Evaluation of the Efficacy of a Care Model that Assists Patients with Aphonia Resulting from Total Laryngectomy to Master the Esophageal Speech Method

Abstract

Abstract

The aim of this study was to evaluate the efficacy of a care model that assists patients with aphonia resulting from total laryngectomy to master the esophageal speech method. A study using a pretest-posttest design with a nonequivalent control group was performed to compare two groups：a group of 10 patients who were treated under an applicable care model following approximately one week of esophageal speech therapy（application group）, and another group of 12 patients who were not treated under the same care model（non-application group）. In the application group, a survey about “therapy-related stress and coping”, “self-practice situation”, “number of vocalizations”, “psychological factors”, and “psychological adaptation state” were conducted after approximately one week of speech therapy and again after one month of care model application. Data were also collected in the same way from the non-application group without the application of the care model. Statistical analysis using the t test, the paired t test, and repeated measures analysis of variance found an interaction effect between “number of vocalizations” and the intervention as well as the timing of the survey. This is likely because patients in the application group performed an imagery technique and a muscle relaxation method to relax the neck and shoulders, making it easier to inject air into the esophagus and to generate voice. Patients also practiced speech at home after mastering an individualized self-practice technique through conversations with a researcher about the therapy. This likely also improved the “number of vocalizations”. The survey timing had a main effect on “practice frequency”, “self-practice duration”, and “mutually supportive coping”, suggesting that continuation of therapy at the esophageal speech training center contributed to the results.