Department of Undergraduate Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Department of Otolaryngology-Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Unity-Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Laryngoscope. 2024 Jan;134(1):361-366. doi: 10.1002/lary.30925. Epub 2023 Aug 10.
OBJECTIVE(S): Voice rest is commonly recommended following phonomicrosurgery to minimize vocal fold scarring, but associated quality of life (QoL) is low resulting in poor compliance. This study aimed to explore patients' experiences with voice rest following phonomicrosurgery to identify facilitators and barriers.
This qualitative study used prospective, typical case technique for purposive sampling of consecutive patients who underwent voice rest following phonomicrosurgery for benign vocal fold lesions. Participants were enrolled at a single tertiary Laryngology center located at Unity Health Toronto - St. Michael's Hospital from 2020 to 2022. Semi-structured virtual interviews were conducted 4 weeks following patients' surgery. All interview transcripts were transcribed verbatim and underwent thematic analysis. Participant recruitment was stopped once thematic saturation was achieved.
Twenty participants were recruited and 4 withdrew due to scheduling conflicts. Sixteen participants completed interviews, all of whom reported minimal impact of postoperative voice rest on QoL. The participants attributed their success to facilitators such as notifying close contacts of their situation beforehand and adopting nonverbal forms of communication. No participant endorsed a negative attitude toward voice rest. Understanding the rationale for voice rest and the consequences of noncompliance were reported to be effective in encouraging compliance.
Overall, the participants tolerated voice rest well owing to facilitators such as early preparation, lifestyle modifications, and understanding the rationale for voice rest. Social disconnect and work demands were barriers of voice rest. Moving forward, facilitators and barriers should be addressed in efforts to optimize the voice rest experience for future patient populations.
4 Laryngoscope, 134:361-366, 2024.
在显微声带手术后，通常建议患者进行嗓音休息以最大程度地减少声带瘢痕形成，但这会导致生活质量（QoL）下降，从而降低患者的依从性。本研究旨在探讨患者在显微声带手术后进行嗓音休息的体验，以确定促进因素和障碍因素。
本定性研究采用前瞻性、典型病例技术，对 2020 年至 2022 年期间在多伦多联合健康圣迈克尔医院单一三级喉科中心接受显微声带手术治疗良性声带病变并进行嗓音休息的连续患者进行了有针对性的抽样。在患者手术后 4 周进行半结构式虚拟访谈。所有访谈记录均逐字转录，并进行主题分析。一旦达到主题饱和，即停止招募参与者。
共招募了 20 名参与者，其中 4 名因日程冲突而退出。16 名参与者完成了访谈，他们都报告说术后嗓音休息对 QoL 的影响极小。参与者将他们的成功归因于一些促进因素，例如事先告知亲密接触者他们的情况，并采用非言语形式的交流。没有参与者对嗓音休息持消极态度。了解嗓音休息的原理和不遵守规定的后果被认为可以有效地鼓励患者遵守。
总体而言，由于早期准备、生活方式改变和理解嗓音休息的原理等促进因素，患者能够很好地耐受嗓音休息。社交脱节和工作需求是嗓音休息的障碍。未来，应解决这些促进因素和障碍因素，以优化未来患者群体的嗓音休息体验。
4 Laryngoscope，134：361-366，2024。
