December 2009 to December 2019 were reviewed. Patients receiving fat grafting were included. The leakage around the prosthesis was assessed with a methylene blue test. Twenty patients experiencing tracheoesophageal fistula enlargement were treated with fat grafting. At the one-month follow-up, all patients were considered improved with no leakage observed. At six months, a single injection was sufficient to solve 75% of cases (n 15), whereas 25% (n 5) required a second procedure. The overall success rate was 80% (n 16). Results remained stable for a follow-up of 5.54 ± 3.97 years. Fat grafting performed around the voice prosthesis, thanks to its volumetric and regenerative properties, is a valid and lasting option to solve persistent periprosthetic leakage.
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Affiliation(s)
- Claudio Parrilla
- Otolaryngology Unit, Department of Head and Neck Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.P.); (Y.L.); (G.A.)
| | - Aurora Almadori
- Plastic Surgery Unit, Department of Women’s and Child Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Centre for Nanotechnology and Regenerative Medicine, Division of Surgery and Interventional Science, University College of London, London NW3 2QG, UK
- Correspondence:
| | - Ylenia Longobardi
- Otolaryngology Unit, Department of Head and Neck Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.P.); (Y.L.); (G.A.)
| | - Wanda Lattanzi
- Applied Biology Unit, Department of Life Sciences and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Marzia Salgarello
- Plastic Surgery Unit, Department of Women’s and Child Health Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Giovanni Almadori
- Otolaryngology Unit, Department of Head and Neck Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.P.); (Y.L.); (G.A.)
- Head & Neck Oncologic Unit, Department of Head and Neck Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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16
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Longobardi Y, Savoia V, Parrilla C, Marchese MR, Morra L, Mari G, Degni E, D’Alatri L. Pre-operative speech-language pathology counselling in patients undergoing total laryngectomy: A pilot randomized clinical trial. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01932-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Batista EKL, Soares JFR, Alves GADS, Pessoa LSDF, Andrade WTLD, Lucena VLD, Pernambuco L. Common mental disorders and patient-reported swallowing disorders following total laryngectomy. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/20212368921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2023] Open
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18
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Rossi VC, Guimarães MF, Moreira MJDS, Lopes L, Moreti F. Brazilian choirs of total laryngectomized individuals. Codas 2020; 32:e20190224. [PMID: 33174990 DOI: 10.1590/2317-1782/20202019224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/29/2019] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Michelle Ferreira Guimarães
- Departamento de Voz da Sociedade Brasileira de Fonoaudiologia - SBFa - São Paulo (SP), Brasil.,Comitê de Fononcologia do Departamento de Voz da Sociedade Brasileira de Fonoaudiologia (gestão 2017-2019) - SBFa - São Paulo (SP), Brasil.,Universidade Federal do Espírito Santo - UFES - Vitória (ES), Brasil
| | - Márcio José da Silva Moreira
- Departamento de Voz da Sociedade Brasileira de Fonoaudiologia - SBFa - São Paulo (SP), Brasil.,Comitê de Fononcologia do Departamento de Voz da Sociedade Brasileira de Fonoaudiologia (gestão 2017-2019) - SBFa - São Paulo (SP), Brasil.,Universidade Federal Fluminense - UFF - Nova Friburgo (RJ), Brasil
| | - Leonardo Lopes
- Departamento de Voz da Sociedade Brasileira de Fonoaudiologia - SBFa - São Paulo (SP), Brasil.,Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil
| | - Felipe Moreti
- Departamento de Voz da Sociedade Brasileira de Fonoaudiologia - SBFa - São Paulo (SP), Brasil.,Centro Universitário Saúde ABC/Faculdade de Medicina do ABC - FMABC - Santo André (SP), Brasil.,Complexo Hospitalar Municipal de São Bernardo do Campo - CHMSBC - São Bernardo do Campo (SP), Brasil
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19
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Lu YA, Pei YC, Chuang HF, Lin LY, Hsin LJ, Kang CJ, Huang SF, Chiang HC, Tsao CK, Fang TJ. Speech Performance after Anterolateral Thigh Phonatory Tube Reconstruction for Total Laryngectomy. Laryngoscope 2020; 131:1349-1357. [PMID: 33280117 DOI: 10.1002/lary.29005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/19/2020] [Accepted: 07/20/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Traditionally, after total laryngopharyngectomy (TLP), patients cannot speak without a prosthesis or an artificial larynx. In Taiwan, most patients use a commercialized pneumatic laryngeal device (PLD). Phonatory tube reconstruction with the anterolateral thigh (ALT) flap is a novel, modified version of synchronous digestive and phonatory reconstruction involving a free muscular cutaneous flap. This study reviewed and compared speech performance between patients who underwent novel flap reconstruction and conventional PLD users. METHOD We retrospectively reviewed patients with laryngeal or hypopharyngeal cancer who underwent TLP from August 2017 to September 2019. The voice handicap index (VHI), speech intelligibility, acoustic and aerodynamic analysis results, and speech range profile (SRP) were compared between patients who underwent ALT phonatory tube reconstruction (ALT group) and those using PLDs (PLD group). RESULTS Twenty patients were included; 13 patients were included in the ALT group, and 7 patients were included in the PLD group. Compared to the PLD group, the ALT group had a better fundamental frequency range (P < .001) and semitone range (P < .001) during speech but showed worse jitter, shimmer, and harmonic-to-noise ratios. The two groups showed comparable VHI and speech intelligibility performance. CONCLUSIONS The ALT phonatory tube, a novel flap for reconstruction, can restore digestive and voice functions simultaneously. Compared with PLD use, ALT phonatory tube reconstruction yields an improved speech range and comparable levels of voice handicap and speech intelligibility, suggesting that the technique is a good alternative for patients after TLP. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1349-1357, 2021.
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Affiliation(s)
- Yi-An Lu
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Cheng Pei
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Feng Chuang
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Yun Lin
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Jen Hsin
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Jan Kang
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shiang-Fu Huang
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hui-Chen Chiang
- Graduate School of Management, Ming Chuan University, Taipei, Taiwan
| | - Chung-Kan Tsao
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Plastic and Reconstructive Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tuan-Jen Fang
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
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20
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Hsieh YH, Fang TJ, Huang SF, Kang CJ, Liao CT, Hung SY, Cheong CF, Tsao CK. Synchronous reconstruction of esophageal defect and voice with J-flap after laryngopharyngectomy: Indications and outcomes. Oral Oncol 2020; 110:104947. [PMID: 32836094 DOI: 10.1016/j.oraloncology.2020.104947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/19/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The primary reconstruction goal for patients with laryngopharyngectomy is the restoration of esophagus, whereas voice reconstruction is less readily reconstructed. J-flap is a novel surgical technique designed to reconstruct voice and esophagus synchronously, permitting functional rehabilitation of aerodigestive tract after laryngopharyngectomy. OBJECTIVES This study aims to present indications, surgical steps, and outcomes of an innovative technique for synchronous reconstruction of the esophagus and voice tube with a free thigh flap (J-flaps). METHOD Single-center study from 2011 to 2017 recruiting patients with hypopharyngeal cancer needing laryngopharyngectomy and J-flaps reconstruction. Patient details were analyzed, and surgical outcomes were examined. RESULTS 20 patients were recruited with an average age of 61. Tumor staging was IIB or above. The average follow-up period was 15 months. 65% of these patients resumed a full diet. The row phonation rate was 75%. The average maximum phonation time was 8.9 s, and the average number of counting in a breath was 14. CONCLUSIONS Most patients achieved a conversational level of speech capacity with a humanoid voice. J-flap can be utilized safely, supporting the social re-integration of these patients with their new voice.
