1
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Mikhael M, Kansara B, Basta A, Hume E, Nguyen OT, Reblin M, Hong YR, Tabriz AA, Patel K, Magnuson JS, Turner K. Optimizing presurgical education for patients with head and neck cancer receiving laryngectomy and free flap surgery: A qualitative study. Head Neck 2024. [PMID: 38459809 DOI: 10.1002/hed.27729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND There has been limited study of oncology professionals' perspectives on optimizing delivery of presurgical education for individuals with head and neck cancer (HNC). Therefore, we assessed oncology professionals' perspectives about presurgical education for laryngectomy and free flap surgeries, which have a significant impact on patients' quality of life. METHODS Interviews were conducted with 27 oncology professionals from an NCI-designated Comprehensive Cancer Center and a community oncology setting. RESULTS Participants identified six recommendations to improve presurgical education: (1) establishing preoperative consultations with allied health professionals; (2) educating patients and providers on the concept of team-based care; (3) optimizing education through multimodal strategies; (4) connecting patients with other HNC surgical patients; (5) preparing caregivers for their role; and (6) educating patients on insurance navigation. CONCLUSIONS Study findings demonstrate gaps in the timing, content, and mode of delivery for presurgical education and suggest strategies for further evaluation in future studies.
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Affiliation(s)
- Marian Mikhael
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Bhargav Kansara
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Ameer Basta
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Emma Hume
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Oliver T Nguyen
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Maija Reblin
- Department of Family Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Young-Rock Hong
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida, USA
| | - Amir Alishahi Tabriz
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Krupal Patel
- Department of Head and Neck Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Jeffery Scott Magnuson
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
- Department of Head and Neck Surgery, AdventHealth Orlando, Orlando, Florida, USA
| | - Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida, USA
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2
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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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Grimmett C, Heneka N, Chambers S. Psychological Interventions Prior to Cancer Surgery: a Review of Reviews. CURRENT ANESTHESIOLOGY REPORTS 2022; 12:78-87. [PMID: 35125973 PMCID: PMC8801554 DOI: 10.1007/s40140-021-00505-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 01/26/2023]
Abstract
Purpose of Review Patients with cancer who have high levels of psychological distress have poor treatment compliance and worse outcomes. This “review of reviews” provides a narrative synthesis of the impact of psychological prehabilitation interventions on individuals awaiting cancer surgery. Recent Findings Twenty reviews of prehabilitation with psychological interventions were identified. There is a trend towards improved psychological outcomes following intervention, particularly when psychologist-led. However, there was considerable heterogeneity within interventions, outcome measures, and timing of assessment precluding numeric synthesis. Methodological limitations including non-blinding, absence of stratification, and underpowered studies were also pervasive. Summary Providing psychological support early in the cancer pathway and prior to surgery has the potential to improve psychological health and outcomes. The application of existing knowledge in psycho-oncology, including distress screening, is needed in the prehabilitation setting. Consistent outcome assessments, accurate reporting of intervention components and delivery methods, and a consideration of effective systems and economical implementation strategies would facilitate advancements in this field. Supplementary Information The online version contains supplementary material available at 10.1007/s40140-021-00505-x.
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Affiliation(s)
- Chloe Grimmett
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Nicole Heneka
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia
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4
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Kamal M, Baudo M, Shmushkevich S, Geng Y, Hanna E, Goepfert RP, Lewis CM, Rahouma M. COVID-19 infection and its consequences among surgical oncology patients: A systematic analysis, meta-analysis and meta-regression. J Surg Oncol 2022; 125:813-823. [PMID: 35014703 PMCID: PMC9015254 DOI: 10.1002/jso.26787] [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: 12/22/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 12/15/2022]
Abstract
We conducted this meta‐analysis to address the outcomes in cancer patients after oncologic surgery during COVID‐19 pandemic. The primary endpoint was the COVID‐19–related mortality rate. Higher body mass index was significantly and negatively associated with higher all‐cause mortality and in‐hospital COVID‐19 infection rates. Male sex, preoperative respiratory disease, and smoking history were positively and significantly associated with increased all‐cause mortality rates. Furthermore, male sex was positively and significantly associated with the COVID‐19 infection rate.
