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Ushimaru Y, Nagano S, Kawabata R, Nishikawa K, Takeoka T, Kitagawa A, Ohara N, Tomihara H, Maeda S, Imasato M, Noura S, Miyamoto A. Enhancing surgical outcomes in elderly gastric cancer patients: the role of comprehensive preoperative assessment and support. World J Surg Oncol 2024; 22:136. [PMID: 38778314 PMCID: PMC11112811 DOI: 10.1186/s12957-024-03421-6] [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: 03/27/2024] [Accepted: 05/21/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND As the prevalence of gastric cancer rises in aging populations, managing surgical risks and comorbidities in elderly patients presents a unique challenge. The Comprehensive Preoperative Assessment and Support (CPAS) program, through comprehensive preoperative assessments, aims to mitigate surgical stress and improve outcomes by enhancing patient awareness and preparation. This study investigates the efficacy of a CPAS program, incorporating frailty and sarcopenia evaluations, to improve short-term outcomes in elderly gastric cancer patients. METHODS A retrospective analysis was conducted on 127 patients aged 75 or older who underwent surgery with CPAS between 2018 and August 2023, compared to 170 historical controls from 2012 to 2017. Propensity score matching balanced both groups based on age-adjusted Charlson Comorbidity Index and surgical details. The primary focus was on the impact of CPAS elements such as rehabilitation, nutrition, psychological support, oral frailty, and social support on short-term surgical outcomes. RESULTS Among 83 matched pairs, the CPAS group, despite 40.4% of patients in the CPAS group and 21.2% in the control group had an ASA-PS score of 3 or higher (P < 0.001), demonstrated significantly reduced blood loss (100 ml vs. 190 ml, P = 0.026) and lower incidence of serious complications (19.3% vs. 33.7%, P = 0.034), especially in infections and respiratory issues. Sarcopenia was identified in 38.6% of CPAS patients who received tailored support. Additionally, the median postoperative hospital stay was notably shorter in the CPAS group (10 days vs. 15 days, P < 0.001), with no in-hospital deaths. These results suggest that personalized preoperative care effectively mitigates operative stress and postoperative complications. CONCLUSION Implementing CPAS significantly enhances surgical safety and reduces complication rates in elderly gastric cancer patients, emphasizing the critical role of personalized preoperative care in surgical oncology for this demographic.
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Affiliation(s)
- Yuki Ushimaru
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
- Department of Next Generation Endoscopic Intervention (Project ENGINE), Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shinnosuke Nagano
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
| | - Ryohei Kawabata
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan.
| | - Kazuhiro Nishikawa
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
| | - Tomohira Takeoka
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
| | - Akihiro Kitagawa
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
| | - Nobuyoshi Ohara
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
| | - Hideo Tomihara
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
| | - Sakae Maeda
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
| | - Mitsunobu Imasato
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
| | - Shingo Noura
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
| | - Atsushi Miyamoto
- Department of Gastroenterological Surgery, Sakai City Medical Center, 1-1-1 Ebaraji-Cho, Nishi-Ku, Sakai City, Osaka, 593-8304, Japan
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Bianco MR, Pricoco GO, Azzolina A, Drago GD, Saita V, Allegra E. Olfactory function in laryngectomised patients: tracheo-oesophageal versus oesophageal speech. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2023; 43:20-25. [PMID: 36860146 PMCID: PMC9978304 DOI: 10.14639/0392-100x-n2253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/23/2022] [Indexed: 03/03/2023]
Abstract
Objective This study aimed to evaluate olfactory function in patients rehabilitated with oesophageal (ES) voice or tracheo-oesophageal (TES) prosthesis to further verify whether there were differences in smell alterations depending on voice rehabilitation modality. Methods A total of 40 patients who had undergone total laryngectomy participated in the study. Speech rehabilitation was achieved through TES in 20 patients (Group A) or ES in 20 patients (Group B). Olfactory function was evaluated using the Sniffin' Sticks test. Results At olfactory evaluation, in Group A, 4/20 patients (20%) were anosmic, whereas 16/20 patients (80%) were hyposmic; in Group B, 11/20 patients (55%) were anosmic whereas 9/20 patients (45%) were hyposmic. A significant difference (p = 0.04) was found at global objective evaluation. Conclusions The study shows that the rehabilitation with TES contributes to maintaining a functioning, albeit limited, sense of smell.