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Affiliation(s)
- Yun-Huan Hsieh
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taiwan; Chang Gung Medical College and Chang Gung University, Taiwan.
| | - Tuan-Jen Fang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Taiwan; Chang Gung Medical College and Chang Gung University, Taiwan.
| | - Shiang-Fu Huang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Taiwan; Chang Gung Medical College and Chang Gung University, Taiwan.
| | - Chung-Jan Kang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Taiwan; Chang Gung Medical College and Chang Gung University, Taiwan.
| | - Chun-Ta Liao
- Department of Otolaryngology, Chang Gung Memorial Hospital, Taiwan; Chang Gung Medical College and Chang Gung University, Taiwan.
| | - Shao-Yu Hung
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taiwan; Chang Gung Medical College and Chang Gung University, Taiwan.
| | - Chon-Fok Cheong
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taiwan; Chang Gung Medical College and Chang Gung University, Taiwan.
| | - Chung-Kan Tsao
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taiwan; Chang Gung Medical College and Chang Gung University, Taiwan; Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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21
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Kemps GJF, Krebbers I, Pilz W, Vanbelle S, Baijens LWJ. Affective symptoms and swallow-specific quality of life in total laryngectomy patients. Head Neck 2020; 42:3179-3187. [PMID: 32621568 PMCID: PMC7586820 DOI: 10.1002/hed.26365] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 05/26/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study is to determine the prevalence of clinically relevant affective symptoms and level of swallow‐specific quality of life (QoL) in dysphagic patients with total laryngectomy (TL) and to explore the relationship between affective symptoms and swallow‐specific QoL. Methods Thirty‐five TL patients completed the Hospital Anxiety and Depression Scale (HADS) and the MD Anderson Dysphagia Inventory (MDADI). Student's t test and linear regression were used. Results Eight (23%) patients showed clinically relevant symptoms of anxiety, 8 (23%) of depression, and 11 (31%) showed either one. These groups had significantly lower mean MDADI scores. One‐point increase in HADS‐anxiety or HADS‐depression subscale score corresponds with a decrease of 2.7 or 3.0 points, on average, respectively, of the MDADI total score. Conclusions Clinically relevant affective symptoms were present in approximately one‐third of the TL patients. These preliminary results show that increased affective symptom scores correlate with a decreased swallow‐specific QoL.
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Affiliation(s)
- Glen J F Kemps
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
| | - Iris Krebbers
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
| | - Walmari Pilz
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,School of Mental Health and Neurosciences (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Sophie Vanbelle
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands.,Care and Public Health Research Institute - CAPHRI, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands
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22
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Leemans M, van Sluis KE, van Son RJJH, van den Brekel MWM. Interaction of functional and participation issues on quality of life after total laryngectomy. Laryngoscope Investig Otolaryngol 2020; 5:453-460. [PMID: 32596487 PMCID: PMC7314459 DOI: 10.1002/lio2.381] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/06/2020] [Accepted: 03/24/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Total laryngectomy (TL) leads to lifelong physical changes which can lead to functional and participation issues. To assess the relationship between self-reported quality of life and functional and participation issues, a large international online questionnaire was used. METHOD A questionnaire was sent out to 8119 recipients of whom 1705 (21%) responded. The questionnaire consisted of 26 questions regarding demographic information, product use of the respondents, experienced overall health and independence, and functional and participation issues. Respondents were grouped based on sex, age, time since TL, educational level, and country of residence. Questions were grouped in one measure of reported quality of life (r-QoL) and seven issue themes ("esthetic issues," "experienced limitations in daily activities," "avoiding social activities," "communication issues," "experienced vulnerability due to environmental factors," "pulmonary issues," and "sleep issues") to assess the underlying relations. RESULTS This study showed that more functional and participation issues and a lower r-QoL are reported in the group of younger respondents (<60 years), women, and respondents who have had the TL procedure less than 2 years ago. The issue themes "experienced limitations in daily activities" and "avoiding social activities" are related to r-QoL. Most participants report "pulmonary issues," and these issues have a strong correlation with most other themes. CONCLUSION The ability to participate in meaningful and social activities is a major factor in r-QoL. Due to the frequency and strong correlations of pulmonary issues with other issue themes, pulmonary issues might be an underlying cause of many other issues. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
- Maartje Leemans
- Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam The Netherlands
| | - Klaske E van Sluis
- Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam The Netherlands
- Amsterdam Center for Language and Communication University of Amsterdam Amsterdam The Netherlands
| | - Rob J J H van Son
- Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam The Netherlands
- Amsterdam Center for Language and Communication University of Amsterdam Amsterdam The Netherlands
| | - Michiel W M van den Brekel
- Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam The Netherlands
- Amsterdam Center for Language and Communication University of Amsterdam Amsterdam The Netherlands
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23
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Moors T, Silva S, Maraschin D, Young D, Quinn JM, de Carpentier J, Allouche J, Himonides E. Using Beatboxing for Creative Rehabilitation After Laryngectomy: Experiences From a Public Engagement Project. Front Psychol 2020; 10:2854. [PMID: 32082203 PMCID: PMC7001741 DOI: 10.3389/fpsyg.2019.02854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022] Open
Abstract
Laryngectomy is the surgical removal of the larynx (voice box), usually performed in patients with advanced stages of throat cancer. The psychosocial impact of losing the voice is significant, affecting a person’s professional and social life in a devastating way, and a proportion of this patient group subsequently must overcome depression (22–30%) and social isolation (40%). The profound changes to anatomical structures involved in voicing and articulation, as a result of surgery, radiotherapy or chemotherapy (separately or in combination with one another), introduce challenges faced in speech rehabilitation and voice production that complicate social reintegration and quality of life. After laryngectomy, breathing, voicing, articulation and tongue movement are major components in restoring communication. Regular exercise of the chest, neck and oropharyngeal muscles, in particular, is important in controlling these components and keeping the involved structures supple. It is, however, a difficult task for a speech therapist to keep the patient engaged and motivated to practice these exercises. We have adopted a multidisciplinary approach to explore the use of basic beatboxing techniques to create a wide variety of exercises that are seen as fun and interactive and that maximize the use of the structures important in alaryngeal phonation. We herein report on our empirical work in developing patients’ skills, particularly relating to voiced and unvoiced consonants to improve intelligibility. In collaboration with a professional beatboxing performer, we produced instructional online video materials to support patients working on their own and/or with support from speech therapists. Although the present paper is focused predominantly on introducing the structure of the conducted workshops, the rationale for their design and the final public engagement performance, we also include feedback from participants to commence the critical discourse about whether this type of activity could lead to systematic underlying research and robustly assessed interventions in the future. Based on this exploratory work, we conclude that the innovative approach that we employed was found to be engaging, useful, informative and motivating. We conclude by offering our views regarding the limitations of our work and the implications for future empirical research.
