Difficulties and Solutions in Daily Life of Laryngectomy Patients after Discharge

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  • 喉頭摘出術を受けた患者の退院後の生活における問題と対処

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<p>[Objective] To identify difficulties other than aphonia faced by patients who have undergone laryngectomy as a surgical procedure commonly required in total laryngectomy and hypopharyngolaryngo-cervical esophagectomy, such difficulties were predicted based on morphological and functional changes related to the procedure. Furthermore, changes in the degrees of these difficulties with time after surgery and solutions in each case were examined.</p><p>[Methods] A questionnaire survey was conducted, involving 1,602 laryngectomy patients, and responses were obtained from 799 (response rate: 49.9%). Statistical and content analyses were performed.</p><p>[Results] The difficulties faced by these patients in daily life after discharge were explained by the following 3 factors and 15 subfactors: [Factor I: permanent tracheostomy and breathing]: 2) difficulty carrying heavy things, 8) frequent water in the tracheostomy when taking a bath or shower, 11) frequent foreign objects in the tracheostomy, 12) dry airways, 13) frequent bleeding from the tracheostomy, 14) frequent phlegm, and 15) skin erosion around the tracheostomy, [Factor II: meals and excretion]: 3) difficulty straining when excreting, 4) difficulty blowing on hot foods to cool them, 5) difficulty eating noodles and soups, 6) frequent belching and flatulence, 7) frequent choking on solid foods, and 10) hyposmia; and [Factor III: physical activities] 1) difficulty running with maximal effort and 9) limitations in physical activities, such as swimming. The degrees of difficulties represented by Subfactors 3)-5), 8), and 14) decreased with time after surgery. To resolve these difficulties, approaches to manage aphonia, the permanent tracheostomy, phlegm, meals, constipation, and overall daily life were suggested.</p><p>[Discussion] The solutions to 1) 9) and 10) were not suggested. For a problem to continue irrespective of passed years after an operation, establishment of educational method is needed.</p>

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