Uticaj vokalne rehabilitacije na kvalitet života laringektomiranih pacijenata

Abstract

Uvod: Karcinom larinksa je jedan od najčešćih malignih tumora glave i vrata, koji dovodi do promene normalnih anatomskih odnosa u vratu, što izaziva poremećaj komunikacije i promenu psihosocijalnog statusa pacijenta. Totalna laringektomija pacijenta izlaže velikom psihičkom stresu i narušava njegov Kvalitet života u domenu fizičkog, emocionalnog i funkcionalnog aspekta.Cilj rada je: Utvrditi uticaj vokalne rehabilitacije na poboljšanje Kvaliteta života pacijenata nakon totalne laringektomije.Materijal i metode: U studiju je uključeno 50 pacijenata posle totalne laringektomije. Istraživanje je sprovedeno u JZU Bolnica ,,Sveti Vračevi‖ u Bijeljini i Vojnomedicinskoj akademiji u Beogradu od aprila 2014. godine do novembra 2015. godine. Sprovedena je subjektivna procena glasa i govora pomoću dva instrumenta Likertovog tipa, Indeks glasovnog oštećenja (Voice Handicap Index — VHI) i Kvalitet života pacijenata sa karcinomom glave i vrata, Univerzitet u Mičigenu (University of Michigan Quality of Life Instrument —HNQOL). Istaživanje je sprovedeno u dva navrata. Pacijenti su upitnike popunjavali prvi put kada su se javili u logopedsku ambulantu, pre vokalne rehabilitacije i drugi put po završetku vokalne rehabilitacije.Rezultati: Inedksom glasovnog oštećenja (Voice Handicap Index — VHI) pre vokalne rehabilitacije svi ispitanici (100%) pripadali su po kategoriji grupe teškoj govornoj hendikepiranosti...

Introduction: Laryngeal carcinoma is the most common malignant tumors of the head and neck, which leads to changes in the normal anatomical relationships in the neck, causing a disorder of communication and changing social status of the patient. Total laryngectomy patients exposed to high psychological stress and impairs their Quality of life in the domain of physical, emotional and functional aspects.Objectives: To determine the influence of vocal rehabilitation on improving the quality of life of patients after total laryngectomy.Material and Methods: The study included 50 patients after total laryngectomy. The survey was conducted in the Public Health Hospital ―St Vračevi‖ in Bijeljina and the Military Medical Academy in Belgrade from April 2014 to November 2015. We performed a subjective assessment of speech and voice using two Likert type instrument, Voice Handicap Index (VHI) и University of Michigan Quality of Life Instrument (HNQOL). The research was conducted on two occasions. Patients filled out questionnaires for the first time when they were announced in the speech therapy clinic, pre vocal rehabilitation for the second time after the completion of vocal rehabilitation.Results: Voice Handicap Index (VHI) scale before vocal rehabilitation of all respondents (100%) belonged to the group by category difficult speech disability. The t-test for paired samples, there was a change in the results before and after vocal rehabilitation VHI subscales, and to change the results of the total score scale. Statistically significant improvements recently occurred in all subscales...