Loading...
Publication
Qualidade de vida vocal em laringectomizados totais
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 19744 | 1017.8 KB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
A Laringectomia Total (LT) é a principal cirurgia realizada em pacientes com cancro da larínge avançado. De uma forma bastante sucinta, é vista como um procedimento cirúrgico que consiste na remoção da glote, supraglote e subglote, com a extração de todas as estruturas inseridas entre a base da língua até ao segundo/terceiro anel traqueal, incluindo o osso hioide. A parte superior da faringe é suturada à base da língua e a traqueia à pele da base do pescoço, criando um estoma permanente denominado de traqueostoma. As sequelas desta levam à perda da capacidade de emissão do som laríngeo, alterações ao nível da respiração, paladar, olfato, imagem corporal, comunicação, rotinas e autoestima.
Deste modo, as consequências da LT atingem o indivíduo como um todo, exigindo atenção para a qualidade de vida inerente à mudança vocal destes pacientes.
Neste sentido a qualidade de vida é definida como uma noção pessoal da posição do indivíduo na vida, no âmbito da sua cultura e sistema de valores nos quais está inserido e em relação aos seus objetivos, expectativas, padrões e apreensões.
Este estudo teve como intuito caraterizar a qualidade de vida inerente à mudança vocal em pacientes laringectomizados totais nos aspetos físico, emocional e social das suas vidas, assim como determinar a correlação entre as duas escalas (VHI-9 e V-RQOL) e os dados sociodemográficos (idade, tempo de laringectomia e meio de comunicação atual) destes pacientes.
Participaram 28 laringectomizados da Associação Portuguesa de Limitados da Voz (APLV), assim como pacientes que frequentam terapia da fala nos seguintes hospitais: Hospital Geral de Santo António (HGSA), Instituto Português de Oncologia (IPO) do Porto e ULS-Matosinhos (Hospital Pedro Hispano (HPH)).
A avaliação destes pacientes foi caracterizada pelos protocolos Voice-Related Quality of Life (V-RQOL) e Voice Handicap Índex-9 (VHI-9), analisando e correspondendo as informações obtidas por estes instrumentos aos dados de identificação pessoal, tempo de cirurgia e tipo de voz não laríngea adotada.
Os resultados obtidos neste estudo sugerem que a média total dos fatores de ambos os questionários foi mais significativa no fator emocional e social e a correlação de Spearman’s realizada entre o total dos questionários é positiva e estatisticamente significativa (p ≤0.01).
Neste estudo, conclui-se que a qualidade de vida da voz de cada sujeito varia consoante as suas circunstâncias físicas, funcionais e sócio-emocionais, portanto é essencial a criação de programas integrados e pluridisciplinares. Apesar de a qualidade de vida ser um tema muito abrangente é imprescindível continuar a aperfeiçoar este conceito, promovendo assim a melhoria do estilo de vida destes pacientes.
Total Laryngectomy (TL) is a major surgery in patients with advanced laryngeal cancer. In short, it’s a surgical procedure that involves the removal of the glottis, supraglottis and subglottis, the extraction of all structures inserted between the base of the tongue to the second / third tracheal ring, including the hyoid bone. The upper part of the pharynx is sutured to the base of the tongue and trachea to the skin of the base of the neck, creating a permanent stoma called tracheostomy. The consequences of this lead to the loss of ability to issue the laryngeal sound, changes in breathing, taste, smell, body image, communication, routines and self-esteem. Thus, the effects of TL reach the individual as a whole, requiring attention to the inherent quality of life for these patient’s voice change. In this sense, the quality of life is defined as a personal notion of the individual's position in life, in its culture and value system in which one lives in and in relation to one’s goals, expectations, standards and concerns. This study aimed to characterize the quality of life inherent to the change in vocal aspects of total laryngectomy patients, in their physical, emotional and social lives, as well as determine the correlation between the two scales (VHI-9 and V-RQOL) and data sociodemographic (age, time since laryngectomy and atual medium) of these patients. There was the participation of 28 laryngectomized patients from the Portuguese Association of Speech Limited (CMA), as well as patients from speech therapy from the following hospitals: Hospital Geral de Santo António (HGSA), Portuguese Institute of Oncology (PIO) of Porto and Matosinhos-ULS (Hospital Pedro Hispano (HPH)). The evaluation of these patients was characterized by the protocols Voice-Related Quality of Life (V-RQOL) and Voice Handicap Index-9 (VHI-9), analyzing and responding to the obtained information by these instruments to personal identification data, time since surgery and type of non laryngeal voice adopted. The results obtained from this study suggest that the total average fator of both questionnaires was more significant in the emotional and social factors and the Spearman's correlation performed between the total of the questionnaires is positive and statistically significant (p ≤ 0.01). In this study, it can be concluded that the quality of life of the voice of each subject varies according to their physical, functional and socioemotional circumstances, so it is essential the creation of integrated and multidisciplinary programs. Although the quality of life is a very embracing theme it is essential to continue to refine this concept, thus promoting the improvement of the lifestyle of these patients.
Total Laryngectomy (TL) is a major surgery in patients with advanced laryngeal cancer. In short, it’s a surgical procedure that involves the removal of the glottis, supraglottis and subglottis, the extraction of all structures inserted between the base of the tongue to the second / third tracheal ring, including the hyoid bone. The upper part of the pharynx is sutured to the base of the tongue and trachea to the skin of the base of the neck, creating a permanent stoma called tracheostomy. The consequences of this lead to the loss of ability to issue the laryngeal sound, changes in breathing, taste, smell, body image, communication, routines and self-esteem. Thus, the effects of TL reach the individual as a whole, requiring attention to the inherent quality of life for these patient’s voice change. In this sense, the quality of life is defined as a personal notion of the individual's position in life, in its culture and value system in which one lives in and in relation to one’s goals, expectations, standards and concerns. This study aimed to characterize the quality of life inherent to the change in vocal aspects of total laryngectomy patients, in their physical, emotional and social lives, as well as determine the correlation between the two scales (VHI-9 and V-RQOL) and data sociodemographic (age, time since laryngectomy and atual medium) of these patients. There was the participation of 28 laryngectomized patients from the Portuguese Association of Speech Limited (CMA), as well as patients from speech therapy from the following hospitals: Hospital Geral de Santo António (HGSA), Portuguese Institute of Oncology (PIO) of Porto and Matosinhos-ULS (Hospital Pedro Hispano (HPH)). The evaluation of these patients was characterized by the protocols Voice-Related Quality of Life (V-RQOL) and Voice Handicap Index-9 (VHI-9), analyzing and responding to the obtained information by these instruments to personal identification data, time since surgery and type of non laryngeal voice adopted. The results obtained from this study suggest that the total average fator of both questionnaires was more significant in the emotional and social factors and the Spearman's correlation performed between the total of the questionnaires is positive and statistically significant (p ≤ 0.01). In this study, it can be concluded that the quality of life of the voice of each subject varies according to their physical, functional and socioemotional circumstances, so it is essential the creation of integrated and multidisciplinary programs. Although the quality of life is a very embracing theme it is essential to continue to refine this concept, thus promoting the improvement of the lifestyle of these patients.
Description
Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Terapêutica da Fala