Subjektivna procena kvaliteta života laringektomiranih pacijenata pre i nakon govorne rehabilitacije

Abstract

Introduction: Total laryngectomy exposes the patient to a great deal of psychological stress, both because of the underlying disease and the loss of a very important organ in the overall functioning of the organism and organs, which enables an adequate communication process. Objective: The aim of this study is to conduct a subjective assessment of the quality of life of laryngectomized patients before and after vocal rehabilitation. Methods: The study involved 50 patients after total laryngectomy, ranging in age from 51 years to 83 years. A subjective assessment of speech and voice was conducted with the University of Michigan Quality of Life Instrument - HNQOL and Voice Handicap Index - VHI. These instruments provide information from the patient about the treatment or treatment applied, as well as the impact that vocal rehabilitation has on the quality of his or her life before and after treatment. Results: Prior to vocal rehabilitation of the HNQOL scale, patients experienced pronounced difficulties on all subscales, especially when it came to communication (x = 5.75 ± 8.64) and emotions (x = 16.66 ± 15.17); expressed, while chewing/food ingestion (x = 53.91 ± 26.45) and pain (x = 50.50 ± 17.71) had mean values. VHI scale (physical subscale x = 36.6 ± 2.93; emotional subscale x = 34.96 ± 3.79; functional subscale x = 35.64 ± 3.37) before vocal rehabilitation, all subjects (100%) belonged to the third category (severe handicap), which was a problem when it came to psychosocial functioning. After vocal rehabilitation, the mean values on the HNQOL scale were very highly expressed and statistically highly significantly improved (communication x = 93.37 ± 10.28; emotions x = 90.58 ± 8.23; chewing/swallowing food x = 96.66 ± 5.77; pain x = 92.25 ± 6.98) which indicated a good quality of life. On the VHI scale of low value (physical subscale x = 10.84 ± 4.41; emotional subscale x = 4.42 ± 4.63; functional subscale x = 21.32 ± 13.29) shows a statistically high significant improvement, ie good psychophysical and functional condition patient. Conclusion: Subjective assessment after vocal rehabilitation resulted in improvement of all parameters tested, especially in the domain of communications and emotions. Vocal rehabilitation has had a positive effect on improving the quality of life of these patients, integrating them into the family and the environment, as well as performing daily activities that we observe through their physical, emotional and functional state.