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Affiliation(s)
- Mona Kamal
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Massimo Baudo
- Department of Cardiac Surgery, Spedali Civili di Brescia, Brescia, Italy
| | - Shon Shmushkevich
- Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Cardiothoracic Surgery, New York-Presbyterian Weill Cornell Medical Center, New York City, New York, USA
| | - Yimin Geng
- Division of Education & Training, Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ehab Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carol M Lewis
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mohamed Rahouma
- Department of Surgical Oncology, National Cancer Institute, Cairo University, Giza, Egypt
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5
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Queirós SMM, Pinto IES, de Brito MAC, Santos CSVDB. Nursing interventions for the promotion of tracheostomy self-care: A scoping review. J Clin Nurs 2021; 30:3055-3071. [PMID: 34101275 DOI: 10.1111/jocn.15823] [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: 02/17/2021] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To map nursing interventions, their characteristics, and outcomes, in promoting self-care of the person with a tracheostomy. BACKGROUND The development of competencies in self-care of a person with a tracheostomy is recognised as one of the most significant nursing intervention areas for the promotion of autonomy, prevention of complications and adaptation. Identifying nursing interventions for the promotion of self-care of the person with a tracheostomy enables enhanced clinical practice knowledge within different care contexts and the identification of gaps in the available evidence. DESIGN The Joanna Briggs Institute (JBI) methodology was used to perform this scoping review. METHOD A search was conducted on the CINAHL, Scopus, Web of Science, PubMed, JBI Database of Systematic Reviews and Implementation Reports, and Cochrane Database of Systematic Reviews. The search for grey literature included Portugal´s Open Access Scientific Repository, OpenGrey, and ProQuest Dissertations and Theses. Studies published in Portuguese, English, Spanish and French were included. The PRISMA-ScR checklist was used. RESULTS From a total of 4,224 identified articles, 31 were included in this review. Multiple nursing interventions were identified and grouped into four types of action: informing, managing, determining and attending. Although most interventions are implemented with the face-to-face method, there is a growing interest in using technologies for this purpose. The dose is the characteristic most poorly described in interventions. Various results were obtained; however, valid assessment tools were not always used. CONCLUSIONS Designing and testing intervention programmes for the promotion of self-care of the person with a tracheostomy is necessary, based on available and robust evidence to guide clinical practice. RELEVANCE TO CLINICAL PRACTICE This review allowed to systematise nursing interventions to promote self-care of the person with a tracheostomy. The use of combined interventions and methodologies is likely to be more effective in care delivery.
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Affiliation(s)
- Sílvia Maria Moreira Queirós
- Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal.,Hospital Epidemiology Center, Centro Hospitalar Universitário de S. João, Porto, Portugal
| | - Igor Emanuel Soares Pinto
- Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal.,Surgery Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Portugal.,Nursing School of Porto, Porto, Portugal
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6
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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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7
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van Sluis KE, Kornman AF, van der Molen L, van den Brekel MWM, Yaron G. Women's perspective on life after total laryngectomy: a qualitative study. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:188-199. [PMID: 31674722 PMCID: PMC7079180 DOI: 10.1111/1460-6984.12511] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 09/26/2019] [Accepted: 10/02/2019] [Indexed: 05/06/2023]
Abstract
BACKGROUND Physical and psychosocial challenges are common after total laryngectomy. The surgery leads to lifelong changes in communication, airway, swallowing and appearance. As we move towards health models driven by patient-centred care, understanding the differential impacts of surgical procedures on subgroups of patients can help improve our care models, patient education and support systems. This paper discusses the experiences of women following total laryngectomy. AIMS To gain an insight into the impact of total laryngectomy on women's daily life while identifying their specific rehabilitation needs. METHODS & PROCEDURES This paper is based on in-depth, semi-structured interviews with eight women who had undergone total laryngectomy. These interviews were conducted with women at least 1 year after they had undergone total laryngectomy, and the participants did not have recurrent disease. Using an interview guide, participants were encouraged to discuss their everyday experiences, while also focusing on issues typical to women. The transcribed interview data were analysed by thematic analysis, taking interpretative phenomenological analysis as a lead. OUTCOMES & RESULTS The interviews revealed three main themes: disease and treatment as a turning point, re-establishing meaningful everyday activities, and persistent vulnerability. Participants reported experiencing challenges in their rehabilitation process due to physical disabilities, dependency on others and experienced stigma. Women-specific challenges arose in dealing with the altered appearance and voice, performing care activities, and the spousal relationship (including intimacy). CONCLUSIONS & IMPLICATIONS Women who undergo total laryngectomy are likely to experience issues in returning to work, the performance of informal care-work, the spousal relationship, intimacy and social interaction due to stigmatization. Medical pretreatment counselling and multidisciplinary rehabilitation programmes should help patients form realistic expectations and prepare them for the changes they will face. A gender- and age-matched laryngectomized patient visitor can contribute to this process. Rehabilitation programmes should incorporate the partner and offer psychosocial support for women following total laryngectomy to return to their former roles in family life, social life and work-related activities.
