Effect of Augmentative Technology on Communication and Quality of Life After Tracheostomy or Total Laryngectomy
Effect of Augmentative Technology on Communication and Quality of Life After Tracheostomy or Total Laryngectomy
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DOI：
10.1177/01945998211013778
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发表时间：
2021-06-01
影响因子：
3.4
通讯作者：
Casper, Keith A.
中科院分区：
文献类型：
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作者：
Haring, Catherine T.;Farlow, Janice L.;Casper, Keith A.
目的外科手术使患者出现严重的语音障碍，可使患者经历严重的焦虑和痛苦。我们询问了气管切开术或喉切除术后患者的感觉，并调查了引入增强技术是否与患者报告的结果改善有关。方法纳入2018年4月至2019年12月因气管切开术或全喉切除术而急性丧失说话能力的住院患者。我们分发了关于患者沟通体验的问题和验证过的V-RQOL（语音相关生活质量）问卷中的相关问题。给患者一片带有电子通讯应用程序的药片。干预前后两组采用卡方分析进行比较。结果35例患者（干预前18例，干预后17例）共完成问卷调查。在使用辅助技术之前，89%有语音障碍的患者报告沟通困难，特别是注意呼吸或吸痰（56%），治疗和出院计划（78%），或即时需求，如疼痛和使用浴室（39%）。沟通困难导致焦虑（55%）、抑郁（44%）或沮丧（62%），92%的患者对使用电子通信设备感兴趣。与干预前相比，患者报告干预后沟通困难减少（53%对89%，P = 0.03），包括治疗或出院计划沟通困难减少（35%对78%，P < 0.01）。V-RQOL评分不变。手术引起的急性发音丧失对患者来说是非常痛苦的，使用辅助技术可以通过改善沟通来缓解这些挑战。需要进一步的研究来确定哪些额外的策略可以改善整体幸福感。电子通讯设备可能对急性失音患者有益。
Objective Surgical procedures that render patients acutely aphonic can cause them to experience significant anxiety and distress. We queried patient perceptions after tracheostomy or laryngectomy and investigated whether introducing augmentative technology was associated with improvement in patient-reported outcomes. Methods Participants included hospitalized patients who acutely lost the ability to speak due to tracheostomy or total laryngectomy from April 2018 to December 2019. We distributed questions regarding the patient communication experience and relevant questions from the validated V-RQOL questionnaire (Voice-Related Quality of Life). Patients were offered a tablet with the electronic communication application Verbally. Pre- and postintervention groups were compared with chi-square analyses. Results Surveys were completed by 35 patients (n = 18, preintervention; n = 17, postintervention). Prior to using augmentative technology, 89% of patients who were aphonic reported difficulty communicating, specifically noting breathing or suctioning (56%), treatment and discharge plans (78%), or immediate needs, such as pain and using the bathroom (39%). Communication difficulties caused anxiety (55%), depression (44%), or frustration (62%), and 92% of patients were interested in using an electronic communication device. Patients reported less trouble communicating after the intervention versus before (53% vs 89%, P = .03), including less difficulty communicating about treatment or discharge plans (35% vs 78%, P < .01). V-RQOL scores were unchanged. Discussion Acute loss of phonation arising from surgery can be highly distressing for patients, and use of augmentative technology may alleviate some of these challenges by improving communication. Further studies are needed to identify what additional strategies may improve overall well-being. Implications for Practice Electronic communication devices may benefit patients with acute aphonia.