[Assessment of degree of psychological health involvement in pre-laryngectomized patients]

Abstract

Introduction and objective: Several authors have found increased anxiety in patients the day before an intervention and its correlation with anxiety levels the post-operative period. In this study, we determined a number of problems to which patients who underwent total laryngectomy often objected: the tracheostomy, being left without a voice and it being an aggressive, major surgery. Our objective was to assess the degree of anxiety and fears of the patient prior to total laryngectomy.

Material and methods: We compared 2 groups of 20 patients who underwent operation for total laryngectomy and for other ENT pathologies. On the day before the operation, we collected demographic and medical data and administered the Spanish versions of the Folstein Mini-Mental State Examination (MMSE) and the Goldberg General Health Questionnaire (GHQ-28). We also investigated whether the patients had any fear or fear of surgery and what that fear was.

Results: Completion of the MMSE revealed cognitive impairment in only one patient. We subsequently conducted the GHQ-28 and found psychological distress in 20-25% of our cases. When the different fears in both groups were compared by X(2), the results were not statistically significant.

Conclusions: Total laryngectomy causes the loss of oral communication and impairs self-image, contributing to a strong emotional reaction. It is essential to have effective rehabilitation, which considers all aspects of health-sickness, such as the recovery of spoken language, social aspects and the psychological characteristics, vital for proper comprehensive patient management.