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Affiliation(s)
- Klaske E. van Sluis
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
- Amsterdam Center for Language and CommunicationUniversity of AmsterdamAmsterdamthe Netherlands
| | - Anne F. Kornman
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
| | - Lisette van der Molen
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
| | - Michiel W. M. van den Brekel
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
- Amsterdam Center for Language and CommunicationUniversity of AmsterdamAmsterdamthe Netherlands
| | - Gili Yaron
- Department of Head and Neck Oncology and SurgeryNetherlands Cancer Institute‐Antoni van LeeuwenhoekAmsterdamthe Netherlands
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life SciencesMaastricht UniversityMaastrichtthe Netherlands
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8
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Carroll-Alfano MA. Education, counseling, support groups, and provider knowledge of total laryngectomy: The patient's perspective. JOURNAL OF COMMUNICATION DISORDERS 2019; 82:105938. [PMID: 31557689 DOI: 10.1016/j.jcomdis.2019.105938] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 06/19/2019] [Accepted: 09/06/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE Studies over a 40 year period have reported inadequate education and counseling for persons with laryngectomy; however, several long-term trends, including centralization of laryngectomy surgeries in major teaching hospitals, the rise of the internet, and the increased use of the tracheoesophageal prosthesis (TEP) for voice all have the potential to improve this situation. This study investigated if persons with total laryngectomy reported receiving adequate education and counseling before and after their laryngectomy, and how this varied by gender, geographic setting, communication method, and time. It also examined who participated in in-person and online support groups, and what health care providers and settings are perceived as most knowledgeable about laryngectomy. METHODS This research was a cross-sectional study, with 200 participants meeting the inclusion criteria. Results were analyzed via descriptive statistics, Pearson chi-square test, McNemar's test, Fisher's exact test, and one-way ANOVA with post-hoc analysis. RESULTS About half of persons with total laryngectomy reported receiving adequate education and counseling pre- and post-surgery, with men being more likely to report adequate education than women, and persons using a TEP for voice more likely to report adequate education than persons using alternate communication methods. Most participants (71%) participated in support groups, with women more likely to participate than men. Participants in rural areas were less likely to participate in in-person support groups than those from suburban or urban areas. Participants using a TEP as a communication method were more likely to participate in in-person support groups than those using other communication methods. Doctors, speech-language pathologists (SLPs), the internet, and support groups were highly rated sources of information. Among health-care providers, ENTs and SLPs were rated as the most knowledgeable, and primary-care physicians, dentists, and emergency medical technicians the least. CONCLUSIONS There continues to be a need for adequate education and counseling both before and after surgery. This education and counseling may need to continue for months or years post-surgery, due to the traumatic nature of the laryngectomy procedure. Doctors and SLPs can play a leading part in providing education and counseling, and with other health professions and in-person and online support groups also having a role to play. Frontline health care providers are perceived as having low knowledge of laryngectomy.
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Affiliation(s)
- Miriam A Carroll-Alfano
- Department of Communication Science and Disorders, Saint Xavier University, 3700 W 103rd St., Chicago, IL 60655, United States(1).
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9
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Graboyes EM, Kallogjeri D, Zerega J, Kukuljan S, Neal L, Rosenquist KM, Nussenbaum B. Association of a Perioperative Education Program With Unplanned Readmission Following Total Laryngectomy. JAMA Otolaryngol Head Neck Surg 2019; 143:1200-1206. [PMID: 28880984 DOI: 10.1001/jamaoto.2017.1460] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Evan M Graboyes
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Dorina Kallogjeri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Jan Zerega
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Sara Kukuljan
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Linda Neal
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Kelsey M Rosenquist
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Brian Nussenbaum
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
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10
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Petersen JF, Berlanga A, Stuiver MM, Hamming-Vrieze O, Hoebers F, Lambin P, van den Brekel MWM. Improving decision making in larynx cancer by developing a decision aid: A mixed methods approach. Laryngoscope 2019; 129:2733-2739. [PMID: 30663068 PMCID: PMC6899876 DOI: 10.1002/lary.27800] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/10/2018] [Accepted: 12/19/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Patients diagnosed with advanced larynx cancer face a decisional process in which they can choose between radiotherapy, chemoradiotherapy, or a total laryngectomy with adjuvant radiotherapy. Clinicians do not always agree on the best clinical treatment, making the decisional process for patients a complex problem. METHODS Guided by the International Patient Decision Aid (PDA) Standards, we followed three developmental phases for which we held semi-structured in-depth interviews with patients and physicians, thinking-out-loud sessions, and a study-specific questionnaire. Audio-recorded interviews were verbatim transcribed, thematically coded, and analyzed. Phase 1 consisted of an evaluation of the decisional needs and the regular counseling process; phase 2 tested the comprehensibility and usability of the PDA; and phase 3 beta tested the feasibility of the PDA. RESULTS Patients and doctors agreed on the need for development of a PDA. Major revisions were conducted after phase 1 to improve the readability and replace the majority of text with video animations. Patients and physicians considered the PDA to be a major improvement to the current counseling process. CONCLUSION This study describes the development of a comprehensible and easy-to-use online patient decision aid for advanced larynx cancer, which was found satisfactory by patients and physicians (available on www.treatmentchoice.info). The outcome of the interviews underscores the need for better patient counseling. The feasibility and satisfaction among newly diagnosed patients as well as doctors will need to be proven. To this end, we started a multicenter trial evaluating the PDA in clinical practice (ClinicalTrials.gov Identifier: NCT03292341). LEVEL OF EVIDENCE NA Laryngoscope, 129:2733-2739, 2019.
