Department of Communicative Sciences and Disorders, Michigan State University, East Lansing.
Department of Otolaryngology - Head & Neck Surgery, Division of Laryngology, Stanford University School of Medicine, CA.
Am J Speech Lang Pathol. 2021 Nov 4;30(6):2430-2445. doi: 10.1044/2021_AJSLP-21-00117. Epub 2021 Oct 19.
Purpose This study described the clinical experiences of patients with a total laryngectomy (TL) during the COVID-19 pandemic and identified changes in communication, tracheostoma care, and heat-moisture exchange (HME) use that were recommended or self-implemented. Method An online survey addressing the study aims was completed by 173 people with a TL who live in the United States. The survey was open from July 5 to August 10, 2020. Results In-person clinic visits, appointment cancellations, and contact from their speech-language pathologists (SLPs) were reported by 42%, 19%, and 54% of the TL respondents, respectively. At clinic visits, 78% were required to wear a mask over their nose/mouth, and 73% were required to wear a mask over their tracheostoma. Masks, gloves, and face shields worn by the SLP at these visits were reported by 84%, 82%, and 70% of the TL patients, respectively. Alaryngeal communication changes were recommended by the SLP for 7%-18% of TL patients, depending on their method of communication, whereas 43%-45% implemented changes on their own. Changes in tracheostoma care and HME use were recommended by the SLP for 27% and 21% of the TL respondents, respectively, whereas 54% and 47% made changes on their own. Conclusions Individuals with a TL will require in-person care even during a pandemic, as reflected in this study. Many had not been contacted by their SLP or otolaryngologist about TL guidelines that were becoming available. Notably, larger percentages of TL patients reported self-initiated changes to their communication, tracheostoma care, and HME use because of the pandemic than their SLP had advised. The types of communication changes varied in part, depending on the method of alaryngeal speech a respondent used. Supplemental Material https://doi.org/10.23641/asha.16807270.
目的 本研究描述了在 COVID-19 大流行期间全喉切除术(TL)患者的临床经历,并确定了推荐或患者自行实施的沟通、气管造口护理和热湿交换(HME)使用方面的变化。 方法 2020 年 7 月 5 日至 8 月 10 日,美国 173 名 TL 患者在线完成了一项针对研究目的的调查。 结果 42%、19%和 54%的 TL 受访者报告了门诊就诊、预约取消和言语语言病理学家(SLP)的联系。在门诊就诊时,78%的人需要在口鼻处佩戴口罩,73%的人需要在气管造口处佩戴口罩。84%、82%和 70%的 TL 患者分别报告了 SLP 在这些就诊时佩戴的口罩、手套和面罩。根据 TL 患者的沟通方式,SLP 建议 7%-18%的患者改变发声方式,而 43%-45%的患者自行做出改变。SLP 建议 27%和 21%的 TL 受访者分别改变气管造口护理和 HME 使用,而 54%和 47%的受访者自行做出改变。 结论 正如本研究所示,即使在大流行期间,TL 患者仍需要亲自接受护理。许多患者尚未收到有关 TL 指南的通知,这些指南正在不断更新。值得注意的是,由于疫情,报告自行改变沟通、气管造口护理和 HME 使用的 TL 患者比例高于 SLP 建议的比例。沟通方式的变化类型在一定程度上取决于受访者使用的非言语性发声方式。 补充材料 https://doi.org/10.23641/asha.16807270.