Kotake Kumiko, Suzukamo Yoshimi, Kai Ichiro, Iwanaga Kazuyo, Takahashi Aya
Faculty of Nursing, Nara Medical University, 840 Shijou-cho, Kashihara City, Nara, 634-8521, Japan.
Physical Medicine and Rehabilitation, Tohoku University School of Medicine, Tohoku, Japan.
Eur Arch Otorhinolaryngol. 2017 Mar;274(3):1557-1565. doi: 10.1007/s00405-016-4310-0. Epub 2016 Sep 29.
The objective is to clarify whether social support and acquisition of alternative voice enhance the psychological adjustment of laryngectomized patients and which part of the psychological adjustment structure would be influenced by social support. We contacted 1445 patients enrolled in a patient association using mail surveys and 679 patients agreed to participate in the study. The survey items included age, sex, occupation, post-surgery duration, communication method, psychological adjustment (by the Nottingham Adjustment Scale Japanese Laryngectomy Version: NAS-J-L), and the formal support (by Hospital Patient Satisfaction Questionnaire-25: HPSQ-25). Social support and communication methods were added to the three-tier structural model of psychological adjustment shown in our previous study, and a covariance structure analysis was conducted. Formal/informal supports and acquisition of alternative voice influence only the "recognition of oneself as voluntary agent", the first tier of the three-tier structure of psychological adjustment. The results suggest that social support and acquisition of alternative voice may enhance the recognition of oneself as voluntary agent and promote the psychological adjustment.
目的是阐明社会支持和获得替代发声方式是否能增强喉切除患者的心理调适，以及社会支持会对心理调适结构的哪一部分产生影响。我们通过邮件调查联系了1445名加入患者协会的患者，其中679名患者同意参与研究。调查项目包括年龄、性别、职业、术后时长、沟通方式、心理调适（采用诺丁汉调适量表日本喉切除版：NAS-J-L）以及正式支持（采用医院患者满意度问卷-25：HPSQ-25）。将社会支持和沟通方式添加到我们之前研究中所示的心理调适三层结构模型中，并进行协方差结构分析。正式/非正式支持以及获得替代发声方式仅影响心理调适三层结构中第一层“将自己视为自主行为者的认知”。结果表明，社会支持和获得替代发声方式可能会增强将自己视为自主行为者的认知，并促进心理调适。
