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[喉切除术后的感知污名化]

[Perceived stigmatisation following laryngectomy].

作者信息

Singer Susanne, Danker Helge, Bloching Marc, Kluge Angela, Schwenke Jens, Oeken Jens, Fuchs Michael, Schwarz Reinhold

机构信息

Die Institutsangaben sind am Ende des Beitrags gelistet.

出版信息

Psychother Psychosom Med Psychol. 2007 Aug;57(8):328-33. doi: 10.1055/s-2006-952016. Epub 2007 Mar 5.

DOI:10.1055/s-2006-952016
PMID:17334971
Abstract

Patients who have had a cancer-related total laryngectomy (N = 217) were studied in order to investigate possible associations between perceived stigmatisation and such physical and social factors as: type and intelligibility of the replacement alaryngeal voice, mental health, and gender. The laryngectomees participated in structured interviews. The German questionnaire "Fragebogen zur pyschosozialen Anpassung nach Laryngectomie" (Questionnaire for Psychosocial Adjustment after Laryngectomy, FPAL) was used to measure patients' perceived stigmatisation. Speech intelligibility was measured both by using the Post-laryngectomy Telephone Intelligibility Test (PLTT) and by taking into account patients' own evaluation of how well they are able to speak. Patients' mental health was measured with the Hospital Anxiety and Depression Scale (HADS). Multi-factorial analysis of variance and covariance was used to test the effects of the parameters. Results show that stigmatisation is associated with anxiety (F = 5.992, p < 0.05 and F = 12.895, p < 0.001) but not with speech intelligibility, alaryngeal voice type, gender, or depression. There is a correspondence between the degree to which patients feel stigmatised because of their voice or tracheostomy and their sense of loneliness (F = 4.917, p < 0.05 and F = 6.271, p < 0.05). We can conclude that perceived stigmatisation is frequently accompanied by anxiety and loneliness. Men are apparently as often concerned as women. Stigmatisation is not increased when patients do use electronic devices for communication, and it is not lower in patients whose operation dates back several years.

摘要

为了研究感知到的污名化与以下身体和社会因素之间可能存在的关联,对217例接受了与癌症相关的全喉切除术的患者进行了研究:替代喉发声的类型和可懂度、心理健康状况以及性别。喉切除患者参与了结构化访谈。使用德国问卷“喉切除术后心理社会适应问卷”(FPAL)来测量患者感知到的污名化程度。通过使用喉切除术后电话可懂度测试(PLTT)以及考虑患者自身对其说话能力的评估来测量言语可懂度。使用医院焦虑和抑郁量表(HADS)来测量患者的心理健康状况。采用多因素方差分析和协方差分析来检验各参数的影响。结果表明,污名化与焦虑相关(F = 5.992,p < 0.05和F = 12.895,p < 0.001),但与言语可懂度、喉替代发声类型、性别或抑郁无关。患者因声音或气管造口术而感到被污名化的程度与他们的孤独感之间存在对应关系(F = 4.917,p < 0.05和F = 6.271,p < 0.05)。我们可以得出结论,感知到的污名化常常伴随着焦虑和孤独感。男性显然与女性一样经常受到影响。当患者确实使用电子设备进行交流时,污名化程度不会增加,而且手术时间追溯到几年前的患者的污名化程度也不会更低。

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