Cognitive Appraisal of Patients before Total Laryngectomy

Abstract

Abstract

This study examines the cognitive appraisal of patients who have decided to undergo total laryngectomy, conducted immediately before the operation. Data were collected from 5 patients who had been hospitalized for total laryngectomy, using the methods of participant-observer study and semi-structured interview. The collected data were analyzed in the following process: 1) The cognitive appraisal for each patient was summarized in concise sentences, 2) For each patient, sentences of similar context were grouped and each group was given a name, 3) The four groups common to all patients were selected: “realization that the surgery is unavoidable”, “sense that the surgery is unacceptable”, “hope that surgery is the best option” and “determination that life will be meaningful after the surgery”. The results show that patients tend to recognize that the operation is the best option and that they try to face it despite feeling unwilling to become aphonic because of laryngeal cancer. Regarding nursing, the results reveal the necessity of understanding ambivalence in patients, that they feel the surgery is unacceptable despite agreeing to it.