The laryngectomy patient's need for support groups in a hospital setting : a social work perspective

[摘要] A laryngectomy is mostly indicated as treatment for an advanced stage of cancer ofthe larynx, during which the patient's voice box is removed. This operation can holdmajor psycho-social implications for the patient and family. To cope with thechallenges in daily life, patients need social support. A lack of available literatureand research regarding the role of the social worker in facilitating support groups forthese patients and families was identified and motivated this research study.The goal of the study was to gain a better understanding of the laryngectomypatient's need for support groups in a hospital setting when attending the follow-upclinic at the hospital. A combination of both the exploratory and descriptive researchdesigns together with a combination of mainly a qualitative and to a certain extentthe quantitative research approaches, was used. From this, knowledge, insight andan understanding of the need for support groups in a hospital setting from a socialwork perspective were obtained. Permission to conduct the proposed study wasgranted by the Committee for Human Research at the University of Stellenbosch.The literature study first focused on medical aspects of a laryngectomy and socialwork intervention services within a hospital setting as part of the multi-disciplinaryapproach. Second, psycho-social effects of a laryngectomy from an ecologicalperspective were discussed, referring to the physical, social and psychologicaleffects of surgery upon the patient and family. Third, support and aftercare werediscussed with specific reference to the role of the social worker in offering socialsupport to the patient and family.For the empirical study, twenty laryngectomy patients from the service area ofTygerberg Hospital were involved from January 2008 to May 2008. Criteria forinclusion in the study referred to patients who had their operation not less than threemonths previously, attended the support group during follow-up visits at the hospitaland who had successfully acquired tragea-oesophageal speech. Based on theliterature review, a semi-structured questionnaire and face-to-face interview wereused as research instruments to overcome the limitation of illiteracy.The results of the investigation mainly confirmed the findings of the literature studynamely that laryngectomy patients can benefit from support groups in order toaddress their need for social support in dealing with daily life challenges. Patientsindicated that they mainly needed information regarding post-operative adaptation asthis was where problems were mostly experienced. The majority of patientssuggested the use of support groups in this regard. Focus was placed on anexploration and description of patients' needs for such support groups. Benefits ofsupport groups were found to be totally compatible with the role of the social worker.The results therefore gave an indication of social work intervention services andreferred to: provision of information, problem-solving, offer of social and emotionalsupport, and promotion of rehabilitation opportunities, thereby improving the patient'squality of life.Recommendations were aimed at social work intervention services relating tosupport and aftercare offered to laryngectomy patients and relatives. Futureresearch to develop social work programmes for health care professionals in orderto effectively support these patients and their families was proposed. From practicalexperience of support groups a study regarding the role of pre- and primaryschoolchildren or grandchildren in the rehabilitation of laryngectomy patients wasalso suggested.

[发布机构] Stellenbosch University