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Affiliation(s)
- Maria Rita Bianco
- Otolaryngology, Department of Health Science, University of Catanzaro, Italy,Correspondence Maria Rita Bianco Otolaryngology-Head and Neck Surgery, Department of Health Sciences, University Magna Graecia of Catanzaro, viale Europa, 88100 Germaneto (CZ), Italy E-mail:
| | | | - Alfio Azzolina
- Otolaryngology Unit, Cannizzaro Hospital, Catania, Italy
| | | | - Vincenzo Saita
- Otolaryngology Unit, Cannizzaro Hospital, Catania, Italy
| | - Eugenia Allegra
- Otolaryngology, Department of Health Science, University of Catanzaro, Italy
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Scriney A, Russell A, Loughney L, Gallagher P, Boran L. The impact of prehabilitation interventions on affective and functional outcomes for young to midlife adult cancer patients: A systematic review. Psychooncology 2022; 31:2050-2062. [PMID: 36073575 PMCID: PMC10092088 DOI: 10.1002/pon.6029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Cancer remains one of the most enduring health crises of the modern world. Prehabilitation is a relatively new intervention aimed at preparing individuals for the stresses associated with treatment from diagnosis. Prehabilitation can include exercise, psychological and nutrition-based interventions. The present systematic review aimed to assess the efficacy of prehabilitation on affective and functional outcomes for young to midlife adult cancer patients (18-55 years). Outcomes of interest included prehabilitation programme composition, duration, mode of delivery and measures used to determine impact on affective and functional outcomes. METHODS The following databases were searched with controlled and free text vocabulary; Psychological Information database (PsychINFO), Culmunated Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE) and Public MEDLINE (PubMed). Abstract and full-text screening was conducted with a secondary reviewer and final texts were subject to risk of bias analysis. RESULTS Thirteen texts were included at full-text. These included data of 797 prehabilitation participants (mean age 53 years) and a large representation of female participants (71% average). Evidence was found for the efficacy of psychological prehabilitation for anxiety reduction. Prehabilitation did not significantly affect health related quality of life. Findings moderately supported the therapeutic validity of exercise prehabilitation for functional outcomes, both in terms of clinical and experimental improvement with respect to the quality of evidence. Variation between all prehabilitation types was observed. There was insufficient evidence to support the efficacy of psychological prehabilitation on stress, distress or depression. CONCLUSION Implications for future research are highlighted and then discussed with respect to this young to midlife age group.
