Moors Thomas, Silva Sanjeev, Maraschin Donatella, Young David, Quinn John M, de Carpentier John, Allouche Johan, Himonides Evangelos
Shout at Cancer, London, United Kingdom.
School of Arts and Creative Industries, London South Bank University, London, United Kingdom.
Front Psychol. 2020 Jan 14;10:2854. doi: 10.3389/fpsyg.2019.02854. eCollection 2019.
Laryngectomy is the surgical removal of the larynx (voice box), usually performed in patients with advanced stages of throat cancer. The psychosocial impact of losing the voice is significant, affecting a person's professional and social life in a devastating way, and a proportion of this patient group subsequently must overcome depression (22-30%) and social isolation (40%). The profound changes to anatomical structures involved in voicing and articulation, as a result of surgery, radiotherapy or chemotherapy (separately or in combination with one another), introduce challenges faced in speech rehabilitation and voice production that complicate social reintegration and quality of life. After laryngectomy, breathing, voicing, articulation and tongue movement are major components in restoring communication. Regular exercise of the chest, neck and oropharyngeal muscles, in particular, is important in controlling these components and keeping the involved structures supple. It is, however, a difficult task for a speech therapist to keep the patient engaged and motivated to practice these exercises. We have adopted a multidisciplinary approach to explore the use of basic beatboxing techniques to create a wide variety of exercises that are seen as fun and interactive and that maximize the use of the structures important in alaryngeal phonation. We herein report on our empirical work in developing patients' skills, particularly relating to voiced and unvoiced consonants to improve intelligibility. In collaboration with a professional beatboxing performer, we produced instructional online video materials to support patients working on their own and/or with support from speech therapists. Although the present paper is focused predominantly on introducing the structure of the conducted workshops, the rationale for their design and the final public engagement performance, we also include feedback from participants to commence the critical discourse about whether this type of activity could lead to systematic underlying research and robustly assessed interventions in the future. Based on this exploratory work, we conclude that the innovative approach that we employed was found to be engaging, useful, informative and motivating. We conclude by offering our views regarding the limitations of our work and the implications for future empirical research.
喉切除术是指通过手术切除喉部（喉腔），通常用于治疗晚期喉癌患者。失去声音所带来的心理社会影响重大，会对患者的职业和社交生活造成毁灭性影响，而且这部分患者群体中有一定比例的人随后必须克服抑郁情绪（22%-30%）和社交孤立（40%）。由于手术、放疗或化疗（单独或相互结合使用）导致发声和发音所涉及的解剖结构发生深刻变化，给言语康复和发声带来了挑战，进而使社会重新融入和生活质量变得复杂。喉切除术后，呼吸、发声、发音和舌头运动是恢复交流的主要组成部分。特别是定期锻炼胸部、颈部和口咽肌肉，对于控制这些组成部分并保持相关结构的柔韧性很重要。然而，让言语治疗师使患者参与并积极练习这些锻炼是一项艰巨的任务。我们采用了多学科方法，探索运用基本的节奏口技技巧来设计各种练习，这些练习被视为有趣且具有互动性，并且能最大限度地利用在无喉发声中重要的结构。我们在此报告我们在培养患者技能方面的实证工作，特别是与浊辅音和清辅音相关的技能，以提高可懂度。我们与一位专业的节奏口技表演者合作，制作了在线教学视频材料，以支持患者独自练习和/或在言语治疗师的支持下练习。尽管本文主要侧重于介绍所举办工作坊的结构、设计原理以及最终的公众参与表演，但我们也纳入了参与者的反馈，以开启关于此类活动未来是否能够引发系统性基础研究和经过严格评估的干预措施的批判性讨论。基于这项探索性工作，我们得出结论，我们所采用的创新方法具有吸引力、实用性、信息性且能激发积极性。我们最后提出了对我们工作局限性的看法以及对未来实证研究的启示。
