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      Limits on quality of life in communication after total laryngectomy

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          Summary

          Introduction: Among people affected by cancer, the impairment of quality of life of people affected by cancer can cause have devastating effects. The self-image of patients after post-laryngectomyzed patients may be find themselves compromised, affecting the quality of life in this population.

          Objective: To characterize quality of life in related to communication in people who have undergone went total laryngectomy surgery.

          Methods: This is an observational study, with a cross-sectional and descriptive series.

          Design of series study. The sample were comprised 15 patients interviewed the period from January to February of 2011. We used the Quality Protocol for Life Communication in Post-laryngectomy adapted from Bertocello (2004); which this questionnaire contains 55 questions. The protocol was organized from the nature of using responses classified as positive and negative aspects, proposals in with respect to five 5 communication domains: family relationships, social relationships, personal analysis; morphofunctional aspect, and use of writing. To promote and guarantee the autonomy of the respondents, was examiners made use of used assistive technology with the Visual Response Scale.

          Results: The responses that total laryngectomy compromises the quality of life in communication amounted to 463 occurrences (65.7%), and that who responses suggesting good quality of life were represented with amounted to 242 occurrences (34.3%), from a total of 705 occurrencesresponses. From Among the five 5 Communication domains, four 4 had percentages of above 63% for occurrences of negative content for impact on communication. Appearance Morphofunctional appearance gave the had the highest percentage of negative content, amounting to 77.3% of cases.

          Conclusions: The results showed important limitations of a personal and social nature due to poor communication with their peers. Thus, there is a need for multidisciplinary interventions that aim to minimize the entrapment of negative impact on these people communication among these patients.

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          Most cited references26

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          The epidemiology of laryngeal cancer in Brazil

          The city of São Paulo exhibits one of the highest incidences of laryngeal cancer in world and Brazil presents remarkable occurrence, compared with other Latin American countries. Around 8,000 new cases and 3,000 deaths by laryngeal cancer occur annually in the Brazilian population. In the city of São Paulo, incidence rates for laryngeal cancer among males have been decreasing since the late 1980s while, among females, the rates have shown a stable trend. This phenomenon is probably the expression of changes in gender behavior related to tobacco smoking. Several risk factors are involved in the genesis of laryngeal cancer. The most important are tobacco smoking and alcohol intake, but occupational hazards have also been associated with the disease, such as asbestos, strong inorganic acids, cement dust and free crystalline silica. Additionally, salted meat and total fat intake have been linked to elevated risk of laryngeal cancer. Conversely, several studies have confirmed that fruits, raw leaf vegetables and legumes protect against this cancer. Some researchers have postulated a possible association between laryngeal squamous cell carcinoma and human papilloma virus (HPV), but this is not universally accepted. Gastroesophageal reflux disease is weakly, but consistently correlated with laryngeal cancer. Familial cancer clusters, particularly of head and neck tumors, seem to increase the risk of laryngeal cancer. Some genetic polymorphisms, such as of genes that code for xenobiotic-metabolizing enzymes, have shown elevated risk for laryngeal cancer according to recent studies. Public health policies regarding the control of tobacco smoking and alcohol consumption, and also surveillance of carcinogen exposure in occupational settings, could have an impact on laryngeal cancer. No proposals for screening have been recommended for laryngeal cancer, but one diagnostic goal should be to avoid treatment delay when suspected symptoms have been observed.
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            Immediate impact of primary surgery on health-related quality of life of hospitalized patients with oral and oropharyngeal cancer.

            Oral and oropharyngeal tumor resection may be associated with disfigurement and dysfunctions that affect essential domains of life. This study aimed at assessing the immediate impact of primary surgery on the health-related quality of life for these patients. Forty-seven patients with squamous cell carcinoma of the lips, oral cavity, or oropharynx, and undergoing treatment in the head and neck surgery center of a large general hospital in the city of São Paulo, Brazil, from October 2005 to September 2006, completed the University of Washington Quality of Life questionnaire pre- and postoperatively (before hospital discharge). A paired t test evaluated differences between assessments; Poisson regression estimated ratios of ratings attributed to each domain (pain, appearance, activity, recreation, swallowing, chewing, speech, shoulder pain, taste, saliva, mood, and anxiety) per patient stratified by sociodemographic, clinical, and behavioral characteristics. The immediate impact of surgery on health-related quality of life corresponded to a 31.1% reduction in the overall rating. The most affected domains were chewing (-73.5%), taste (-61.4%), swallowing (-57.3%), speech (-46.0%), and pain (-42.3%). Anxiety (+65.5%) was the sole domain that improved immediately after surgery. Comparisons involving subgroups of patients indicated that different clinical conditions (regional metastasis, tumor size, and location) were not associated with discrepant health-related quality of life immediately after surgery. The routine pre- and postoperative assessment of health-related quality of life may contribute to evaluate treatment effectiveness, which would otherwise rely exclusively on assessing end-point results such as survival and tumor relapse. This information is relevant to attenuate the prejudicial impact of surgery on the physical and psychosocial functioning of patients.
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              Qualidade de vida do laringectomizado traqueostomizado

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                Author and article information

                Journal
                Int Arch Otorhinolaryngol
                Int Arch Otorhinolaryngol
                10.1055/s-00025477
                International Archives of Otorhinolaryngology
                Thieme Publicações Ltda (Rio de Janeiro, Brazil )
                1809-9777
                1809-4864
                October 2012
                : 16
                : 4
                : 482-491
                Affiliations
                [1 ]Doctor in course in Linguistics. Federal University of Paraíba - (Assistant Professor in Speech Therapy).
                [2 ]Doctor in course in Public Health Federal University of Rio Grande do Norte - (Assistant Professor in Speech Therapy).
                [3 ]Doctor in course in Neuropsychiatry and Behavioral Sciences Federal University of Pernambuco - (Speech Therapy).
                [4 ]Master in Biometrics -Federal Rural University of Pernambuco - (Assistant Professor in Statistics).
                [5 ]Speech Therapy. Federal University of Pernambuco - (Speech Therapy).
                [6 ]Specialized Center in Speech Therapy - Redentor College - (Speech Therapy).
                [7 ]PhD in Nutrition -. Federal University of Pernambuco - (Adjunct Professor 2).
                Institution: Universidade Federal de Pernambuco. Recife / PE – Brazil.
                MCT/CNPq/CT-Saúde/MS/SCTIE/DECIT n° 67/2009 - REBRATS
                Author notes
                Address for correspondence Adriana Di Donato Universidade Federal de Pernambuco/ Departamento de Fonoaudiologia - Rua Arthur de Sá, s/n - Cidade Universitária – Recife / PE - Brazil - Zip code: 50740-520–Telephone: (+55 81) 2126-8927 adrianadidonato1@ 123456gmail.com
                Article
                160409
                10.7162/S1809-97772012000400009
                4399649
                25991977
                31c57c82-637e-41fd-a163-d073646ea1b8
                © Thieme Medical Publishers
                History
                : 24 April 2012
                : 10 August 2012
                Categories
                Article

                quality of life,laryngectomy,communication,protocols
                quality of life, laryngectomy, communication, protocols

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