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Li J, Jing X, Xue W, Yang Y, Ma S, Kou X, Wang Z. Effect of systemic rehabilitation nursing intervention on psychological status and postoperative recovery of laryngeal cancer patients in perioperative period. Minerva Med 2022; 113:1045-1046. [PMID: 32734745 DOI: 10.23736/s0026-4806.20.06847-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Jingjing Li
- Department of Otolaryngology, The Second Affiliated Hospital of Xi'an Jiaotong University (Xibei) Hospital, Xi'an, China
| | - Xiaohong Jing
- Department of Otolaryngology, The Second Affiliated Hospital of Xi'an Jiaotong University (Xibei) Hospital, Xi'an, China
| | - Wen Xue
- Department of Otolaryngology, The Second Affiliated Hospital of Xi'an Jiaotong University (Xibei) Hospital, Xi'an, China
| | - Yeye Yang
- Department of Otolaryngology, The Second Affiliated Hospital of Xi'an Jiaotong University (Xibei) Hospital, Xi'an, China
| | - Sijing Ma
- Department of Otolaryngology, The Second Affiliated Hospital of Xi'an Jiaotong University (Xibei) Hospital, Xi'an, China
| | - Xiaohui Kou
- Department of Otolaryngology, The Second Affiliated Hospital of Xi'an Jiaotong University (Xibei) Hospital, Xi'an, China
| | - Zhenghui Wang
- Department of Otolaryngology, The Second Affiliated Hospital of Xi'an Jiaotong University (Xibei) Hospital, Xi'an, China -
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LEARNS Model as Perioperative Education Strategy for Patients with Laryngeal Tumors. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3360966. [PMID: 36276849 PMCID: PMC9581709 DOI: 10.1155/2022/3360966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/17/2022] [Indexed: 11/05/2022]
Abstract
Objective To evaluate LEARNS model as a perioperative strategy for health education and nursing supervision of patients with laryngeal tumors. Methods LEARNS scheme based on the best practice guidelines was applied to patients in the observation group: (1) analyze the needs of patients (Listen_L); (2) establish therapeutic partnership (Establish_E); (3) adopt intentional intervention (Adopt_A); (4) reinforce health awareness (Reinforce_R); (5) implement feedback assessment of knowledge (Name_N); (6) strengthen self-management based on community resources (Strengthen_S). In the control group, traditional medical care instructions were provided to the patients by medical staff. Parameters such as anxiety status, treatment compliance, nursing satisfaction, self-care ability, and life quality were compared between the observation and control groups. Results Upon admission, there was no significant difference in self-care ability and anxiety level between two groups. However, the anxiety level of observation group was significantly lower than that of the control group 1 day before operation and 7 days after operation. Postoperative treatment compliance and nursing satisfaction were also improved in the observation group. In addition, self-care ability and life quality in the observation group were significantly enhanced as compared to the control group. Conclusion As a mutual learning process between nurses and patients, LEARNS model motivates nurses to assess the needs of patients voluntarily. Furthermore, evidence-based education reinforces the self-care ability and health awareness of the patients. Our data suggests that LEARNS model is of great value in improving the life quality of the patients with laryngeal tumors and nursing satisfaction.
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D'Alatri L, Longobardi Y, Parrilla C, Crudo F, Oliveto G, Mari G, Marchese MR, Passali GC, Ausili Cefaro C, Paludetti G, Galli J. Long-term voice outcomes and quality of life after open partial horizontal laryngectomy type II vs. total laryngectomy: A cross-sectional study. Clin Otolaryngol 2022; 47:464-470. [PMID: 35231162 DOI: 10.1111/coa.13924] [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: 09/10/2021] [Revised: 11/09/2021] [Accepted: 02/20/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We aim to analyse long-term voice outcomes and quality of life (QoL) in patients undergoing open partial horizontal laryngectomy type II (OPHL type II) and to compare them to those obtained by patients undergoing total laryngectomy (TL) with voice prosthesis (VP). DESIGN Cross-sectional cohort study. SETTING Patients undergoing surgery for advanced laryngeal cancer, assessed during the usual follow-up consultations at the Phoniatric Unit (February 2020-December 2020). PARTICIPANTS Forty-five patients were enrolled and divided into two groups: OPHL group and TL group. MAIN OUTCOMES MEASURES Acoustic analysis, maximum phonation time, INFV0 scale, I-SECEL, UW-QoL-V4 and MDADI questionnaires were used to assess the long-term outcomes. RESULTS Voices of patients undergoing OPHL Type II were worse than those of laryngectomised patients with VP. Nevertheless, scores in voice and dysphagia-related QoL were comparable and scores in the social domain of QoL were higher in OPHL group. CONCLUSIONS Open partial horizontal laryngectomy Type II allows an acceptable voice recovery and a satisfactory QoL.
