Klaske van Sluis

130 8.1. What this paper adds interview data were analysed by the method of Thematic Analysis, taking in- terpretative phenomenological analysis as a lead. Outcomes & Results: The interviews revealed three main themes: disease and treatment as a turning point, re-establishing meaningful everyday activi- ties, and persistent vulnerability. Participants reported experiencing challenges in their rehabilitation process due to physical disabilities, dependency on oth- ers and experienced stigma. Women-specific challenges arose in dealing with the altered appearance and voice, performing care activities, and the spousal relationship (including intimacy). Conclusions & Implications: Women who undergo total laryngectomy are likely to experience issues in returning to work, the performance of informal care work, the spousal relationship, intimacy, and social interaction due to stigmati- zation. Medical pre-treatment counselling and multidisciplinary rehabilitation programs should help patients form realistic expectations and prepare them for the changes they will face. A gender- and age-matched laryngectomized patient visitor can contribute to this process. Rehabilitation programs should incorporate the partner and offer psychosocial support for women following to- tal laryngectomy to return to their former roles in family life, social life and work-related activities. 8.1 What this paper adds 8.1.1 What is already known on the subject? Total laryngectomy is a major surgery, which has a significant impact on af- fected individuals’ quality of life. Patients are confronted with long term con- sequences including communication problems, altered breathing, swallowing issues, changed appearance, and psychosocial issues. The current, limited body of qualitative literature on the impact of total laryngectomy predominantly features the perspective of men. As a result, little is known about experiences specific to women. 8.1.2 What this paper adds to existing knowledge Using a qualitative approach, this paper shows that women after total laryn- gectomy experience problems in returning to work, the performance of informal care work, the spousal relationship, and spousal intimacy. Women dislike their new voice and experience stigma due to their unusual voice and appearance. This study demonstrates the value of peer support in pre-treatment counselling and rehabilitation, especially with gender-matched and age-matched individu- als.