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Affiliation(s)
| | | | - Donatella Maraschin
- School of Arts and Creative Industries, London South Bank University, London, United Kingdom
| | - David Young
- School of Science and Engineering, University of Dundee, Dundee, United Kingdom
| | - John M Quinn
- First Faculty of Medicine, Institute of Hygiene and Epidemiology, Charles University, Prague, Czechia
| | | | | | - Evangelos Himonides
- UCL Institute of Education, University College London, London, United Kingdom
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24
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Lee YH, Goo-Yoshino S, Lew HL, Chi WC, Yen CF, Liao HF, Chen SC, Liou TH. Social participation in head and neck cancer survivors with swallowing disorder: World Health Organization Disability Assessment Schedule 2.0 study. Head Neck 2019; 42:905-912. [PMID: 31886608 DOI: 10.1002/hed.26062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 11/17/2019] [Accepted: 12/17/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Social function and quality of life were negatively impacted by the sequelae of treatment for the disease in the head and neck cancer survivor with swallowing disorder. METHOD Data from a total of 1023 survivors between July 2012 and November 2017 were collected from the Taiwan Data Bank of Persons with Disability. Nonparametric rank F test was used to analyze the influence of different variables on social participation. RESULTS (a) All WHODAS (World Health Organization Disability Assessment Schedule) 2.0 scores revealed significantly increased difficulty when swallowing impairment increased (P < .001). (b) Unemployment, institutionalization, severity of swallowing impairment, cancer sites, and WHODAS 2.0 score of domains 1 to 4 were negatively related to social participation, while living in rural area is related to increased social participation. CONCLUSIONS Social participation was negatively affected by many variables in this population. Among these variables, cancer sites and WHODAS 2.0 score of domains 1 to 4 were the strongest factors.
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Affiliation(s)
- Yu-Hao Lee
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shari Goo-Yoshino
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Henry L Lew
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii.,Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Wen-Chou Chi
- School of Occupational Therapy, Chungshan Medical University, Taichung, Taiwan
| | - Chia-Feng Yen
- Department of Public Health, Tzu Chi University, Hualien, Taiwan
| | - Hua-Fang Liao
- Taiwan Association of Child Development and Early Intervention, Hualien City, Taiwan.,School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shih-Ching Chen
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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25
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Roick J, Danker H, Dietz A, Papsdorf K, Singer S. Predictors of changes in quality of life in head and neck cancer patients: a prospective study over a 6-month period. Eur Arch Otorhinolaryngol 2019; 277:559-567. [PMID: 31642956 DOI: 10.1007/s00405-019-05695-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/10/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE Patients with head and neck cancer experience multiple complaints during treatment which also affect quality of life. The present study assessed predictors of temporal changes in quality of life over a 6-month period among patients treated for head and neck cancer. METHODS Patients completed questionnaires at the beginning (t1) and end (t2) of their hospital stay and 3 (t3) and 6 months (t4) thereafter. Quality of life was evaluated using EORTC QLQ-C30 and QLQ-H&N35. Descriptive statistics were computed across measurement points for different domains of quality of life; predictors were identified using general linear models. RESULTS Eighty-three patients (mean age: 58, SD = 11, 20.5% female) participated. Quality of life decreased during treatment and slowly recovered thereafter. From t1 to t4, there were adverse changes that patients consider to be relevant in physical and role functioning, fatigue, dyspnea, insomnia, loss of appetite, financial difficulties, problems with senses and teeth, limited mouth opening, mouth dryness, social eating, coughing, and sticky saliva. Temporal changes in global quality of life between t1 and t2 were predicted by tumor stage (B = - 5.6, p = 0.04) and well-being (B = 0.8, p = 0.04); radiotherapy was a predictor of temporal changes in physical functioning (B = - 12.5, p = 0.03). CONCLUSIONS Quality of life decreases during treatment, half a year after hospital stay there are still restrictions in some areas. A special focus should be given on head and neck cancer patient's quality of life in the aftercare.
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Affiliation(s)
- Julia Roick
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
| | - Helge Danker
- Division of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Andreas Dietz
- Department of Otolaryngology, University Medical Center Leipzig, Leipzig, Germany
| | - Kirsten Papsdorf
- Department of Radiation-Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of Johannes Gutenberg University Mainz, Mainz, Germany
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26
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Henry M, Fuehrmann F, Hier M, Zeitouni A, Kost K, Richardson K, Mlynarek A, Black M, MacDonald C, Chartier G, Zhang X, Rosberger Z, Frenkiel S. Contextual and historical factors for increased levels of anxiety and depression in patients with head and neck cancer: A prospective longitudinal study. Head Neck 2019; 41:2538-2548. [PMID: 30887617 DOI: 10.1002/hed.25725] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/01/2019] [Accepted: 02/18/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND This study aimed at examining predictors of clinical anxiety and depressive symptoms in patients with head and neck cancer (HNC) at 3, 6, and 12 months post-diagnosis, with a particular interest in contextual and historical factors. METHODS Prospective longitudinal study of 219 consecutive patients newly diagnosed with a first occurrence of primary HNC, including psychometric measures, Structured Clinical Interview for DSM-IV Diagnoses (SCID), and medical chart reviews. RESULTS Point prevalence of clinical anxiety symptoms (Hospital Anxiety and Depression Scale-Anxiety subscale) was 32.0%, 21.9%, 12.1%, and 12.6% at baseline, 3, 6, and 12 months; and clinical depressive symptoms on the Depression Subscale was 19.4%, 21.9%, 13.5%, and 9.2%, respectively. Predictors of anxiety and depressive symptoms included upon diagnosis SCID major depressive or anxiety disorder, stressful life events in previous year, neuroticism, and levels of anxiety and depressive symptoms upon cancer diagnosis. CONCLUSIONS This study emphasizes the predictive contribution of broader personal contextual and historical factors that increase psychological vulnerability in HNC and merit consideration.
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Affiliation(s)
- Melissa Henry
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Oncology, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Fabienne Fuehrmann
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Oncology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Michael Hier
- Department of Oncology, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Anthony Zeitouni
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Karen Kost
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Keith Richardson
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Alex Mlynarek
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,McGill University Health Centre, Montreal, Quebec, Canada
| | - Martin Black
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Gabrielle Chartier
- Department of Nursing, Jewish General Hospital, Montreal, Quebec, Canada
| | - Xun Zhang
- McGill University Health Centre Research Institute, Montreal, Quebec, Canada
| | - Zeev Rosberger
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Saul Frenkiel
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
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27
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Quality of life after total laryngectomy: evaluating the effect of socioeconomic status. The Journal of Laryngology & Otology 2019; 133:129-134. [PMID: 30773143 DOI: 10.1017/s0022215119000215] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Total laryngectomy is considered the primary treatment modality for advanced laryngeal carcinoma. This study assessed the quality of life in patients after total laryngectomy, and ascertained whether quality of life is affected by socioeconomic status. METHOD Forty-seven patients (20 state- and 27 private-sector) who underwent total laryngectomy between 1998 and 2014 responded to the University of Washington Quality of Life Questionnaire, the Voice-Related Quality of Life Questionnaire and the Brief Illness Perception Questionnaire. RESULTS Significant differences were found in socioeconomic status between state- and private-sector patients (p < 0.001). There was no significant difference in overall quality of life between groups (p = 0.210). State-sector patients scored significantly higher Voice-Related Quality of Life Questionnaire scores (p = 0.043). Perception of illness did not differ significantly between groups. CONCLUSION Overall quality of life after total laryngectomy appears to be similar in patients from different socioeconomic backgrounds. However, patients from lower socioeconomic circumstances have better voice-related quality of life. The results illustrate the importance of including socioeconomic status when reporting voice outcomes in total laryngectomy patients.
