Pre-operative counselling for laryngectomy patients: a systematic review

Fitzgerald, Éilís; Perry, Alison

doi:10.1017/s0022215115002984

Cited by 17 publications

(27 citation statements)

References 30 publications

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“…Perhaps not surprisingly, a recent review on preoperative counseling for TL patients demonstrated that the majority of patients and their spouses considered the current preoperative counseling inadequate. Up to 20% of patients were unaware that loss of normal voice would occur, and up to 41% noted that they had not received any counseling at all . Although this might have been forgotten by the patients because patients from our study also indicated that they often did not remember information received during counseling, the implications for improvements are clear.…”

Section: Discussionmentioning

confidence: 80%

Improving decision making in larynx cancer by developing a decision aid: A mixed methods approach

et al. 2019

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ObjectivePatients 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.MethodsGuided 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.ResultsPatients 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.ConclusionThis 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 http://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 (http://ClinicalTrials.gov Identifier: NCT03292341).Level of EvidenceNA Laryngoscope, 129:2733–2739, 2019

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Section: Discussionmentioning

confidence: 80%

Improving decision making in larynx cancer by developing a decision aid: A mixed methods approach

et al. 2019

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“…, Raol et al . , Fitzgerald and Perry ). However, we recommend that the information given also includes expected everyday issues after the procedure, specifically as experienced from a patients’ point of view.…”

Section: Discussionmentioning

confidence: 98%

“…, Watson ). Peer support provided by a laryngectomized patient visitor can play an important role in both information giving and counselling before surgery (Fitzgerald and Perry , Raol et al . , van der Molen et al .…”

Section: Discussionmentioning

confidence: 99%

“…Peer support is highly satisfying for people with cancer (Hoey et al 2008, Watson 2017. Peer support provided by a laryngectomized patient visitor can play an important role in both information giving and counselling before surgery (Fitzgerald and Perry 2016, Raol et al 2017, van der Molen et al 2013. Indeed, all eight participants of this study remembered the preoperative meeting with a laryngectomized patient visitor vividly.…”

Section: Discussionmentioning

confidence: 99%

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Women's perspective on life after total laryngectomy: a qualitative study

Sluis

Kornman

Molen

et al. 2019

Intl J Lang & Comm Disor

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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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“…Although total laryngectomy is a well‐established surgical procedure, conducted since 1873, and efforts to reduce its debilitating impact have long been in place, relatively little is known about the effects of different rehabilitation programs on vocal, vocational, and psychological outcomes . There is some literature reporting on the frequency of different outcomes, but how these outcomes were achieved is rarely reported, apart from the voice technique used .…”

Section: Introductionmentioning

confidence: 99%

Multicenter prospective study on the use and outcome of rehabilitation after total laryngectomy in Germany

et al. 2018

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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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Pre-operative counselling for laryngectomy patients: a systematic review

Cited by 17 publications

References 30 publications

Improving decision making in larynx cancer by developing a decision aid: A mixed methods approach

Improving decision making in larynx cancer by developing a decision aid: A mixed methods approach

Women's perspective on life after total laryngectomy: a qualitative study

Multicenter prospective study on the use and outcome of rehabilitation after total laryngectomy in Germany

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