Self-expression and identity after total laryngectomy: Implications for support
Self-expression and identity after total laryngectomy: Implications for support
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DOI：
10.1002/pon.4818
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发表时间：
2018-11-01
期刊：
影响因子：
3.6
通讯作者：
Hersh, Deborah
中科院分区：
文献类型：
--
作者：
Bickford, Jane M.;Coveney, John;Hersh, Deborah
目的探讨不同背景的喉切除术（IWL）患者对全喉切除术后身体和功能变化的意义和适应。检查主要支持者（PS）和卫生专业人员（HP）能够在多大程度上支持IWL应对手术带来的心理社会和生存挑战，这些挑战会显著影响一个人的说话、呼吸、吞咽和外观。方法采用建构主义扎根理论和符号互动理论指导数据收集和分析。进行了半结构化面试。对28名参与者（12名IWL，9名PS和7名HP）进行了访谈。研究结果表明，IWL的经验显着的变化，他们的自我认同，有证据表明，一系列的被动和主动的重构模式（不稳定，辞职，坚决，和转化）。自我表达的丧失包括交流参与、个人风格、食物偏好和社会角色的变化。短期和长期支助似乎会影响到结果，但往往不足以应付国际妇女游说团的心理社会需要。结论喉全切除术后自我表达的缺失影响了自我认同和自我调节。个人如何重塑自己的身份似乎与他们如何看待自己的残疾和毁容有关。这些看法似乎也受到其他人的反应和现有支持的影响。需要进一步的资源、教育和培训，以便PS和HP能够提供整体护理。
Objective To explore how individuals with a laryngectomy (IWL) from diverse backgrounds make meaning and adjust to the physical and functional changes from a total laryngectomy. To examine the extent primary supporters (PS) and health professionals (HP) are able to support IWL with the psychosocial and existential challenges rendered by a surgery that significantly impacts a person's talking, breathing, swallowing, and appearance. Methods Results A constructivist grounded theory approach and symbolic interactionism were used to guide data collection and analysis. Semi-structured interviewing occurred. Twenty-eight participants (12 IWL, 9 PS, and 7 HP) were interviewed. The findings suggest that IWL experience significant change to their self-identity and there is evidence of a range of passive and active reframing patterns (destabilised, resigned, resolute, and transformed). The loss of self-expression included changes to communicative participation, personal style, food preferences, and social roles. Short and longer-term supports appear to influence outcomes but are often ill-equipped to manage the psychosocial needs of IWL. Conclusions Loss of self-expression after total laryngectomy influences self-identity and adjustment. How individuals reframe their identity appears to be tied with how they view their disabilities and disfigurement. These perceptions also appear to be influenced by the reactions of others and the support available. Further resourcing, education, and training are needed so that PS and HP can provide holistic care.