The impact of total laryngectomy: the patient's perspective.

PURPOSE/OBJECTIVES To describe the experiences of patients who had total laryngectomy from their perspective. RESEARCH APPROACH Descriptive, qualitative study. SETTING Participants' homes or investigator's hospital office. PARTICIPANTS 10 patients after total laryngectomy. METHODOLOGIC APPROACH Data were collected by semistructured, open-ended interviews during a period of six months, with an interview topic guide built on the framework of the literature review. Data were analyzed with descriptive content analysis. Trustworthiness of the study was enhanced through the use of verbatim quotations, audible data analysis trail, and a reflexive approach. MAIN RESEARCH VARIABLES Patients' experiences of undergoing total laryngectomy. FINDINGS Patients who have undergone a total laryngectomy report difficulties and concerns that are largely functional and psychological. The functional difficulties reported included descriptions of altered swallow, excess phlegm, speech difficulties, weak neck muscles, and altered energy levels. The psychological concerns reported included descriptions of depression, regrets, and personal resolve. CONCLUSIONS As a group, patients experience a broad range of problems well after completion of treatment, reinforcing the need for rehabilitation management for prolonged periods after surgery. INTERPRETATION Nurses are suitably positioned to support this group of patients across the disease management trajectory, from the initial preoperative period to the postoperative period and through to the rehabilitative period and beyond.