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全喉切除术的影响:患者视角

The impact of total laryngectomy: the patient's perspective.

作者信息

Noonan Brendan J, Hegarty Josephine

机构信息

School of Nursing and Midwifery, University College Cork, South Infirmary-Victoria University Hospital, Cork, Ireland.

出版信息

Oncol Nurs Forum. 2010 May;37(3):293-301. doi: 10.1188/10.ONF.293-301.

DOI:10.1188/10.ONF.293-301
PMID:20439213
Abstract

PURPOSE/OBJECTIVES: To describe the experiences of patients who had total laryngectomy from their perspective.

RESEARCH APPROACH

Descriptive, qualitative study.

SETTING

Participants' homes or investigator's hospital office.

PARTICIPANTS

10 patients after total laryngectomy.

METHODOLOGIC APPROACH

Data were collected by semistructured, open-ended interviews during a period of six months, with an interview topic guide built on the framework of the literature review. Data were analyzed with descriptive content analysis. Trustworthiness of the study was enhanced through the use of verbatim quotations, audible data analysis trail, and a reflexive approach.

MAIN RESEARCH VARIABLES

Patients' experiences of undergoing total laryngectomy.

FINDINGS

Patients who have undergone a total laryngectomy report difficulties and concerns that are largely functional and psychological. The functional difficulties reported included descriptions of altered swallow, excess phlegm, speech difficulties, weak neck muscles, and altered energy levels. The psychological concerns reported included descriptions of depression, regrets, and personal resolve.

CONCLUSIONS

As a group, patients experience a broad range of problems well after completion of treatment, reinforcing the need for rehabilitation management for prolonged periods after surgery.

INTERPRETATION

Nurses are suitably positioned to support this group of patients across the disease management trajectory, from the initial preoperative period to the postoperative period and through to the rehabilitative period and beyond.

摘要

目的/目标:从患者自身角度描述全喉切除术患者的经历。

研究方法

描述性定性研究。

研究地点

参与者家中或研究者的医院办公室。

参与者

10例全喉切除术后患者。

方法学途径

在六个月的时间里,通过半结构化、开放式访谈收集数据,访谈主题指南基于文献综述框架构建。采用描述性内容分析法对数据进行分析。通过使用逐字引用、可听的数据分析过程和反思性方法提高了研究的可信度。

主要研究变量

患者接受全喉切除术的经历。

研究结果

接受全喉切除术的患者报告了主要在功能和心理方面的困难与担忧。报告的功能困难包括吞咽改变、痰液过多、言语困难、颈部肌肉无力和精力水平改变。报告的心理担忧包括抑郁、遗憾和个人决心。

结论

总体而言,患者在治疗结束后很长一段时间内会经历各种各样的问题,这强化了术后长期进行康复管理的必要性。

解读

护士在疾病管理过程中处于合适的位置,能够在从术前初始阶段到术后阶段,再到康复阶段及以后,为这群患者提供支持。

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