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28
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Wang Y, Lu W, Shen X. Assessment of preoperative psychologic distress in laryngeal cancer patients. Acta Otolaryngol 2019; 139:184-186. [PMID: 30794021 DOI: 10.1080/00016489.2018.1523555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Preoperative psychologic distress is common in head and neck cancer patients and related to deleterious effects in patient treatment and recovery. Routine screening and appropriate referral of all patients with cancer for psychiatric assessment is now a part of the medical treatment. OBJECTS The aim was to assess the level of preoperative psychologic distress in laryngeal cancer patients scheduled for surgical treatment. METHODS After the Institutional Review Board approval and informed written consent, 211 patients scheduled for total or partial laryngectomy were interviewed preoperatively. Each patient was asked to fulfil the Hospital Anxiety and Depression Scale. Demographic characteristics that may relate to psychologic distress were also recorded. RESULTS The mean age (+/-SD) was 62.1 (8.2) years. The surgical type was total laryngectomy (n = 79) and partial laryngectomy (n = 132). Median (first/third quartile) HADS score was 6 (3/10). A total of 39.6% patients had psychologic distress. The HADS score was higher for total laryngectomy patients than partial laryngectomy patients [7 (4/10) versus 5 (3/10), p < .05]. Age was negatively correlated with HADS score (p = .049). CONCLUSIONS Our study showed that laryngeal cancer patients scheduled for total laryngectomy had higher level of psychologic distress. Age was a predictive factor for psychologic distress.
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Affiliation(s)
- Yiru Wang
- Department of Anaesthesiology, The Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Weisha Lu
- Department of Anaesthesiology, The Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Xia Shen
- Department of Anaesthesiology, The Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
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29
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Longobardi Y, Savoia V, Bussu F, Morra L, Mari G, Nesci DA, Parrilla C, D'Alatri L. Integrated rehabilitation after total laryngectomy: a pilot trial study. Support Care Cancer 2019; 27:3537-3544. [PMID: 30685792 DOI: 10.1007/s00520-019-4647-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Acquisition and acceptance of the alaryngeal voice, psychological state, and Quality of Life (QoL) of laryngectomized patients. METHODS Thirty-two patients who underwent total laryngectomy were included in the study; 17 of them were treated by a psychologist and a speech therapist (experimental group); 15 performed only speech therapy (control group). RESULTS The experimental group showed a significant improvement in all parameters of the INFVo scale, in the score of the Environment subscale and in the total score of the I-SECEL (Self-Evaluation of Communication Experiences after Laryngeal Cancer); in the Depression, Obsession-Compulsion and Paranoia areas of the SCL-90-R (Symptom Check List-90-Revised); and in the Social area (REL) of the WHOQOL-B (World Health Organization Quality of Life Scale-Brief). CONCLUSIONS An integrated rehabilitative approach to laryngectomized patients improves emotional state and psychosocial aspects and promotes acceptance and use of the new voice and recovery of a better quality of life.
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Affiliation(s)
- Ylenia Longobardi
- Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy
| | - Vezio Savoia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Unità di Consultazione Psichiatrica, L.go F. Vito 1, I-00168, Rome, Italy
| | - Francesco Bussu
- Otolaryngology Division, AOU Sassari, V.le San Pietro 43/B, I-07100, Sassari, Italy.,Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy
| | - Luciana Morra
- Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy
| | - Giorgia Mari
- Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy
| | - Domenico A Nesci
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Unità di Consultazione Psichiatrica, L.go F. Vito 1, I-00168, Rome, Italy
| | - Claudio Parrilla
- Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy.
| | - Lucia D'Alatri
- Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, L.go F. Vito 1, I-00168, Rome, Italy
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30
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Jespersen LN, Michelsen SI, Tjørnhøj-Thomsen T, Svensson MK, Holstein BE, Due P. Living with a disability: a qualitative study of associations between social relations, social participation and quality of life. Disabil Rehabil 2018; 41:1275-1286. [PMID: 29357697 DOI: 10.1080/09638288.2018.1424949] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE We explored which shared aspects of social relations were considered important to the quality of life of persons between the ages of 10 and 40 years living with a disability. We examined how social relations were experienced as affecting quality of life and social participation. MATERIALS AND METHODS Fifteen focus groups involving 48 persons with disabilities were conducted using photo elicitation, preference ranking and props. Focus group interviews were supplemented with seven individual interviews with individuals unable to participate in focus groups. All focus group interviews and individual interviews were audiotaped, transcribed, and thematic data analysis was conducted. RESULTS We identified caregiving, dependency, and understanding as essential for quality of life. Acceptance from society, discrimination and prejudice, and the ability to participate in society were also highlighted as affecting quality of life. The use of social tactics to avoid confrontation with certain aspects of their disability was common among participants. CONCLUSIONS Across disabilities, caregiving, dependency, understanding and acceptance, and discrimination and prejudice were all important aspects for the quality of life of the individuals. Social relations were closely related to social participation, and the latter affected the quality of life of the participants. Social tactics were used to navigate social relations. Implications for rehabilitation We suggest to formalize the concept of social tactics and use it in patient education to enhance quality of life in individuals living with disabilities. People may accept and learn to cope with the impact of their disability, but how they maintain their social participation and social relations also impact on their quality of life. In their assessment, professionals working with individuals with disabilities should, therefore, give more priority to analyze the impact of social relations. When intervening, an effort to establish and maintain social relations should be considered along with psychological help, allocation of aids and economical support aiming to enhance quality of life and social participation among individuals with disabilities. When evaluating efforts to improve quality of life, it is important to investigate whether the intervention has improved the social relations.
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Affiliation(s)
- Louise Norman Jespersen
- a National Institute of Public Health , University of Southern Denmark , Copenhagen , Denmark
| | - Susan Ishøy Michelsen
- a National Institute of Public Health , University of Southern Denmark , Copenhagen , Denmark
| | - Tine Tjørnhøj-Thomsen
- a National Institute of Public Health , University of Southern Denmark , Copenhagen , Denmark
| | | | - Bjørn Evald Holstein
- a National Institute of Public Health , University of Southern Denmark , Copenhagen , Denmark
| | - Pernille Due
- a National Institute of Public Health , University of Southern Denmark , Copenhagen , Denmark
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31
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Tuttle TG, Erath BD. Design and Evaluation of a Mechanically Driven Artificial Speech Device. J Med Device 2017. [DOI: 10.1115/1.4038222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This paper presents the design of a mechanically driven artificial speech device to be used by laryngectomees as an affordable alternative to an electrolarynx (EL). Design objectives were based on feedback from potential end users. The device implements a mainspring powered gear train that drives a striker. The striker impacts a suspended drum-like head, producing sound. When pressed against the neck, the head transmits sound into the oral cavity, allowing the user to produce intelligible speech. The dynamics of the vibrating head and sound pressure levels (SPLs) produced at the mouth were measured to compare performance between the device and a common, commercially available EL. The results showed comparable performance and sound output.