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Affiliation(s)
- Lucia D'Alatri
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Ylenia Longobardi
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Claudio Parrilla
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Fabrizio Crudo
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma, Italy
| | - Giuseppe Oliveto
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma, Italy
| | - Giorgia Mari
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Maria Raffaella Marchese
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giulio Cesare Passali
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Carolina Ausili Cefaro
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Gaetano Paludetti
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Jacopo Galli
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma - Università Cattolica del Sacro Cuore, Roma, Italy
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Wu F, Wei P, Wang G, Wu C, Hu Y, Hu J. Roles of preoperative anxiety and depression in the outcomes of microvascular decompression in hemifacial spasm for adolescent patients. Medicine (Baltimore) 2021; 100:e26831. [PMID: 34397888 PMCID: PMC8360617 DOI: 10.1097/md.0000000000026831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/16/2021] [Indexed: 01/04/2023] Open
Abstract
Hemifacial spasm (HFS) has been recognized as the frequently occurring disease of cranial nerve. At the same time, several articles indicate that, dystonia results in certain psychological disorders. Consequently, this study aimed to examine the association of preoperative depression and anxiety with HFS severity; meanwhile, the role in microvascular decompression (MVD) outcomes after surgery among adolescent patients was also examined.All cases had been classified as two groups based on MVD outcomes among HFS cases; in addition, the preoperative Hamilton anxiety rating scale (HARS) and the Hamilton depression rating scale (HDRS) scores were compared between patients not and still suffering from spasm. Moreover, the multiple logistic regression model was employed in assessing the relationship between preoperative HARS as well as HDRS scores and outcomes of adolescent cases undergoing MVD.The preoperative HARS and HDRS scores showed positive correlation with Cohen spasm grades in HFS patients. Meanwhile, compared with spasm-free group, patients of persistent spams group had apparently higher preoperative HARS and HDRS scores.Our results suggest that, preoperative anxiety and depression status show close association with HFS severity, and they could also impact the MVD outcomes for adolescent cases.
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Ezratty C, Kessel E, Kim MK, Lin JJ. Cancer Beliefs Associated with Posttraumatic Stress Disorder in Neuroendocrine Tumor Survivors. J Gastrointest Cancer 2021; 52:369-373. [PMID: 33507439 DOI: 10.1007/s12029-021-00592-3] [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] [Accepted: 01/21/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Earlier detection and improved treatment of neuroendocrine tumors (NETs) have prolonged survivorship in NET patients. We undertook this study to understand the prevalence of NET-related posttraumatic stress disorder (PTSD) and the factors and cancer-related illness beliefs associated with PTSD. METHODS We recruited patients with a diagnosis of NET from a large NET center in New York City. Cancer-related PTSD was assessed using the Revised Impact of Events scale (IES), with probable PTSD as ≥ 33. We used the Brief Illness Perception Questionnaire (BIPQ) to assess NET-related beliefs. Data on baseline patient characteristics were collected. Comparisons used chi-squares and Fisher exact tests, as appropriate. RESULTS Of the 73 participants, 48 (66%) were female and the mean age was 60 years (standard deviation (SD) 11.7, see Table 1). Twelve patients (16%) met criteria for probable NET-related PTSD. Women were more likely to meet criteria for probable PTSD (15% vs. 1%, p = 0.04). Those who met criteria for probable PTSD were more likely to have higher overall scores on the BIPQ (64 vs. 57, p = 0.03), report constantly feeling unwell due to their cancer (4 vs. 1, p = 0.04), as well as report more physical and emotional symptoms from their cancer (5 vs. 1, p = 0.03, and 7 vs. 4, p = 0.02, respectively). CONCLUSION NET patients with probable PTSD were more likely to be women with greater physical and emotional burden due to their cancer. Our findings suggest that specific threatening cancer-related beliefs, not disease characteristics, predict a higher risk of PTSD among NET survivors.
