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The purpose of the study was to assess the quality of life of patients after surgical treatment for cancer of the larynx. Three groups of patients were identified according to surgical treatment: total laryngectomy, 111 patients; near-total laryngectomy, 38 patients; and partial laryngectomy, 23 patients. The impact of successful surgical treatment on their life roles was analyzed in terms of work, activities, familial and spousal relationships, sexuality, and psychologic features such as stress and anxiety. Two questionnaires were used; the Psychosocial Adjustment to Illness Scale (PAIS) and the Mayo Clinic Postlaryngectomy Questionnaire. With the PAIS questionnaire, no difference was found in role adjustment between the total laryngectomy and near-total laryngectomy groups, with one exception. In the work domain, the total laryngectomy patients who were working had better adjustment than the near-total laryngectomy patients. The overall adjustment of both groups was less favorable than that of a comparison group of patients with nonlaryngeal cancer. The patients who had the classic conservation operations adjusted in all domains more favorably than the patients with permanent tracheostomas. The partial operation patients adjusted better than the nonlaryngeal cancer patients. We conclude that the stoma has a negative impact on adjustment postoperatively and that it may have a more serious impact on life adjustment than voice alteration. Further investigation and standardization of measurement tools are needed.

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The vocational interests of 156 persons with spinal cord injury (SCI) were studied with the Strong Campbell Interest Inventory an average of 82 days after injury. Mean age of 134 male participants was 26.3 years; 22 females averaged 31.7 years. Participants' scores were compared to the norms for Menand Women-In-General on the inventory. Data were also subjected to rank order analysis. Males' responses showed them to be introverted and more interested in working with things than data or people. Although the smaller sample of females makes conclusions less certain, the females' responses were similar to the males'. Since the interests of these people were often incongruent with the physical limitations imposed by their disability, the findings suggest that counselors must apply extra ingenuity to assist in identifying vocational alternatives.Spinal cord injury (SCI) often results in severe disability with a broad impact on the physical, social, vocational, and psychological functioning of the affected person. Typically, both movement and sensation are lost below the level of the injury. A wheelchair is usually needed for ambulation, and even hand function is sometimes impaired; consequently, many occupations are precluded. An extended period of psychological adjustment may be required, since a different body image and many other changes must be integrated into a new lifestyle.Spinal cord injury occurs in roughly 50 people per million per year in the United States, producing about 11,000 new cases per year. The total SCI population in the United States is now approximately 150,000 (Young & Northrup, Note 1, pp. 2-3). The disability affects primarily young people, so the cost to society of maintenance and lost vocational productivity are very high. Consequently, in recent years there has been much interest in learning more about the This study was supported in part by research grants 16-P-56810 and 13-P-59130 from the