Gastro-pharyngeal reflux and total laryngectomy. Increasing knowledge about its management

Mannelli, Giuditta; Santoro, Roberto; Segala, Francesco Vladimiro; Surrenti, E.; Gallo, Oreste

doi:10.1016/j.amjoto.2017.12.010

Cited by 4 publications

(1 citation statement)

References 52 publications

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“…The revised NOC includes questions related to mental health, which could help patients improve their mental well-being; it may also help nurses provide health guidance to improve psychosocial health. Moreover, patients may encounter issues such as disease recurrence, interruption of treatment information, and a lack of health care knowledge after surgical discharge [ 28 ]. Telephone follow-up according to the revised NOC repeatedly reinforces information that can positively affect knowledge acquisition and behavior compliance.…”

Section: Discussionmentioning

confidence: 99%

Nurse-led telephone follow-up according to the revised nursing outcomes classification for laryngeal carcinoma surgery patients: a randomized controlled trial

et al. 2022

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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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Section: Discussionmentioning

confidence: 99%

Nurse-led telephone follow-up according to the revised nursing outcomes classification for laryngeal carcinoma surgery patients: a randomized controlled trial

et al. 2022

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Implementation of Esophageal Screening in an Outpatient Hospital-Based Setting: A Quality Improvement Project

Gregor,

Watts

2023

Am J Speech Lang Pathol

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Purpose: Despite evidence supporting interconnectivity of oropharyngeal and esophageal swallowing, evaluation and treatment are dichotomized. When the videofluoroscopic swallowing study (VFSS) only considers oropharyngeal swallowing, the full scope of swallowing impairment may be missed. A lower rate of esophageal screening in an outpatient hospital setting may result from lack of speech-language pathologist (SLP) training and understanding of screening feasibility. This project was an internal quality improvement project (QIP) at Mayo Clinic in Arizona to (a) educate and train SLPs on conducting the Robust Esophageal Screening Test (REST) and (b) determine the feasibility of REST protocol implementation in a multidisciplinary swallow clinic. Method: Fishbone analysis was used to identify potential causes of the gap in quality. Six Sigma methodology was used to outline the QIP. SLPs were trained in the REST protocol. To ensure adequate training, reliability ratings were assessed with the Cohen's kappa statistic. Esophageal screening via REST was implemented as an adjunct to the standard protocol during VFSS over a 3-month period for referred patients with dysphagia. Clinical findings were recorded. Results: All clinical rater SLPs reached the threshold of κ = .8 to ensure adequate rater reliability. Among 136 outpatients who underwent esophageal screening via REST, 100 patients completed the full REST screening and 36 completed a partial REST screening. Of the 100 full screenings, 80 patients had a failed screening, which indicated a potential esophageal swallowing impairment. Findings were discussed by members of the multidisciplinary dysphagia care team. Conclusions: The results of this QIP show that focusing on assessment of dysfunction and interplay across the swallowing continuum can substantially improve patient care by expediting and specifying next steps of the multidisciplinary dysphagia care team.

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The Importance of Looking at the REST of the Swallow in Patients With Head and Neck Cancer

Gregor

2023

Perspect ASHA SIGs

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Purpose: The swallowing continuum is highly complex and interrelated and has both upstream and downstream implications for volitional swallowing behaviors, anatomic and physiologic impairments, and interventions. Pathologic reflux can cause a plethora of upstream anatomic and physiologic changes in the swallow with associated consequences. Although pathologic reflux can occur in isolation, there is a high incidence of both pathologic reflux and esophageal pathology in patients with head and neck cancer. Along with their known oropharyngeal dysfunction that can evolve over time posttreatment and cause downstream effects in the swallowing continuum, pathologic reflux and esophageal pathology can cause upstream effects, further complicating the interplay and contributing to the overall swallowing impairment. Conclusions: The entire swallowing continuum should be evaluated with videofluoroscopy at yearly intervals in patients with head and neck cancer so that the multidisciplinary dysphagia team understands the interplay, which informs best interventions. The Robust Esophageal Screening Test (REST) is a standardized, validated esophageal screening protocol that can be implemented during the videofluoroscopic swallowing study to better identify potential esophageal pathology, which can be of complex etiology in this population. Results of a recent quality improvement project implementing REST protocol with patients with head and neck cancer found significant esophageal pathology and enhanced team collaborations and decision making for optimal patient care (Gregor & Watts, 2022).

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Gastro-pharyngeal reflux and total laryngectomy. Increasing knowledge about its management

Cited by 4 publications

References 52 publications

Nurse-led telephone follow-up according to the revised nursing outcomes classification for laryngeal carcinoma surgery patients: a randomized controlled trial

Nurse-led telephone follow-up according to the revised nursing outcomes classification for laryngeal carcinoma surgery patients: a randomized controlled trial

Implementation of Esophageal Screening in an Outpatient Hospital-Based Setting: A Quality Improvement Project

The Importance of Looking at the REST of the Swallow in Patients With Head and Neck Cancer

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