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'Is there something wrong with your voice?' A qualitative study of the voice concerns of people with laryngotracheal stenosis.
- Source :
- International Journal of Language & Communication Disorders; Mar2023, Vol. 58 Issue 2, p376-389, 14p, 2 Diagrams, 2 Charts
- Publication Year :
- 2023
-
Abstract
- Background: Acquired laryngotracheal stenosis (LTS) is a rare condition that causes breathlessness and dyspnoea. Patients have reconstructive airway surgery to improve their breathing difficulties, but both LTS and the surgery can cause voice difficulties. The existing evidence base for management of voice difficulties for adults with LTS focuses on symptoms. There is limited information to provide clinical guidance for speech and language therapists (SLTs) and a limited understanding of the impact of voice changes on adults with LTS. Aim: To investigate the lived experience of adults with laryngotracheal stenosis (LTS), who have had reconstructive surgery; here focussing on voice concerns with the aim of guiding clinical care for SLTs. Methods and Procedures: A phenomenological, qualitative study design was used. Focus groups and semi‐structured interviews were completed with adults living with LTS who had had reconstructive surgery. Audio recordings were transcribed and inductive thematic analysis was used by the research team to identify themes and sub‐themes. Outcomes and Results: A total of 24 participants (five focus groups and two interviews) took part in the study before thematic saturation was identified in analysis. Three main themes were identified specific to the experience of living with LTS: the Medical, Physical and Emotional journey. All participants referenced voice difficulties as they related to each of these overall themes. Sub‐themes directly related to voice included experience of surgery, information provision, staff expertise/complacency, symptoms, symptom management, identity, support networks, impact on life and living with a chronic condition. Conclusions and Implications: In this qualitative study participants have described the integral part voice difficulties play in their lived experience of LTS and reconstructive surgery. This is considered in the context of their clinical care and the need for individualised management and information provision throughout the course of their condition. The broader research literature relating to voice difficulties is explored with links made to people with LTS and recommendations made for future research into people living with LTS and dysphonia. What this paper adds: What is already known on this subject: Adults with laryngotracheal stenosis (LTS) experience voice changes as a result of their condition, and the surgeries necessary as a treatment. These changes can lead to altered pitch, vocal fatigue, loss of pitch range and loss of volume control. Although there are known psychosocial implications both to living with a chronic condition and voice difficulties there has been no research exploring this in adults with LTS, and there is minimal clinical guidance for speech and language therapists (SLTs) working with these patients. What this paper adds to existing knowledge: This research is the first study to explore the lived experience of adults with LTS who undergo reconstructive surgery, focusing on their voice concerns. This study demonstrates the multifactorial impacts of voice changes on all aspects of the lives of adults with LTS and the need for individualised information provision and clinical care to help support them. What are the potential or actual clinical implications of this work?: Adults with LTS want expert SLTs to facilitate their care and support them throughout their LTS journey alongside other support networks. They want to be carefully prepared for reconstructive surgery and given clear information about symptoms and management of their voice difficulties. This has led to the reorganisation of the care pathway at our centre, and the introduction of a patient‐led pretreatment session. [ABSTRACT FROM AUTHOR]
- Subjects :
- CHRONIC diseases & psychology
HEALTH facility employees
TRACHEAL diseases
FOCUS groups
MEDICINE information services
SOCIAL support
STENOSIS
RESEARCH methodology
SELF-evaluation
ATTITUDES of medical personnel
WORK
ATTITUDE (Psychology)
PLASTIC surgery
INTERVIEWING
SURGERY
PATIENTS
MEDICAL care
GROUP identity
EXPERIENCE
PATIENTS' attitudes
RISK assessment
QUALITATIVE research
PHENOMENOLOGY
HEALTH information services
MEDICAL protocols
LARYNGEAL diseases
RESEARCH funding
SOUND recordings
CLINICAL competence
QUALITY of life
DESCRIPTIVE statistics
HEALTH attitudes
PSYCHOSOCIAL factors
EXPERIENTIAL learning
THEMATIC analysis
DATA analysis software
PSYCHOLOGICAL adaptation
VOICE disorders
DISEASE risk factors
DISEASE complications
SYMPTOMS
ADULTS
Subjects
Details
- Language :
- English
- ISSN :
- 13682822
- Volume :
- 58
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- International Journal of Language & Communication Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 162399045
- Full Text :
- https://doi.org/10.1111/1460-6984.12794