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头颈部癌非手术治疗后吞咽困难的生活体验。

The lived experience of dysphagia following non-surgical treatment for head and neck cancer.

作者信息

Nund Rebecca L, Ward Elizabeth C, Scarinci Nerina A, Cartmill Bena, Kuipers Pim, Porceddu Sandro V

机构信息

The University of Queensland , Brisbane , Australia.

出版信息

Int J Speech Lang Pathol. 2014 Jun;16(3):282-9. doi: 10.3109/17549507.2013.861869. Epub 2013 Dec 18.

Abstract

The prevalence and severity of dysphagia in people treated non-surgically for primary head and neck cancer (HNC) is well documented. However, few studies have looked beyond the physiological impairment to explore the lived experience of dysphagia in the post-treatment period of HNC. The current study adopted a person-centred, qualitative approach to describe the experiences of people living with dysphagia in the months and years following non-surgical treatment for HNC. Using maximum variation sampling, 24 participants who had undergone radiotherapy treatment for HNC were recruited. Individual interviews were conducted to explore the impact of dysphagia on participants' everyday lives. The themes identified included: (1) physical changes related to swallowing; (2) emotions evoked by living with dysphagia; (3) altered perceptions and changes in appreciation of food; and (4) personal and lifestyle impacts. The data revealed the breadth and significance of the impact of dysphagia on the lives of people treated curatively for HNC. Assessment and management in the post-treatment period must be sufficiently holistic to address both the changing physical states and the psychosocial needs of people with dysphagia following HNC. Rehabilitation services which focus only on impairment-based management will fail to fully meet the support needs of this clinical population.

摘要

对于接受非手术治疗的原发性头颈癌(HNC)患者,吞咽困难的患病率和严重程度已有充分记录。然而,很少有研究超越生理损伤,去探究头颈癌治疗后吞咽困难患者的生活体验。本研究采用以人为本的定性方法,描述头颈癌非手术治疗后数月乃至数年中吞咽困难患者的经历。采用最大差异抽样法,招募了24名接受过头颈癌放射治疗的参与者。通过个人访谈来探究吞咽困难对参与者日常生活的影响。确定的主题包括:(1)与吞咽相关的身体变化;(2)吞咽困难生活引发的情绪;(3)对食物认知的改变和欣赏的变化;(4)个人和生活方式的影响。数据揭示了吞咽困难对接受治愈性治疗的头颈癌患者生活影响的广度和重要性。治疗后阶段的评估和管理必须足够全面,以满足头颈癌后吞咽困难患者不断变化的身体状况和心理社会需求。仅专注于基于损伤管理的康复服务将无法完全满足这一临床群体的支持需求。

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