Coping strategies in laryngectomy patients

BACKGROUND: Over the last few years, paradigms for judging the results of treatment of tumor patients have shifted. In addition to characteristics such as the complete excision of the tumor and the duration of patient survival, restoring the quality of life has become an equally important aim. There is still a lack of systematic (and sufficient) research on coping strategies as a means of dealing with malignant tumors of the head and neck. PATIENTS AND METHOD: In a cross-sectional study, 25 laryngectomees, whose voices had been successfully restored with a Provox voice prosthesis,were examined for their coping strategies and the effects of the illness on their lives. The standardized Trier Scales of Coping Strategies and a custom-made questionnaire, which helped to structure the anamnesis of disease specific functional restrictions and the state of rehabilitation, were used as the means of inquiry. RESULTS: A high percentage of patients were content despite objective and subjective restrictions.Voice replacement was mainly experienced as unproblematic,with psychosocial restraints more commonly being felt in connection with pain and difficulties ingesting food. A correlation between the patients' evaluation of physical,psychological and social experiences and the coping strategies applied could not be verified. The way laryngectomees deal with their illness does not differ from the strategies of patients suffering from malignant or chronic diseases of other organ systems. CONCLUSION: The Trier Scales of Coping Strategies is a suitable means for determining the coping strategies of laryngectomees who have been successfully rehabilitated with the help of voice prostheses.The patients examined here did not apply different coping strategies from groups of patients with other severe illnesses. Obviously, the limitations on communication do not constitute a determining factor in coping with the disease. This finding is useful when planning psychological and social rehabilitation, e.g. by psychosomatic interventions.