Navigating life after laryngectomy: a qualitative study on adjustment and distress in the first 6 months following surgery

TL;DR

This study explores how people adjust emotionally and socially in the first six months after undergoing a laryngectomy for cancer.

Contribution

The study identifies three distinct adjustment phases and highlights the need for tailored, multidisciplinary support post-surgery.

Findings

Three phases of adjustment were identified: 'Not normal life', 'Never going to be the same again', and 'Just get on with it'.

Emotional distress was moderate two weeks post-discharge but significantly reduced by six months.

Timely, personalized care is crucial to support patients through the adjustment process.

Abstract

Total laryngectomy, the surgical removal of the larynx, is a life-saving procedure for individuals with advanced laryngeal or hypopharyngeal cancer. While the physical consequences of this surgery are well documented, the psychological, emotional, and social adjustment to life post-surgery is less well understood. The aim of this study was to explore the lived experience of adjustment within the first 6 months following a laryngectomy.

A longitudinal multimethods study was undertaken at St. Vincent’s Hospital, Melbourne, Australia, involving patients scheduled for total laryngectomy between August 2018 and April 2020. Data were collected in one-to-one, in-depth, semi-structured interviews at 2 weeks post-hospital discharge and at 3 and 6 months post-surgery. Psychological distress was assessed preoperatively and prior to semi-structured interviews, using the Distress Thermometer. Interview data were analysed using inductive thematic analysis.

Four participants completed all three interviews, and a further two participants completed one interview each. Three phases of adjustment were identified: (1) Not normal life, (2) Never going to be the same again, and (3) Just get on with it. Emotional distress was moderate 2 weeks following hospital discharge but reduced significantly by 6 months post-surgery.

This study sheds new light on the lived experience of adjustment following total laryngectomy, highlighting a clear pattern of psychological, emotional, and social transition in the acute healing period. The findings underscore the importance of timely, multidisciplinary support that aligns with patients’ evolving needs. Understanding the phases of adjustment provides clinicians with a framework to proactively guide and personalise care during this vulnerable period.

Figures