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Affiliation(s)
- Charlotte Ezratty
- Department of General Internal Medicine, Icahn School of Medicine At Mount Sinai, New York, NY, 10029, USA.
| | - Elizabeth Kessel
- Department of Gastroenterology, Icahn School of Medicine At Mount Sinai, New York, NY, 10029, USA
| | - Michelle Kang Kim
- Department of Gastroenterology, Icahn School of Medicine At Mount Sinai, New York, NY, 10029, USA
| | - Jenny J Lin
- Department of General Internal Medicine, Icahn School of Medicine At Mount Sinai, New York, NY, 10029, USA
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Zhang S, Chen H, Zhang M, Sun X, Liu X. Reduction of depression symptoms in laryngeal cancer patients receiving psychology services. Am J Transl Res 2020; 12:6637-6645. [PMID: 33194060 PMCID: PMC7653580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
Depression is prevalence in patients with laryngeal cancer. In this study, we aim to investigate whether psychological intervention could reduce the depression of patients receiving cancer treatment. In this study, 258 patients with laryngeal cancer were assigned into two groups with or without psychological intervention. The depression symptoms of all patients were assessed using Hamilton depression rating scale (HAMD) and Hamilton anxiety rating scale (HAMA). Europe Organization for research and Treatment of cancer Quality of life Questionnaire (EORTC QLQ-C30) was used to measure the life quality of the participants. Other measurements including general attitudes towards psychology services, hospitalization duration and expenses were analyzed. We found that patients with intervention showed more positive attitudes towards psychology services compared to those in control group. Hospitalization duration and expenses were significantly less in intervention group compared to control group. In addition, the intervention group showed a significantly lower HAMD and HAMA scores and improved life quality than control group. Patients aged lower than 40 years showed more obvious reductions in HAMD and HAMA scores and better life quality compared to older patients. In conclusion, our study demonstrated that psychological intervention was necessary and effective in patients with laryngeal cancer during treatment.
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Affiliation(s)
- Shanshan Zhang
- Department of Otorhinolaryngology, Weifang People's Hospital No. 151 Guangwen Street, Kuiwen District, Weifang 261041, Shandong, China
| | - Haina Chen
- Department of Otorhinolaryngology, Weifang People's Hospital No. 151 Guangwen Street, Kuiwen District, Weifang 261041, Shandong, China
| | - Min Zhang
- Department of Otorhinolaryngology, Weifang People's Hospital No. 151 Guangwen Street, Kuiwen District, Weifang 261041, Shandong, China
| | - Xiaoyan Sun
- Department of Otorhinolaryngology, Weifang People's Hospital No. 151 Guangwen Street, Kuiwen District, Weifang 261041, Shandong, China
| | - Xiaoying Liu
- Department of Otorhinolaryngology, Weifang People's Hospital No. 151 Guangwen Street, Kuiwen District, Weifang 261041, Shandong, China
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Pribuisis K, Pribuisiene R, Liutkevicius V, Padervinskis E, Uloza V. Investigation of Relationship Between Auditory-Perceptual Methods and Self-reported Speech Handicap Index in the Assessment of Substitution Voicing. J Voice 2020; 36:435.e23-435.e31. [PMID: 32665116 DOI: 10.1016/j.jvoice.2020.06.011] [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: 02/09/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess correlations between auditory-perceptual and self-reported speech evaluation methods for substitution voicing (SV) and to investigate the robustness of these methods in a clinical setting. METHODS Fifty-nine male patients who underwent laryngeal oncosurgery and 62 healthy male controls were included in this prospective study. Lithuanian versions of the Speech Handicap Index (SHI-LT) and Impression of voice quality (I), Impression of intelligibility (I), Unintended additive Noise (N), Fluency (F), and Quality of Voicing (Vo) scale (IINFVo-LT) were used to assess and compare self-reported and auditory-perceptual evaluations of SV. Speech samples were rated by a panel of experienced raters. RESULTS The IINFVo-LT revealed good inter-rater reliability (ICC = 0.825) and intrarater reliability over time (ICC = 0.976) when assessing SV. Statistically significant differences (P < 0.05) of the mean scores of IINFVo-LT among the cordectomy, partial laryngectomy (22.52 [SD 9.98]), tracheoesophageal prosthesis (16.92 [SD 10.71]), and control (48.01 [SD 2.88]) groups confirmed the usefulness of IINFVo-LT for SV rating. A moderate negative correlation (r = -0.61; P < 0.001) demonstrated good concurrent validity between the IINFVo-LT and the SHI-LT total scores. A statistically significant, strong, negative correlation (r = -0.74) was obtained between the IINFVo-LT and SHI-LT speech handicap grade (P < 0.001), demonstrating good concurrent validity. CONCLUSION The combination of IINFVo-LT and SHI-LT represents a potentially valuable and robust tool for evaluating SV and is helpful for assessing the degree of speech abnormality after laryngeal oncosurgery and its impact on patients' quality of life.