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Affiliation(s)
- Tyler G. Tuttle
- Department of Mechanical Engineering, Michigan State University, 428 South Shaw Ln, East Lansing, MI 48824 e-mail:
| | - Byron D. Erath
- Department of Mechanical and Aeronautical Engineering, Clarkson University, 8 Clarkson Ave, Potsdam, NY 13699 e-mail:
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Ernst J, Mehnert A, Dietz A, Hornemann B, Esser P. Perceived stigmatization and its impact on quality of life - results from a large register-based study including breast, colon, prostate and lung cancer patients. BMC Cancer 2017; 17:741. [PMID: 29121876 PMCID: PMC5680772 DOI: 10.1186/s12885-017-3742-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 10/31/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To date, research on stigmatization among cancer patients and related psychosocial consequences has been scarce and mostly based on small and highly selected samples. We investigated stigmatization and its impact on quality of life among a large sample including four major tumor entities. METHODS We assessed 858 patients with breast, colon, lung or prostate cancer from two cancer registries. Stigmatization and quality of life (QoL) was assessed with the Social Impact Scale (SIS-D) and the EORTC Quality of Life Questionnaire (European Organization for Research and Treatment of Cancer), respectively. Group effects were analyzed via analyses of variance, relationships were investigated via Pearson's r and stepwise regression analyses. RESULTS The mean age was 60.7 years, 54% were male. Across cancer sites, the dimensions of stigmatization (isolation, social rejection, financial insecurity and internalized shame) were in the lower and middle range, with the highest values found for isolation. Stigmatization was lowest among prostate cancer patients. Stigmatization predicted all five areas of QoL among breast cancer patients (p < .05), but only affected emotional functioning (p < .01) among lung cancer patients. CONCLUSIONS We found an inverse relationship between perceived cancer-related stigmatization and various dimensions of QoL, with variation between cancer sites. Breast cancer patients should be focused in individual therapies regarding the negative consequences accompanied by perceived stigmatization.
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Affiliation(s)
- J Ernst
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, D - 04103, Leipzig, Germany.
| | - A Mehnert
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, D - 04103, Leipzig, Germany
| | - A Dietz
- Clinic of Otolaryngology, Head and Neck Surgery, University Medical Center Leipzig, Leipzig, Germany.,Tumor Center e.V., University Medical Center Leipzig, Leipzig, Germany
| | - B Hornemann
- University Cancer Center (UCC) Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - P Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, D - 04103, Leipzig, Germany
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Wrapson J, Patterson N, Nakarada-Kordic I, Reay S. A life-changing event: patients’ personal experiences of living with a long-term tracheostomy. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/24735132.2017.1386432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jill Wrapson
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Niamh Patterson
- Department of Psychology, Auckland University of Technology, Auckland, New Zealand
| | - Ivana Nakarada-Kordic
- Design for Health and Wellbeing (DHW) Lab, School of Art and Design, Auckland University of Technology, Auckland, New Zealand
| | - Stephen Reay
- Design for Health and Wellbeing (DHW) Lab, School of Art and Design, Auckland University of Technology, Auckland, New Zealand
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Ichikura K, Yamashita A, Sugimoto T, Kishimoto S, Matsushima E. Patterns of stress coping and depression among patients with head and neck cancer: A Japanese cross-sectional study. Psychooncology 2017; 27:556-562. [PMID: 28857394 DOI: 10.1002/pon.4549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 08/03/2017] [Accepted: 08/24/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Patients with head and neck cancer (HNC) experience many stressful problems with breathing, eating, swallowing, and/or speaking. The aim of this study was to (a) identify the clusters of HNC patients based on their stress coping strategies and (b) evaluate the differences in clinical data and depression among the identified HNC patients' coping clusters. METHODS We conducted a single-center, cross-sectional study with self-completed questionnaires for patients with HNC between April and August 2013. We measured stress coping (an abbreviated version of the COPE Inventory: Brief COPE) and depression (the Japanese version of the Beck Depression Inventory-II: BDI-II). RESULTS Of the 116 patients who completed all the questionnaires, 81 (69.8%) participants were 60 to 79 years old and 105 (90.5%) were men. Cluster analysis based on the standardized z score of Brief COPE showed that patients were classified into 3 clusters, labeled "dependent coping," "problem-focused coping," and "resigned coping." The ANOVA revealed that depression (BDI score) was significantly higher in the dependent-coping cluster compared with the problem-focused coping. CONCLUSIONS This study indicates that patients with a dependent-coping pattern may account for the largest HNC population and are likely to suffer from depression. Dependent coping includes smoking, drinking, seeking support, or engaging self-distraction. In the future, we should develop psychological intervention programs focused on coping strategies and enhancement of the support system for patients with HNC.
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Affiliation(s)
- Kanako Ichikura
- Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Aya Yamashita
- Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Taro Sugimoto
- Department of Otorhinolaryngology, Head and Neck Tumor Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.,Section of Head and Neck Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Seiji Kishimoto
- Section of Head and Neck Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Head and Neck Surgery, Kameda Medical Center, Kamogawa, Japan
| | - Eisuke Matsushima
- Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Raol N, Lilley E, Cooper Z, Dowdall J, Morris MA. Preoperative Counseling in Salvage Total Laryngectomy: Content Analysis of Electronic Medical Records. Otolaryngol Head Neck Surg 2017; 157:641-647. [DOI: 10.1177/0194599817726769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective To study preoperative counseling in patients undergoing salvage total laryngectomy (STL). Study Design Case series with chart review. Setting Tertiary care academic hospital. Subjects and Methods We reviewed charts of patients ≥18 years undergoing STL between 2005 and 2015. Fifty-eight patients were identified. Notes written within 2 months prior to surgery by head and neck surgical oncologists, radiation oncologists, medical oncologists, speech-language pathologists, social workers, and nurse practitioners were extracted and coded into 4 categories. Coded content was then analyzed using a simple tally within content areas. Results Nonphysicians documented patient values and priorities, exclusive of treatment desires, more frequently. These topics included apprehension about family obligations, fear about communication, questions regarding quality of life, and anxiety regarding job continuation. Physician notes documented priorities regarding preferences for surgical treatment. No patients were seen by palliative care preoperatively, and only 14% (n = 8) patients had documentation of an end-of-life discussion. Conclusions Preoperative counseling for STL patients that included nonphysicians had a higher frequency of discussion of patients’ priorities. This suggests including these types of providers may lead to more patient-centered care. A prospective study evaluating patient and physician perceptions of preoperative counseling can better identify where discrepancies exists and help conceptualize a framework for preoperative counseling in STL patients and other patients undergoing high-risk surgery.
