台灣無喉者復聲復健及生活品質之滿意度調查

The Satisfaction in Speech Rehabilitation and Quality of Life Following Laryngectomy in Taiwan

蔡東龍(Tung-Lung Tsai) ； 朱本元(Pen-Yuan Chu) ； 張學逸(Shyue-Yih Chang)

《中華民國耳鼻喉科醫學雜誌》 37卷3期 (2002/03) Pp. 169-175

https://doi.org/10.6286/2002.37.3.169

摘要

背景：癌症治療的目標，在於提高疾病的治癒率，並且要提昇病患的生活品質。本研究以問卷調查的方式，探討台灣無喉者在復健方面的滿意度和生活的現況，以作為目前全喉切除患者復健治療的參考。
方法：以中華民國無喉者復聲協會之會員為對象，進行問卷調查。於2000年4月會員大會期間於會場進行問卷調查，並且請北中南無喉訓練班之負責人將部分問卷帶回協助調查，所回收之問卷資料以 SPSS 10.0軟體進行整理以及敘述性統計的運算。
結果：共回收108份問卷。對於全喉切除後的狀況，94%的受訪者覺得可以接受。呼吸狀況：73.6%覺得呼吸很暢通；吞嚥狀況：66.7%覺得沒有困難，22.6%覺得有點困難但可以吃固體食物；術後復聲方式：氣動式助講器48.1%；食道語22.2%；電子式助講器9.3%；採用理由：容易學習42.7%，協會推薦21.4%，醫師推薦11.7%。復聲復健所花的時間（中位數）：開始學習復聲的時間為手術後30天；發音講話的時間為手術後60天，流利講話的時間為術後75天。復聲清晰度滿意程度約達76.8%，復聲方式方便程度的滿意度約為56.5%。對教導發音的老師滿意度約為57.4%，病友對復聲學習的幫助程度約為62.9%。受訪者認為最理想的無喉復聲方法：48名（44.4%）沒有回答，38名（35.2%）認為是食道語。
結論：由於手術技術的進步，全喉切除手術後的病患在呼吸和吞嚥方面的品質都達到一定的水準，而無喉者復聲協會在復聲復健和心理支持方面具有一定的功能。建議各位喉頭頸科專家多利用無喉者復聲協會所提供的復聲復健師資以及病友互助的環境，進一步促進無喉者的身心復健，以提昇生活品質。

關鍵字

全喉切除術 ； 人工助講器 ； 生活品質

並列摘要

BACKGROUND: The foundations of cancer therapy are shifting from merely increasing survival to promoting quality of life. Using questionnaires, we investigated the quality of life of patients who had undergone laryngectomies in Taiwan, addressing satisfaction with rehabilitation, as well communication, breathing and swallowing.
METHODS: Questionnaires enquiring about satisfaction with rehabilitation programs, as well as the ability to communicate, breath and swallow were sent to members of The Taiwan Laryngectomees' Association. Most of questionnaires were collected in April 2000 during the period of their annual meeting. The data were processed using SPSS 10.0 software for descriptive statistics.
RESULTS: Of the 108 members that replied, the majority (94%) considered their current condition to be acceptable. The mean age of respondents was 68.6 years. The average time since surgery was 14.5 years. In total, 73.6% felt that they had no breathing problems and 66.7% felt that they had no swallowing disorders. A pneumatic artificial larynx was used by 48.1%, esophageal speech was used by 22.2% and 9.3% used an artificial electrical larynx. The median time taken to speak fluently was around 75 days following surgery. Speech was felt to be easily discriminated by others in 76.8% of respondents. Communication methods were felt to be convenient by 56.5% of respondents. Some 62.9% of respondents felt that other laryngectomees had helped in their rehabilitation. Esophageal speech was considered to be the ideal method of alaryngeal speech by 38 (35.2%) respondents.
CONCLUSIONS: Thanks to advances in surgical technique, breathing and swallowing after total laryngectomy were satisfactory. We recommend that patients undergoing a total laryngectomy join the Association of Laryngectomees in Taiwan as early as possible after surgery so that they can obtain help with not only speech rehabilitation, but also psychosocial rehabilitation.

並列關鍵字

laryngectomy ； artifical larynx ； quality of life