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Affiliation(s)
- Kipras Pribuisis
- Department of Otolaryngology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Ruta Pribuisiene
- Department of Otolaryngology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vykintas Liutkevicius
- Department of Otolaryngology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Evaldas Padervinskis
- Department of Otolaryngology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Virgilijus Uloza
- Department of Otolaryngology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Allegra E, La Mantia I, Bianco MR, Drago GD, Le Fosse MC, Azzolina A, Grillo C, Saita V. Verbal performance of total laryngectomized patients rehabilitated with esophageal speech and tracheoesophageal speech: impacts on patient quality of life. Psychol Res Behav Manag 2019; 12:675-681. [PMID: 31616193 PMCID: PMC6699587 DOI: 10.2147/prbm.s212793] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/18/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction Total laryngectomy has important psychophysical and social consequences for patients’ quality of life because of the functional changes resulting from the removal of the larynx. Voice deprivation is perhaps the most relevant limiting factor in social relationships, increasing feelings of solitude and tending to drive individuals into social isolation. Multiple voice rehabilitation methods after total laryngectomy are available. This study aimed to determine the acoustic quality of the rehabilitated voice achieved with esophageal speech (ES) and tracheoesophageal speech (TES), and acoustic quality impacts on patients’ perceptions of their quality of life. Materials and methods The patient inclusion criterion was the completion of a speech rehabilitation course with ES or TES at least 6 months after total laryngectomy. The voice acoustic analysis was carried out automatically by using the Multidimensional Voice Program. The following parameters were extracted: fundamental frequency (F0), Jitter% (Jitt), Shimmer% (Shim), and noise-to-harmonic ratio (NHR). Subjective voice evaluation was performed by using the following questionnaires: Voice Handicap Index (VHI), Voice-related Quality of Life (V-RQOL), and Voice Performance Questionnaire (VPQ). Results The acoustic analysis showed a difference between ES and TES patients on all acoustic parameters; this difference was significant for F0 (133.09±2.4 and 119±3.3, respectively; p<0.001), NHR (0.43±0.21 and 0.31±0.14, respectively; p=0.02), and maximum phonation time (2.02±038 s and 10.64±0.28 s, respectively; p=0.01. Regarding patient-related outcomes, TES correlated with better total scores compared with ES; however, the differences in the total scores on the VHI (p=0.09), V-RQOL (p=0.39), and VPQ (p=0.52) were not statistically significant. Conclusion The rehabilitation of laryngectomized patients must be addressed by a multidisciplinary team that considers the personalities, personal needs, and relational conditions of individual patients in order to determine and apply the phonatory rehabilitation method most suitable for achieving a better quality of life.
