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Learning Objective 1: The learner will be able to ascertain the relationship between conversation method and QOL in laryngectomized patients at different times post-hospital discharge
Learning Objective 2: The learner will be able to ascertain the relationship between conversation method and QOL in laryngectomized patients
Ascertaining the relationships among time elapsed since hospital discharge, conversation method, and quality of life (QOL) in laryngectomized patients
Methods:
Overall, 174 patients who underwent laryngectomy at four Japanese hospitals consented to participate. Of these, those who responded to surveys at three, six, and twelve months post-discharge were considered subjects. The surveys addressed age, gender, conversation methods, and QOL. The SF-36v2(NBSpoint), sent by post, evaluated QOL. Descriptive statistics of basic attributes and QOL scores were calculated. Conversation methods were classified into “alternative voice” and “non-voice.” A t-test evaluated the relationships among number of months since hospital discharge, conversation method, and QOL (p < 0.05). This study was approved by the ethics committee of our institution.
Results:
The patients’ (152 males; 22 females) mean age at laryngectomy was 64.7 years (range: 39–82 years). The alternative voice group had 32, 38, and 29 patients, respectively, at three, six, and twelve months post-discharge. The non-voice group had 59, 41, and 22 patients at the same stages. QOL scores on the standardized role-physical subscale (RP_N) were low for both groups at three months post-discharge. No relationship was found among time elapsed since discharge, conversation method, and QOL.
Conclusion:
The proportion of patients using voice communication increased with the time elapsed since discharge. Recovery from the invasive procedure probably affected voice acquisition. However, many patients still used non-voice communication probably because of the small number of esophagotracheal fistula surgeries performed in Japan and the difficulty in acquiring esophageal speech. No relationship was found between conversation method and QOL, indicating that QOL was affected by other factors.