Laryngektómia je chirurgický výkon, ktorým sa odstraňuje celá časť hrtana. Ide o radikálny zásah do organizmu, ktorý pacienta ovplyvní nielen po somatickej, ale aj po psychickej stránke. Pacient sa musí vyrovnať s mnohými zmenami, ktoré ho po zákroku čakajú. Jeho kvalita života je narušená napríklad zmenou vzhľadu, narušenou komunikáciou, ťažkosťami s príjmom potravy, či problémami s prehĺtaním. Všetky zmeny, ktoré vzniknú, vyvolávajú u pacienta pocit menejcennosti, neistoty a ďalšie maladaptačné prejavy. Z uvedeného dôvodu je hlavným cieľom nášho príspevku poukázať na náročnosť ochorenia a jeho dopad na kvalitu života pacientov.
Laryngectomy is a surgical procedure that removes the entire part of the larynx. It is a radical intervention in the organism, which will affect the patient not only from a somatic point of view, but also from a psychological point of view. The patient has to cope with many changes that await him after the procedure. His quality of life is impaired, for example, by a change in appearance, impaired communication, difficulties with food intake or problems with swallowing. All the changes that arise cause the patient a feeling of inferiority, insecurity and other maladaptive manifestations. For this reason, the main goal of our contribution is to point out the severity of the disease and its impact on the quality of life of patients.
Príspevok približuje starostlivosť o pacienta s karcinómom hrtanu. Iniciatívna spolupráca medzi pacientom, jeho rodinou, sestrou a zdravotníckymi pracovníkmi je dôležitá pre zdarné zvládnutie osobitostí vyskytujúcich sa pri ošetrovateľskej starostlivosti u pacienta s karcinómom hrtanu. Sestry pri poskytovaní ošetrovateľskej starostlivosti predstavuje oporu pre pacienta a jeho rodinu.
The contribution brings closer the care of a patient with cancer of the larynx. Proactive cooperation between the patient, his family, nurse and healthcare workers is important for successful management of the peculiarities occurring in the nursing care of a patient with laryngeal cancer. Nurses provide support for the patient and his family when providing nursing care.
Cílem realizované studie bylo zjistit kvalitu života u pacientů s karcinomem hrtanu po léčbě a následně ji porovnat s kvalitou života u populace daného věkového průměru. Sběr dat byl realizován průřezovým kvantitativním šetřením s využitím standardizovaného nástroje hodnocení kvality života The World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) včetně populačních norem pro věkové skupiny. Sběr dat probíhal u dispenzarizovaných pacientů na klinice otorinolaryngologie, vyhodnocena byla data od 42 pacientů, věkový průměr 70 let, 16 pacientů mělo trvalou tracheostomii. Pro statistické hodnocení kvality života mezi souborem pacientů po léčbě karcinomu hrtanu a populací daného věkového průměru byl použit t-test. Zjistili jsme, že pacienti vykazovali ve všech oblastech WHOQOL-BREF (fyzické zdraví, prožívání, sociální vztahy, prostředí, celková kvalita života a zdraví) kvalitu života spíše na vyšší úrovni. Rozdíl byl v hodnocení oblasti fyzického zdraví, kdy pacienti označili kvalitu života nižší než ostatní zkoumané oblasti. Pomocí párového t-testu pro shodné a různé rozptyly byl prokázán statisticky vysoce významný rozdíl v subjektivním hodnocení kvality života WHOQOL-BREF mezi pacienty po léčbě karcinomu hrtanu a populací daného věkového průměru. Z praktického hlediska (klinických intervencí) nelze jednoznačně stanovit, že by výsledky kvality života u pacientů po léčbě karcinomu hrtanu byly výrazně odlišné od hodnot populace daného věkového průměru.
The aim of the study was to find out the quality of life in patients with laryngeal cancer after the treatment and to compare it with the quality of life of the general population of the same average age. Data collection was conducted through a cross-sectional quantitative survey using the standardized World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), including the population standards for the age groups. Data collection was undertaken in patients treated at the Otorhinolaryngological Department. Data from 42 patients, with an average age of 70 (16 patients with permanent tracheostomy) were evaluated. A t-test was used for the statistical evaluation of the quality of life in patients after the treatment of laryngeal cancer and the general population of the same average age. We found out that patients displayed a higher quality of life in most areas of the WHOQOL-BREF (physical health, psychological health, social relationships, environment, and overall quality of life and health). A difference was found in the area of physical health, which patients rated lower than the other surveyed areas. The use of the paired t-test for equal and unequal variances demonstrated a statistically significant difference in the subjective WHOQOL-BREF assessment of the quality of life between patients after the treatment of laryngeal cancer and the general population of the given average age. From a practical point of view (clinical intervention), it cannot be clearly stated that the results of the quality of life of patients after the treatment of laryngeal cancer are significantly different from the values of the given average age population.
Introduction: Laryngeal cancer is the most frequent cancer in the head and neck area. Approximately one third of patients are treated by total laryngectomy (TL). The rate of the patient's adaptation to new conditions is crucial to the quality of his or her future life. Some patients survive tens of years after this operation. The preparation for TL is a complicated process that affects a patient's cooperation in postsurgical time. The patient is informed of the essence of the disease, treatment possibilities, the process of preoperative preparation, as well as the operation itself. Great emphasis is put on awareness of the postoperative development, the patient's good cooperation, as well as good prognosis of the disease. Losing one's voice and the cosmetic defects caused by the tracheostoma are a great problem for the patient. The aim of this study was to show the main problems that patients after total laryngectomy deal with in common life. Material: In the group, there were 102 patients who had been operated on between 2003 and 2013, 62 of which met the classification criteria. Methods: This prospective study was statistically evaluated. The frequencies of responses were processed in tables. Results: During the early postoperative period, the greatest problem of patients after total laryngectomy is their adaptation to new principles of breathing, which is subsequently followed by the adaptation to a new and different way of communication. The best option for the patient is to communicate using esophageal voice. Only 55% of operated patients use one of the verbal forms of alternative voice communication in their future lives.
Laryngektómia je rozsiahly chirurgický výkon, kedy dochádza k odstráneniu celej časti hrtana. Pacienti s touto diagnózou sú vystavení veľkej psychickej záťaži. Musia sa vyrovnávať s mnohými zmenami, ktoré v ich živote nastanú po operácii. V súčasnej medicínskej praxi je zdravotný stav pacienta a výsledok jeho liečby hodnotený predovšetkým podľa somatických, laboratórnych a zobrazovacích parametrov. Dôležité je však hodnotiť stav pacienta komplexne za pomoci veľkej rady životných aspektov, ktoré môžu byť v rôznej fáze ochorenia a liečby rozdielne zasiahnuté.
Laryngectomy is extensive surgery consisting of the entire larynx removal. Patients with this diagnosis are exposed to extreme mental stress. They are facing a lot of changes that occur in their lives after surgery. In current medical practice it is somatic, laboratory and radiology parameters that are primarily used to evaluate the health of the patient and the outcome of treatment. However, it is important to evaluate the patient globally using the broad range of life aspects that can be in different phase of the disease and treatment affected in a different way.
- Klíčová slova
- mapy péče, edukace, tracheostomická kanyla,
- MeSH
- laryngektomie MeSH
- nádory hrtanu MeSH
- Klíčová slova
- ORL - Otorhinolaryngologie,
- MeSH
- laryngektomie MeSH
- nádory hrtanu MeSH
- péče o pacienta MeSH
