Background: Total laryngectomy is the major treatment for stage III-IV laryngeal cancer, which prolongs patient's life; however, brings significant changes to physical function, mental health, and social life. As a result, patients must adopt various strategies to cope with these changes and challenges. Few studies have investigated the individual experiences of laryngectomized patients returning to home and society in China. Here we explored the living conditions and inner experiences of laryngectomized patients after discharge from the hospital, and identified the main difficulties they encountered and their coping strategies.
Methods: This study adopted a qualitative descriptive approach with a semi-structured interview. Purposive sampling helped to recruit 19 patients who had undergone total laryngectomy at a tertiary hospital. Patients were interviewed at their follow-up visits 6-12 months after discharge. The interview content was analyzed according to the Creswell steps. Similar descriptions of the patients' experiences were categorized into specific themes.
Results: Three major theme categories were extracted from the real-world experiences of patients following total laryngectomy to return to their former roles in family/social life and work-related activities: (I) impact of surgery on family life, including changes in physical function (e.g., decreased physical activities and functional impairment) and family roles (e.g., becoming a burden to the family and attempts to live as before); (II) impact of surgery on returning to society, including reduced social interaction and difficulty in social reintegration; and (III) the patients' coping styles, including negative coping (e.g., avoidance, compromise, and limited access to social resources) and positive coping (e.g., self-motivation and effective use of social resources).
Conclusions: After total laryngectomy, patients face numerous challenges, and adopt different coping styles to deal with stressful situations. Care and support from family can help them adapt to the change in role and regain confidence in life. Actively seeking social support and using social resources effectively can help patients overcome adverse psychological effects and promote self-identity. Medical staff should provide personalized social support (including information, emotional support, and belonging), and strengthen the post-discharge follow-up and continuous management to promote the functional recovery of patients.
Keywords: Total laryngectomy; coping style; life experience; qualitative research; return to home.