Psychosocial adjustment in patients surgically treated for laryngeal cancer

Abstract

OBJECTIVE:To assess the psychosocial adjustment in 62 patients surgically treated for cancer of the head and neck. STUDY DESIGN AND SETTING: Forty-one patients were grouped as having had radical surgery (total laryngectomy) and 21 as having had functional surgery (horizontal supraglottic laryngectomy or partial vertical surgery). The Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) was used for the evaluation. RESULTS: No significant differences were found between groups when global adjustment or domain adjustment was compared. Patients did not consider the permanent stoma and voice loss to be the most important determinant of quality of life. Work and family relationship were the domains with poorest adjustment. CONCLUSION: Social and medical support are important factors in improving patients' self-confidence and satisfaction, playing an important role in recovering useful phonation, psychological adjustment, and global quality of life. SIGNIFICANCE: Information collected in this way may facilitate improved rehabilitation and thus better quality of life. (Otolaryngol Head Neck Surg 2003;129:92-7.) Little is known about the adaptation of patients after treatment and how the presence of sequelae impacts the different aspects of a patient's personal and family life. Although the concept of quality of life is easily understood, its definition and evaluation tools are not familiar outside the behavioral science area. Most studies consider survival and disease control as the end points of their clinical trials, without analyzing the patient's opinion regarding morbidity and whether posttreatment expectations were achieved.Evaluation of quality of life in cancer of the head and neck is especially important because the treatment sequelae impact directly on basic daily functions like breathing, swallowing, speaking, and even on external appearance. Quality of life studies can give us a better idea and understanding of what patients consider to be their problems and priorities after treatment.The purpose of this study was to evaluate the impact of surgical sequelae treatment of cancer of the larynx on the psychosocial adjustment of patients and identify those factors the patients consider most important in the adjustment process. PATIENTS AND METHODSPatients were treated for laryngeal cancer at the Department of Otorhinolaryngology of the Dr Peset University Hospital, Valencia, Spain. Data were collected through mail questionnaires answered by 62 patients who had undergone surgery for laryngeal or hypopharyngeal cancer All patients were followed for more than 36 months. Appropriate consent was obtained from patients who were informed of the aim of the study and assured of the confidentiality of data and voluntary character of the study. Instructions were given to answer questions with reference to the 4 weeks before completion of the questionnaire.The mean age was 63.8 years (range, 41 to 85); 99% (61/62) were male; 87% were married, 2% were divorced, 5% were single, and 6% were widowed. Seventy-one pe...

Long-term workforce participation patterns following head and neck cancer

“…Cancer site and employment status have both been found to influence the likelihood of ceasing to work following HNC [11,7]. While being older has been identified previously as having an impact on workforce participation [6], this was not seen in this study.…”

“…Demographic, clinical and social factors have all been found to influence an individual's likelihood of returning to work following cancer, in both the short and long term [6,7,11,12,5]. In a model of cancer and work based on the literature, Feuerstein and colleagues identify seven factors which influence an individual's return to work, work ability, work performance and workplace retention [13].…”

Gender differences in health‐related quality of life following total laryngectomy

“…There is evidence that patient‐reported QOL changes over time (Jones et al 1992, Murphy et al 2007), and that for total laryngectomy, although there are early post‐operative issues reported for voice, in the long‐term patients report that their general health is the same or better compared with the year before the diagnosis of cancer (Deleyiannis et al 1999). More recent studies indicate that social support is a more important determinant of quality of life and psychological adjustment than the physical sequelae of total laryngectomy (Ramirez et al 2003). Other studies suggest that although in the long‐term voice is no longer such a major issue, due to the advances in surgical voice restoration (Singer and Haymaker 1998), QOL is reported to be lower (De Santo et al 1995, Palmer and Graham 2004).…”

Evaluation Of Psychological Training's Influence On Psychosocial Adaptation Of Patients Who Had Myocardial Infarktus

“…[37] Larenks kanseri olan hastalarla yapılan bir çalışmada total larenjektomi yapılan hastaların PAIS-SR toplam puan ortalaması 54.93 ve total larenjektomi yapılma-yan hastalara göre daha yüksek bulunmuş, bunun total larenjektomi yapılan hastaların geri dönüşsüz olarak yaşadığı fonksiyon kaybı ile ilişkili olduğu ve en çok aile ve mesleki çevre alanlarının etkilendiği saptanmıştır. [38] Retina pigmentasyonuna bağlı görme kaybı yaşayan hastaların psikososyal uyumların incelendiği bir çalışmada PAIS-SR toplam puan ortalamasının 58±8 olduğu ve en çok sağlık bakımına uyum, mesleki çevre, sosyal çevre ve geniş aile ilişkilerinin etkilendiği belirlenmiştir. [39] Durna ve Akın'ın (2006) kalp yetmezliği hastalarında yaptığı çalışmada toplam PAIS-SR puanı ortalamasının 52.28±19.73 olduğu ve en çok etkilenen alanların; mesleki çevre, sosyal çevre ve psikolojik distres alanları olduğu belirlenmiştir.…”