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Affiliation(s)
- Eugenia Allegra
- Otolaryngology, Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Ignazio La Mantia
- Otolaryngology, "G.F Ingrassia" Department, University of Catania, Catania, Italy
| | - Maria Rita Bianco
- Otolaryngology, Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | | | | | - Alfio Azzolina
- Otolaryngology Unit, Cannizzaro Hospital, University of Catania, Catania, Italy
| | - Calogero Grillo
- Otolaryngology, "G.F Ingrassia" Department, University of Catania, Catania, Italy
| | - Vincenzo Saita
- Otolaryngology Unit, Cannizzaro Hospital, University of Catania, Catania, Italy
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Effects of Depression and Anxiety on Microvascular Decompression Outcome for Trigeminal Neuralgia Patients. World Neurosurg 2019; 128:e556-e561. [DOI: 10.1016/j.wneu.2019.04.194] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 01/09/2023]
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13
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Korman MB, Hejri-Rad Y, Goldberg L, Leano A, Ellis J. Oncology nursing role in cancer-related PTSD-Part II. Can Oncol Nurs J 2019; 29:147-150. [PMID: 31148743 PMCID: PMC6516342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
Cancer-related posttraumatic stress disorder (CR-PTSD) is relatively newly defined, lacks clinician awareness and, therefore, often goes undiagnosed. Untreated CR-PTSD can be debilitating; negatively impacting all aspects of a patient's life throughout diagnosis, treatment, and into survivorship. Oncology nurses' frontline role, which includes caring for both patients' physical and psychosocial needs, and commonly forming a trusting relationship with patients, makes them ideal candidates for providing emotional support and assessing patients for risk or symptoms of CR-PTSD. In addition to a brief summary on the current nursing role in assessing and treating mental health disorders such as CR-PTSD, this article provides recommendations for how nurses can identify vulnerable patients, assess these patients for CR-PTSD and provide psychosocial support to those in need, as well as how hospitals can better equip oncology nurses to do so through training, education and supportive resources.
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Affiliation(s)
- Melissa B Korman
- Clinical Research Coordinator, Sunnybrook Health Sciences Centre
| | - Yasmine Hejri-Rad
- York University; Research Volunteer, Sunnybrook Health Sciences Centre
| | - Lauren Goldberg
- University of Toronto; Research Assistant, Sunnybrook Health Sciences Centre
| | - Alyssa Leano
- Research Assistant, Sunnybrook Health Sciences Centre
| | - Janet Ellis
- Psychiatrist, Sunnybrook Health Sciences Centre
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Leano A, Korman MB, Goldberg L, Ellis J. Are we missing PTSD in our patients with cancer? Part I. Can Oncol Nurs J 2019; 29:141-146. [PMID: 31148714 PMCID: PMC6516338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
Posttraumatic Stress Disorder (PTSD) can be defined by the inability to recover from a traumatic event. A common misconception is that PTSD can only develop in circumstances of war or acute physical trauma. However, the diagnostic criteria of PTSD were adjusted in the Diagnostic Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) to include the diagnosis and treatment of a life-threatening illness, such as cancer, as a traumatic stressor that can result in PTSD. The word 'cancer' is so strongly linked to fear, stigma, and mortality, that some patients are fearful to even say 'the C word'. Therefore, it is not surprising that patients may experience a diagnosis of cancer as sudden, catastrophic, and/or life-threatening. Cancer-related PTSD (CR-PTSD) can negatively affect a patient's psychosocial and physical well-being during treatment and into survivorship. Unfortunately, CR-PTSD often goes undiagnosed and, consequentially, untreated. This article provides a general overview of PTSD with cancer as the traumatic event in order to define CR-PTSD, and reviews the growing pool of literature on this topic, including prevalence, risk factors, characterization, and treatment of CR-PTSD. The purpose of this article is to spread awareness of this relatively newly defined and commonly missed disorder among patients with cancer to clinicians and patients alike.
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Affiliation(s)
- Alyssa Leano
- Research Assistant, Sunnybrook Health Sciences Centre
| | - Melissa B Korman
- Clinical Research Coordinator, Sunnybrook Health Sciences Centre
| | - Lauren Goldberg
- University of Toronto; Research Assistant, Sunnybrook Health Sciences Centre
| | - Janet Ellis
- Psychiatrist, Sunnybrook Health Sciences Centre
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