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Affiliation(s)
- Nikhila Raol
- Center for Surgery and Public Health, Harvard Medical School and Harvard T.H. Chan School of Public Health, Department of Surgery, Brigham & Women’s Hospital, Boston, Massachusetts, USA
- Department of Otolaryngology, Emory University, Atlanta, Georgia, USA
| | - Elizabeth Lilley
- Center for Surgery and Public Health, Harvard Medical School and Harvard T.H. Chan School of Public Health, Department of Surgery, Brigham & Women’s Hospital, Boston, Massachusetts, USA
| | - Zara Cooper
- Center for Surgery and Public Health, Harvard Medical School and Harvard T.H. Chan School of Public Health, Department of Surgery, Brigham & Women’s Hospital, Boston, Massachusetts, USA
| | - Jayme Dowdall
- Division of Otolaryngology, Department of Surgery, Brigham & Women’s Hospital, Boston, Massachusetts, USA
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Megan A. Morris
- Department of Community and Behavioral Health, Colorado School of Public Health, Denver, Colorado, USA
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Esser P, Mehnert A, Johansen C, Hornemann B, Dietz A, Ernst J. Body image mediates the effect of cancer-related stigmatization on depression: A new target for intervention. Psychooncology 2017; 27:193-198. [DOI: 10.1002/pon.4494] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/30/2017] [Accepted: 07/03/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Peter Esser
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - Christoffer Johansen
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
- Oncology Clinic, Rigshospitalet; University of Copenhagen; Copenhagen Denmark
- Unit of Survivorship; The Danish Cancer Society Research Center; Copenhagen Denmark
| | - Beate Hornemann
- University Tumor Center (UCC); University Medical Center Dresden; Dresden Germany
| | - Andreas Dietz
- Clinic of Otolaryngology; University Medical Center Leipzig; Leipzig Germany
- Tumor Center e.V; University Medical Center Leipzig; Leipzig Germany
| | - Jochen Ernst
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
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Social and quality of life impact using a voice prosthesis after laryngectomy. Curr Opin Otolaryngol Head Neck Surg 2017; 25:188-194. [DOI: 10.1097/moo.0000000000000361] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Keszte J, Danker H, Dietz A, Meister E, Pabst F, Guntinas-Lichius O, Oeken J, Singer S, Meyer A. Course of psychiatric comorbidity and utilization of mental health care after laryngeal cancer: a prospective cohort study. Eur Arch Otorhinolaryngol 2016; 274:1591-1599. [PMID: 27744529 DOI: 10.1007/s00405-016-4340-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Abstract
In a German multi-center prospective cohort study, we wanted to assess the course of psychiatric comorbidity, utilization of mental health care and psychosocial care needs in laryngeal cancer patients during the first year after partial laryngectomy (PRL). Structured interviews with patients were conducted before surgery, 1 week (1 w), 3 months (3 m) and 1 year (12 m) after PRL. Psychiatric comorbidity was assessed using the Structured Clinical Interview for DSM-IV (SCID). Psychosocial care needs and utilization of mental health care were evaluated with standardized face-to-face interviews. In 176 patients, psychiatric disorders were prevalent in 11 % (1 w), 15 % (3 m) and 14 % (12 m), respectively, of which 4 % (12 m) underwent psychiatric treatment or psychotherapy. Two percent had acute, 15 % emerging and 6 % chronic psychiatric comorbidity. Chronically mental ill patients were more frequently younger than 65 years (p = 0.026), female (p = 0.045) and experienced more often a need for psychological counseling (p ≤ 0.001). One year after surgery, 27 % of the comorbid psychiatric patients expressed a need for additional psychological counseling. Alcohol-related disorders were diagnosed in 3 % (1 w), 3 % (3 m) and 8 % (12 m), respectively. Only one of these patients received psychological treatment, while 14 % expressed a need for psychological counseling and 7 % for additional medical consultations. The non-treatment of alcohol-related disorders measured in our sample indicates a major problem since continued alcohol consumption in laryngeal cancer patients is associated with reduced global quality of life, increased functional impairments and reduced overall survival. Screening instruments integrated into acute care are necessary to detect harmful drinking behavior.
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Affiliation(s)
- J Keszte
- Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany.
| | - H Danker
- Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany
| | - A Dietz
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center, Leipzig, Germany
| | - E Meister
- Department of Otorhinolaryngology, Clinical Center Sankt Georg, Leipzig, Germany
| | - F Pabst
- Department of Otorhinolaryngology, Clinical Center Dresden-Friedrichstadt, Dresden, Germany
| | - O Guntinas-Lichius
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital, Jena, Germany
| | - J Oeken
- Department of Otorhinolaryngology, Clinical Center Chemnitz, Chemnitz, Germany
| | - S Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Mainz, Germany
| | - A Meyer
- Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany
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Microvascular Reconstruction of Free Jejunal Graft in Larynx-preserving Esophagectomy for Cervical Esophageal Carcinoma. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e632. [PMID: 27257562 PMCID: PMC4874276 DOI: 10.1097/gox.0000000000000613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 01/13/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Losing the ability to speak severely affects the quality of life, and patients who have undergone laryngectomy tend to become depressed, which may lead to social withdrawal. Recently, with advancements in chemoradiotherapy and with alternative perspectives on postoperative quality of life, larynx preservation has been pursued; however, the selection of candidates and the optimal reconstructive procedure remain controversial. In this study, we retrospectively reviewed our experience with free jejunal graft for larynx-preserving cervical esophagectomy (LPCE), focusing on microvascular reconstruction. METHODS Seven patients underwent LPCE for cervical esophageal carcinoma, and defects were reconstructed by free jejunal transfer subsequently. We collected preoperative and postoperative data of the patients and assessed the importance of the procedure. RESULTS We mostly used the transverse cervical artery as the recipient, and a longer operative time was required, particularly for the regrowth cases. The operative field for microvascular anastomosis was more limited and deeper than those in the laryngectomy cases. Two graft necrosis cases were confirmed at postoperative day 9 or 15, and vessels contralateral from the graft were chosen as recipients in both patients. CONCLUSIONS Microvascular reconstruction for free jejunal graft in LPCE differed in several ways from the procedure combined with laryngectomy. Compression from the tracheal cartilage to the pedicle was suspected as the reason of the necrosis clinically and pathologically. Therefore, we should select recipient vessels from the ipsilateral side of the graft, and careful and extended monitoring of the flap should be considered to make this procedure successful.
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40
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Eadie TL, Otero D, Cox S, Johnson J, Baylor CR, Yorkston KM, Doyle PC. The relationship between communicative participation and postlaryngectomy speech outcomes. Head Neck 2015; 38 Suppl 1:E1955-61. [PMID: 26714043 DOI: 10.1002/hed.24353] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/04/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine relationships between communicative participation and postlaryngectomy speech outcomes, including listener-rated speech intelligibility and acceptability, and patient-rated speech acceptability and voice handicap. METHODS Thirty-six laryngectomized individuals completed the Communicative Participation Item Bank (CPIB) short form and the Voice Handicap Index-10 (VHI-10). They provided recordings from the Sentence Intelligibility Test (SIT) and a reading passage, and rated their own speech acceptability. Forty-eight inexperienced listeners transcribed the SIT sentences to derive intelligibility scores. Eighteen additional listeners judged the speech acceptability using the rating scales. RESULTS Listeners judged tracheoesophageal speakers as significantly more intelligible and acceptable than electrolaryngeal speakers (p < .05). Speech acceptability was significantly more acceptable to speakers than listeners (p < .05). Weak, nonsignificant relationships were found between communicative participation and listener-rated outcomes. Stronger, significant relationships were found between communicative participation and self-rated speech acceptability and voice handicap (p < .05). CONCLUSION Patient-reported communication outcomes are complementary to listener-rated outcomes. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1955-E1961, 2016.