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Affiliation(s)
- Japke F Petersen
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Adriana Berlanga
- Department of Radiation Oncology (MAASTRO), Research Institute GROW, Maastricht University, Maastricht, The Netherlands
| | - Martijn M Stuiver
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Clinical Epidemiology Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands
| | - Olga Hamming-Vrieze
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Frank Hoebers
- Department of Radiation Oncology (MAASTRO), Research Institute GROW, Maastricht University, Maastricht, The Netherlands
| | - Philippe Lambin
- Department of Radiation Oncology (MAASTRO), Research Institute GROW, Maastricht University, Maastricht, The Netherlands
| | - Michiel W M van den Brekel
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands.,Institute of Phonetic Sciences, University of Amsterdam, Amsterdam, The Netherlands
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11
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Singer S, Vogel HJ, Guntinas-Lichius O, Erdmann-Reusch B, Fuchs M, Taylor K, Meyer A, Keszte J. Multicenter prospective study on the use and outcome of rehabilitation after total laryngectomy in Germany. Head Neck 2018; 41:1070-1079. [PMID: 30548728 DOI: 10.1002/hed.25540] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 08/07/2018] [Accepted: 10/06/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the use and outcome of rehabilitation after total laryngectomy in Germany. METHODS We enrolled patients who were scheduled for total laryngectomy, approached them again after surgery, after 3 months and 1 year. Patients completed questionnaires and were interviewed. RESULTS Of 309 participants, 14% had not received any rehabilitation. Reasons for nonuse were primarily ongoing treatment and poor health. Users of rehabilitation had 4 times the odds of attaining any ability to speak compared to nonusers (odds ratio 3.8, P = .02). The main aim of rehabilitation from the perspective of the users was speech rehabilitation, mentioned by 71% before starting rehabilitation. This was also what most users (27%) found the most helpful part of rehabilitation. CONCLUSIONS Patients are interested in attending rehabilitation. They especially want to improve their speech capacity, which indeed is better among users of rehabilitation than in those without.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany.,University Cancer Centre Mainz, Mainz, Germany
| | - Hans-Joachim Vogel
- Department of Otorhinolaryngology, Sana-Klinikum Remscheid, Remscheid, Germany
| | | | | | - Michael Fuchs
- Department of Otorhinolaryngology, Section of Phoniatrics and Audiology, University of Leipzig, Leipzig, Germany
| | - Katherine Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany.,University Cancer Centre Mainz, Mainz, Germany
| | | | - Judith Keszte
- Department of Medical Psychology and Medical Sociology, University Medical Centre Leipzig, Leipzig, Germany
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12
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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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13
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Liu JC. Commentary on Shenson et al, "Effect of Preoperative Counseling on Hospital Length of Stay and Readmissions after Total Laryngectomy". Otolaryngol Head Neck Surg 2017; 156:203-204. [PMID: 28145831 DOI: 10.1177/0194599816680357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jeffrey C Liu
- 1 Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
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14
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Shenson JA, Craig JN, Rohde SL. Effect of Preoperative Counseling on Hospital Length of Stay and Readmissions after Total Laryngectomy. Otolaryngol Head Neck Surg 2016; 156:289-298. [DOI: 10.1177/0194599816671695] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jared A. Shenson
- Department of Otolaryngology–Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Jennifer N. Craig
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sarah L. Rohde
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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