QOL Flashcards
If they ask what re my chances?
Say, “Honestly I don’t know yet, but I can give a prognosis after gathering information; most people survive this.”
Medical Concerns?
A. Have client tell you what they know about the surgery. B. Fear of death. C. High cure rate. D. Describe the surgery E. Pre-op visit by laryngectomee?
More about medical concerns
Reassure them as much as possible. Let them know: there may be more treatment after surgery, they will wake up in the intensive care unit, and they will stay in the hospital for about 5 days.
Tracheal Stoma
Suture made in the neck to have air go directly into the lungs.
Communication.
A. NO POST-OP VOICE!!! B. Describe different forms of a laryngeal speech. C. How long does therapy take? D. How much does it cost? E. Hearing evaluation. F. Should they practice pre-surgically?
What are the 3 forms of a laryngeal speech?
- Artificial speech
- Esophageal speech
- Tracheoesophageal speech
What is artificial speech?
Speech produced with an external device.
What is esophageal speech?
Traditionally, air taken in through the mouth is used to vibrate from the esophagus and produce speech.
What is tracheoesophageal speech?
Communication established through a fistula connecting the trachea and the esophagus.
How long does therapy take?
Variable; 12 sessions for artificial & t-e, 24 for esophageal. May be more or less.
General Orientation
A. Return to employment. B. Activities: swimming, fishing C. Taste and smell D. Eating/swallowing E. Hearing.
Employment
Most are employed, may are old enough to retire.
Activities
Not recommended because of the open airway.
Taste, smell, eating and swallowing.
Some use a device to smell.
Food does not taste as good due to the loss of smell.
Some accommodations may be necessary.
Hearing
Have trouble receiving feedback such as from therapy. Spouses may not hear which gives negative feedback to the laryngectomee.
General Care
A. Cleaning the Stoma tube B. Cleaning Stoma C. Stoma covers D. Humidity E. Shaving F. Sleeping.
Stoma tube
Metal/plastic short term tube attached to the Stoma. It prevents stenosis and allows healing.
Stoma covers
Wash cloth or tissue. Also have ones for purchase. Cover prevents material from getting in or out of the trachea. It also keeps humidity within the trachea and hides the Stoma for social reasons.
Cleaning the Stoma.
Inner and outer cannula. Remove entire apparatus once a day to clean with soap, water, and a brush.
How are eating habits affected by laryngectomy?
Most reported no change. Several reported a decrease in the amount of food eaten and hunger sensations. 50% reported longer lunches and dinners. Many reported decreased enjoyment of food.
Is QOL better for patients treated with chemo radiation versus surgery?
Laryngectomy patients reported greater impairment of speech and shoulder function. Chemo radiation patients reported greater pain, problems chewing, and difficulty swallowing. Both reported excellent functional outcomes and health-related quality of life.
How is speech intelligibility related to QOL after surgery?
Sentence intelligibility is better than word intelligibility.
How does laryngectomy affect the senses of taste and smell?
Due the path of air entering through the Stoma vs the nose. Smell has a huge role in taste.
Is pulmonary function compromised in laryngectomees? Why or why not?
Yes due to an open airway, and symptoms including coughing, sputum production, dyspnea, chronic diseases and acute infections. Many also reported airway obstruction.
What are important points with regard to management of a tracheostomy tube?
Cleaning