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Affiliation(s)
- Tanya L Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Devon Otero
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Steven Cox
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Jordan Johnson
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Carolyn R Baylor
- Rehabilitation Medicine, University of Washington, Seattle, Washington
| | | | - Philip C Doyle
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.,Department of Otolaryngology Head and Neck Surgery, Western University, London, Ontario, Canada
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Lortie CL, Thibeault M, Guitton MJ, Tremblay P. Effects of age on the amplitude, frequency and perceived quality of voice. AGE (DORDRECHT, NETHERLANDS) 2015; 37:117. [PMID: 26578457 PMCID: PMC5005868 DOI: 10.1007/s11357-015-9854-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 11/03/2015] [Indexed: 05/21/2023]
Abstract
The manner and extent to which voice amplitude and frequency control mechanisms change with age is not well understood. The related question of whether the assessment of one's own voice evolves with age, concomitant with the acoustical changes that the voice undergoes, also remains unanswered. In the present study, we characterized the aging of voice production mechanisms (amplitude, frequency), compared the aging voice in different experimental contexts (vowel utterance, connected speech) and examined the relationship between voice self-assessment and age-related voice acoustical changes. Eighty healthy adults (20 to 75 years old) participated in the study, which involved computation of several acoustical measures of voice (including measures of fundamental frequency, voice amplitude, and stability) as well as self-assessments of voice. Because depression is frequent in older adults, depression and anxiety scores were also measured. As was expected, analyses revealed age effects on most acoustical measures. However, there was no interaction between age and the ability to produce high/low voice amplitude/frequency, suggesting that voice amplitude and frequency control mechanisms are preserved in aging. Multiple mediation analyses demonstrated that the relationship between age and voice self-assessment was moderated by depression and anxiety scores. Taken together, these results reveal that while voice production undergoes important changes throughout aging, the ability to increase/decrease the amplitude and frequency of voice are preserved, at least within the age range studied, and that depression and anxiety scores have a stronger impact on perceived voice quality than acoustical changes themselves.
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Affiliation(s)
- Catherine L Lortie
- Département de Réadaptation, Université Laval, Quebec City, Quebec, Canada
- Département d'ophtalmologie et ORL - chirurgie cervico-faciale, Université Laval, Quebec City, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec (CRIUSMQ), 2601 chemin de la Canardière, Quebec City, Quebec, G1J 2G3, Canada
| | | | - Matthieu J Guitton
- Département d'ophtalmologie et ORL - chirurgie cervico-faciale, Université Laval, Quebec City, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec (CRIUSMQ), 2601 chemin de la Canardière, Quebec City, Quebec, G1J 2G3, Canada
| | - Pascale Tremblay
- Département de Réadaptation, Université Laval, Quebec City, Quebec, Canada.
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec (CRIUSMQ), 2601 chemin de la Canardière, Quebec City, Quebec, G1J 2G3, Canada.
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Cox SR, Theurer JA, Spaulding SJ, Doyle PC. The multidimensional impact of total laryngectomy on women. JOURNAL OF COMMUNICATION DISORDERS 2015; 56:59-75. [PMID: 26186255 DOI: 10.1016/j.jcomdis.2015.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 03/26/2015] [Accepted: 06/29/2015] [Indexed: 06/04/2023]
Abstract
UNLABELLED Based on society's expectations of what defines the norms for what is deemed "masculine" and "feminine", and a propensity for society's members to adhere to these expectations, women may face a unique set of circumstances and pressures following surgical treatment for laryngeal cancer. This is primarily due to the changes that occur to women's physical, psychological, and social functioning when dealing with cancer diagnosis and treatment outcomes. Because of concerns related to physical disfigurement, acoustic and perceptual changes to one's voice, and threat of the psychological sequelae associated with total laryngectomy (TL) (or, the surgical removal of one's voicebox and surrounding structures), there is an increased potential for violation of social expectations that cross these areas of functioning. As such, efforts that seek to better understand the potentially differential impact of TL on women and identify the specific needs they may have leading up to and after such treatment pursuant to contemporary societal expectations are warranted. Thus, this paper provides an examination of the potentially differential impact of TL on women. In addressing this position, this paper examines the unique challenges women may face postlaryngectomy through the framework of the International Classification of Functioning, Disability, and Health (ICF). Through the use of the ICF, this paper will provide an expanded perspective related to the interactions between body functioning, active participation in daily activities, and contextual factors that may act as facilitators or barriers to women's societal reintegration secondary to TL. LEARNING OUTCOMES Readers will be able to describe the multiple factors that may contribute to the differential impact of total laryngectomy (TL) on women. More specifically, readers will gain an understanding about women's physical, psychological, and social functioning secondary to TL. This paper also provides readers with exposure to the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework. This framework provides readers with an expanded perspective related to the interactions between body functioning, active participation in daily activities, and contextual factors that may act as either facilitators or barriers to the societal reintegration of women secondary to TL.
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Affiliation(s)
- Steven R Cox
- Voice Production and Perception Laboratory, University of Western Ontario, London, ON, Canada; Rehabilitation Sciences, University of Western Ontario, London, ON, Canada.
| | - Julie A Theurer
- Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada; Rehabilitation Sciences, University of Western Ontario, London, ON, Canada
| | - Sandi J Spaulding
- Rehabilitation Sciences, University of Western Ontario, London, ON, Canada; School of Occupational Therapy, University of Western Ontario, London, ON, Canada
| | - Philip C Doyle
- Voice Production and Perception Laboratory, University of Western Ontario, London, ON, Canada; Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; Rehabilitation Sciences, University of Western Ontario, London, ON, Canada
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Perry A, Casey E, Cotton S. Quality of life after total laryngectomy: functioning, psychological well-being and self-efficacy. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2015; 50:467-475. [PMID: 25703153 DOI: 10.1111/1460-6984.12148] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 10/24/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Quality of life (QoL) is an important construct when assessing treatment outcomes. AIMS To examine the relative contributions of functioning, psychological well-being and self-efficacy on self-perceived QoL with a sample of total laryngectomy patients in Australia who had surgery for advanced laryngeal cancer. METHODS & PROCEDURES In a cross-sectional study, 113 members of the Laryngectomy Associations of New South Wales and of Victoria, Australia, were recruited, and each was sent a series of questionnaires for postal return. Four psychometrically validated measures were used for participants to document their QoL, functioning (speech, swallowing), psychological well-being and general self-efficacy. OUTCOMES & RESULTS Eighty-six (77%) questionnaires were returned and 83 were analysed. The cohort consists of 70 men and 13 women aged between 46 and 88 years. Overall, this sample of total laryngectomy survivors demonstrated significantly reduced physical health QoL (p < 0.001) and social relationship QoL (p = 0.011) and higher levels of depression (p = 0.008) and anxiety (p = 0.001) when compared with normative samples. This was in the context of them having higher than normal self-efficacy scores and, at worst, mild (self-rated) impairment of speech and of swallowing. Psychological well-being (sr(2) = 0.43, p < 0.001) had a stronger association than functioning (speech, swallowing, sr(2) = 0.08, p < 0.05) for their psychological QoL. Psychological well-being (sr(2) = 0.17, p < 0.001) and not functioning (sr(2) = 0.05, p > 0.05) were significantly associated with social relationship QoL. Self-efficacy scores were significantly higher than norms in this cohort, but were not associated with either their psychological QoL or social relationship QoL, after controlling for psychological well-being and functioning. CONCLUSIONS & IMPLICATIONS For survivors of laryngeal cancer treated by total laryngectomy, it is important to be aware of the impact of psychological well-being (depression, anxiety, stress) on self-perceived QoL. In addition to rehabilitating function (speech, swallowing), specific interventions to assist these individuals better manage their psychological well-being will likely improve their perceived life satisfaction/QoL.
