The Role of Employment Status in Changes in Quality of Life of Laryngectomized Patients Before Surgery and 3 Months after Discharge

Wednesday, 24 July 2013

Yuki Nagamatsu, RN, MSN
Department of Adult Health Nursing, Kurume University School of Nursing, Kurume, Japan
Kumiko Kotake, PhD, RN, MSN
Faculty of Health care and Nursing, Graduate school of Health Care and Nursing, Juntendo University, Urayasu, Japan
Kazuyo Iwanaga, RN, MS
School of Nursing, Fukuoka-University, Fukuoka, Japan
Yoshimi Suzukamo, PhD
Department of Physical Medicine and Rehabilitation, Tohoku University, Graduate School of Medicine, Sendai, Japan
Ichiro Kai, MD, MPH
Social GerontologySchool of Public Health, The University of Tokyo, Tokyo, Japan
Kaori Haba, RN, PHN, MSN
Faculty of Health and Nursing, Juntendo University, Urayasu, Japan
Aya Takahashi, RN, PHN, MSN
Faculty of Health SciencesCDepartment of Nursing, Saitama Prefectural University, Koshigaya, Japan
Rieko Kawamoto, PhD, RN
Depatment of health Sciences, Kyushu University, Fukuoka, Japan

Learning Objective 1: The Learner will be able to know the results of the employment status of laryngectomized patients between preoperative and 3 months after discharge.

Learning Objective 2: The Learner will be able to know the results of the change in QOL for the laryngectomized patients between preoperative and 3months after discharge.

Purpose:

We analyzed the role of employment status in changes in quality of life (QOL) of laryngectomized  patients before surgery and 3 months after discharge.

Methods:

Subjects were 174 patients undergoing a laryngectomy. We assessed basic demographics (age, employment status) and QOL by using the SF-36 v2. An ethics review committee approved the study. Unemployed subjects included individuals who retired before the surgery and those who retired because of the surgery. We used t tests for analysis.

Results:

Of the 174 subjects assessed before surgery, 91 were employed (52.3%), 76 were unemployed (43.7%), and 7 did not indicate employment (mean age: 64.7 ± 8.5 years). Of the 96 subjects assessed post-discharge, 35 were employed (36.5%), 54 were unemployed (56.3%), and 7 did not indicate employment (mean age: 64.5 ± 8.1 years). QOL was lower for both employed (PF (p = .0002), RP (p = .0001), SF (p = .0001), RE (p = .002)) and unemployed subjects after discharge (PF (p = .002), RP (p = .003), BP (p = .004), VT (p = .02), RE (p = .01)).

Conclusion:

QOL decreased for all subjects, regardless of employment status, 3 months after discharge. Pain did not decrease, and fatigue persisted, even after the hospital discharge among unemployed subjects, which might have prevented them from maintaining their social roles. Employed subjects demonstrated reduced social function after discharge, possibly because of experiencing difficulties at work. A support system to help maintain employment should be considered in the future. Given that the percentage of unemployed subjects after discharge was rather high and social function remained low, it is also important to consider a support system for unemployed patients.