Bickford Jane, Coveney John, Baker Janet, Hersh Deborah
Flinders University, Adelaide, Australia. jane.bickford@fl inders.edu.au
Int J Speech Lang Pathol. 2013 Jun;15(3):324-33. doi: 10.3109/17549507.2013.785591. Epub 2013 Apr 16.
Total laryngectomy (TL), a life-preserving surgery, results in profound physical and communication changes for the individual. Physical and psychosocial adjustment to a TL is complex, and quality-of-life (QoL) measures have provided useful knowledge to assist clinical management. However, many tools were developed without considering the perspectives of people who have experienced TL. To improve understanding of the phenomena of living with TL, a qualitative study was conducted which explored the views and experiences of seven men and five women from a range of ages, geographical locations, and social situations who had undergone a TL. Data were collected through in-depth, semi-structured interviews, journals, and field notes, and analysed using a constructivist grounded theory approach and symbolic interactionism. The emergent concept was identifying with the altered self after TL as reflected in dynamic multi-level changes (physical, communication, and psycho-emotional) continuously interacting with intrinsic and extrinsic interpersonal factors including personal and socio-cultural constructs, e.g., age, gender, resilience, beliefs, and supports. This process affected the strategies these individuals used to negotiate their social experiences. The extent to which communication changes disrupted social roles affecting a person's sense of self appeared to relate to long-term adjustment.
全喉切除术（TL）是一种挽救生命的手术，会给患者带来深刻的身体和交流方面的变化。对全喉切除术进行身体和心理社会调适是复杂的，生活质量（QoL）测量为临床管理提供了有用的知识。然而，许多工具在开发时并未考虑经历过全喉切除术的人的观点。为了更好地理解全喉切除术后的生活现象，开展了一项定性研究，探讨了7名男性和5名女性的观点和经历，这些人年龄、地理位置和社会状况各异，均接受过全喉切除术。通过深入的半结构化访谈、日记和实地记录收集数据，并使用建构主义扎根理论方法和符号互动主义进行分析。新出现的概念是，在全喉切除术后认同改变了的自我，这体现在动态的多层次变化（身体、交流和心理情感）中，这些变化与内在和外在的人际因素持续相互作用，包括个人和社会文化建构，如年龄、性别、恢复力、信念和支持。这个过程影响了这些个体用来应对其社会经历的策略。交流变化扰乱社会角色从而影响一个人的自我感的程度似乎与长期调适有关。