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Affiliation(s)
- Alison Perry
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland
| | - Erica Casey
- Uncle Bobs Child Development Centre, The Royal Children's Hospital, Parkville, Melbourne, VIC, Australia
| | - Sue Cotton
- Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, VIC, Australia
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Lee PY, Chang TR. Application of integrative information system improves the quality and effectiveness of cancer case management. J Multidiscip Healthc 2015; 8:287-90. [PMID: 26089680 PMCID: PMC4467751 DOI: 10.2147/jmdh.s77714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Cancer case management provides consecutive care during the entire process through diagnosis to treatment and follow-up. We established an integrative information system with integration of the health information system. This integrative information system shortened the time spent on case screening, follow-up data management, and monthly data summarization of case managers. It also promoted the case follow-up rate. This integrative information system may improve the quality and effectiveness for cancer case management, one important part of cancer nursing.
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Affiliation(s)
- Pei-Yi Lee
- Department of Nursing, MacKay Memorial Hospital, Taipei, Taiwan ; Department of Nursing, MacKay Medical College, Taipei, Taiwan
| | - Tsue-Rung Chang
- Department of Nursing, MacKay Memorial Hospital, Taipei, Taiwan
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45
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Persistence of psychological distress and correlated factors among patients with head and neck cancer. Palliat Support Care 2015; 14:42-51. [PMID: 26089108 DOI: 10.1017/s1478951515000711] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Many patients with head and neck cancer (HNC) suffer from psychological distress associated with dysfunction and/or disfigurement. Our aim was to evaluate the ratio of patients with persistence of psychological distress during hospitalization and identify the predictors of persistence or change in psychological distress among HNC patients. METHOD We conducted a single-center longitudinal study with self-completed questionnaires. We evaluated psychological distress (the Hospital Anxiety and Depression Scale; HADS) and functional level (the Functional Assessment of Cancer Therapy-Head and Neck Scale; FACT-H&N) among patients during hospitalization at the Medical Hospital of Tokyo Medical and Dental University. RESULTS Of 160 patients, 117 (73.1%) completed the questionnaire at both admission and discharge. Some 42 (52.5%) patients reported persistent psychological distress. The physical well-being of patients with continued distress was significantly lower than that of other patients (21.7 ± 4.7, 19.4 ± 6.1, 19.5 ± 5.4; p < 0.01), and the emotional well-being of patients with continued distress was significantly lower than that in patients with no distress and reduced distress (22.3 ± 3.5, 20.5 ± 2.5; p < 0.01). Significant of results: Impaired physical and emotional function appears to be associated with persistent psychological distress among HNC patients. Psychological interventions focused on relaxation, cognition, or behavior may be efficacious in preventing such persistent distress.
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Bruegmann T, van Bremen T, Vogt CC, Send T, Fleischmann BK, Sasse P. Optogenetic control of contractile function in skeletal muscle. Nat Commun 2015; 6:7153. [PMID: 26035411 PMCID: PMC4475236 DOI: 10.1038/ncomms8153] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/13/2015] [Indexed: 12/17/2022] Open
Abstract
Optogenetic stimulation allows activation of cells with high spatial and temporal precision. Here we show direct optogenetic stimulation of skeletal muscle from transgenic mice expressing the light-sensitive channel Channelrhodopsin-2 (ChR2). Largest tetanic contractions are observed with 5-ms light pulses at 30 Hz, resulting in 84% of the maximal force induced by electrical stimulation. We demonstrate the utility of this approach by selectively stimulating with a light guide individual intralaryngeal muscles in explanted larynges from ChR2-transgenic mice, which enables selective opening and closing of the vocal cords. Furthermore, systemic injection of adeno-associated virus into wild-type mice provides sufficient ChR2 expression for optogenetic opening of the vocal cords. Thus, direct optogenetic stimulation of skeletal muscle generates large force and provides the distinct advantage of localized and cell-type-specific activation. This technology could be useful for therapeutic purposes, such as restoring the mobility of the vocal cords in patients suffering from laryngeal paralysis.
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Affiliation(s)
- Tobias Bruegmann
- Institute of Physiology I, University of Bonn, Life and Brain Center, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany.,Research Training Group 1873, University of Bonn, 53127 Bonn, Germany
| | - Tobias van Bremen
- Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - Christoph C Vogt
- Institute of Physiology I, University of Bonn, Life and Brain Center, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - Thorsten Send
- Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - Bernd K Fleischmann
- Institute of Physiology I, University of Bonn, Life and Brain Center, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - Philipp Sasse
- Institute of Physiology I, University of Bonn, Life and Brain Center, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
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de Almeida JR, Vescan AD, Witterick IJ, Gullane PJ, Gentili F, Ringash J, Thoma A, Lohfeld L. Changes Experienced in Quality of Life for Skull Base Surgical Patients: A Qualitative Case Study. J Neurol Surg B Skull Base 2015; 76:129-144. [PMID: 28856080 DOI: 10.1055/s-0034-1371520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 12/28/2013] [Indexed: 10/24/2022] Open
Abstract
Objective Skull base tumors are associated with quality of life (QOL) changes. A qualitative case-study approach may help better understand patients' experiences. Methods A total of 34 skull base surgery patients were selected into focus groups using a criterion-based maximum variation sampling strategy from a sampling frame of 138 patients. Eight groups were organized based on a factorial design of surgical approach (endoscopic/pen) and tumor location (anterior/central). Data were analyzed using a conceptual framework. Qualitative analysis was performed on focus group transcripts to identify major themes and determine if surgical approach or tumor location had differential effects on QOL. Concepts were quantitatively tallied from written workbooks. Results The 34 participants (19 men, 15 women; mean age: 48 years, standard deviation: 14 years) had mixed reactions to their diagnosis ranging from relief to fear. Participants reported physical and nonphysical changes in QOL with some variation in physical complaints by tumor location. Several major themes emerged from the analysis. Skull base tumors are associated with fear and frustration, loss of physical senses and self-identity, social isolation, and coping mechanisms. Conclusions Skull base surgery may impact patients' lives. Qualitative study of patient experiences can provide rich information to better understand this disease.
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Affiliation(s)
- John R de Almeida
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - Allan D Vescan
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Ian J Witterick
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Patrick J Gullane
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Fred Gentili
- Division of Neurosurgery, University of Toronto, Toronto, Canada
| | - Jolie Ringash
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Achilles Thoma
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - Lynne Lohfeld
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
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Breda E, Catarino R, Monteiro E. Transoral laser microsurgery for laryngeal carcinoma: Survival analysis in a hospital-based population. Head Neck 2014; 37:1181-6. [DOI: 10.1002/hed.23728] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 02/17/2014] [Accepted: 04/28/2014] [Indexed: 11/11/2022] Open
Affiliation(s)
- Eduardo Breda
- Department of Otolaryngology; Portuguese Institute of Oncology Dr Francisco Gentil; Porto Portugal
| | - Raquel Catarino
- Department of Molecular Oncology GRP CI; Portuguese Institute of Oncology Dr Francisco Gentil; Porto Portugal
| | - Eurico Monteiro
- Department of Otolaryngology; Portuguese Institute of Oncology Dr Francisco Gentil; Porto Portugal
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Panwar A, Lindau R, Wieland A. Management of premalignant lesions of the larynx. Expert Rev Anticancer Ther 2014; 13:1045-51. [DOI: 10.1586/14737140.2013.829643] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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