Author/Editor     Boltežar, Gašper; Pavlovec, Fedja; Hočevar-Boltežar, Irena; Fischinger, Janez
Title     Vpliv načina sporazumevanja na kakovost življenja pri bolnikih po odstranitvi grla
Translated title     The impact of communication mode on quality of life in laryngectomees
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 76, št. 6
Publication year     2007
Volume     str. 389-95
Language     slo
Abstract     Laryngectomy is the most successful mode of treating an advanced laryngeal and hypopharyngeal cancer: It results in the loss of ability of speech communication. In Slovenia the two most common ways of voice rehabilitation after laryngectomy are esophageal speech (ESA and tracheoesophageal speech (TES). The aim of the study was to compare the influence of these two communication modes on patients' quality of life and to determine the factors influencing the choice of communication mode after laryngectomy. There were 22 patients communicating with TES and 3 Z communicating with ES included in the study. A standardized questionnaire about quality of life (Voice-Related Quality of Life) was used to compare both groups. The patients also assessed their new way of communication on visual analogue scale, and how it affects their lives in general. The data on patients' characteristics, their place of living, mode of treatment, treatment complications, and possible swallowing problems were obtained from the medical documentation. The two groups did not differ with regard to the factors possibly influencing the choice of communication mode. The results of the questionnaire did not show any significant differences between the patients with ES and the patients with TES. The patients with TES stated significantly smaller deterioration of the quality of their lives after laryngectomy than the patients with ES. The patients with TES had fewer problems with the communication in the noise and with social life than the patients with ES but the differences were not significant. The best way of speech rehabilitation after laryngectomy would be the insertion of tracheoesophageal prosthesis and simultaneous teaching of ES. Thus the patient gets the possibility for verbal communication soon after the operation and also learns the mode of communication without any devices. Both modes of speech rehabilitation enable good quality of life after laryngectomy.
Summary     Odstranitev grla je najuspešnejši način zdravljenja napredovanega raka grla in spodnjega žrela, vender pri tem bolnik izgubi možnost govornega sporazumevanja. V Sloveniji sta najpogostejša načina govorne rehabilitacije po odstranitvi grla priučitev ezofagealnega govora (EG) ali traheoezofagealnega govora (TEG). Namen raziskave je bil primerjati vpliv teh dveh načinov sporazumevanja na bolnikovo kakovost življenja ter ugotoviti dejavnike, ki odločajo o izbiri načina sporazumevanja. V raziskavi je sodelovalo 22 bolnikov, ki so se sporazumevali s TEG, ter 31 bolnikov z dobrim EG. Za primerjavo načina sporazumevanja obeh skupin je služil standardizirani vprašalnik o kakovosti življenja (Voice-Related Quality of Life), bolniki pa so tudi ocenili svoj novi način sporazumevanja na vizualni analogni lestvici in njegov vpliv na svoje življenje. Podatke o značilnostih bolnikov in kraju njihovega stalnega bivališča, .svoje zdravljenje, zapletih med zdravljenjem ter težavah pri požiranju po zdravljenju smo povzeli iz medicinske dokumentacije. Glede na rezultate vprašalnika ter glede dejavnikov, ki bi lahko vplivali na izbiro načina govornega sporazumevanja, se skupini med seboj nista značilno razlikovali. Pri oceni vpliva govora na kakovost življenja so bolniki s TEG navedli značilno manjše poslabšanje kakovosti življenja po odstranitvi grla kot bolniki z EG (p = 0,029). Bolniki s TEG .so imeli tudi manj težav pri sporazumevanju v hrupu in zahajanju v družbo kot bolniki z EG, vendar razlika ni bile statistično značilna. Za govorno rehabilitacijo bolnikov po odstranitvi grla bi bila najboljša vstavitev traheoezofagealne proteze in hkratno učenje EG. Tako bolnik hitro spet pridobi možnost govor nega sporazumevanja, hkrati pa se lahko nauči tudi načina sporazumevanja, za katerega ne potrebuje nobenih pripomočkov. Oba načina sporazumevanja omogočata dobro kakovost življenja bolnikom po odstranitvi grla.
Descriptors     LARYNGEAL NEOPLASMS
LARYNGECTOMY
SPEECH, ESOPHAGEAL
VOICE QUALITY
QUALITY OF LIFE