Klaske van Sluis

Life after total laryngectomy 131 8.1.3 What are potential or actual clinical impications of this work? To adequately prepare female patients undergoing total laryngectomy, they should receive counselling on the impact of the procedure on their everyday life. A gender- and age-matched laryngectomized patient visitor can contribute to this process. The provided counselling and support should involve the patient’s partner so that the impact of the surgery on the relationship and family-roles can be discussed. This will allow these females to form realistic expectations, prepare them for the changes they will face, and help them re-integrate into their former roles in family life, social life, and working towards work-related activities. 8.2 Introduction Total laryngectomy has major consequences for essential physical functions in- cluding airway, swallowing, and speech. With the removal of the larynx, the natural voice is lost and patients have to rehabilitate speech, often with help of a voice prosthesis [1]. In addition, patients also have a changed appearance due to the creation of a permanent tracheostoma. The physical alterations lead to ongoing functional issues including reduced physical fitness, problems with food intake, frequent coughing, and communication problems. As a result, patients may be confronted with psychosocial issues [2, 3]. Since survival and compli- cation rates improved over the last decades, scholarly attention has shifted towards providing patients with optimal supportive care [1, 4, 5]. As we move in the direction of health models driven by patient-centred care, understand- ing the differential impacts of surgical procedures on subgroups of our patients is important to help improve our care models, patient education and support systems. Since the majority of patients undergoing this surgery is male, studies into total laryngectomy are typically male-dominated. However, the proportion of female laryngectomees is rising; therefore, research should explore possible woman-specific needs and issues in laryngectomees. Quantitative studies investigating gender-specific issues after total laryn- gectomy show that women might be at risk for a lower global health status, experience a greater impact on their relationship, and have more stigma-related problems [6–9]. Graham and Palmer (2002) show that their studied group of female laryngectomees were younger at time of surgery, were more likely to be working, more often had no partner, had a lower income, had more post- operative physical complaints, and relied more often on support from family and friends instead of support groups compared to their male counterparts [10]. Women run a greater risk of a negative impact of total laryngectomy on their relationship than men after total laryngectomy [8]. Sexual problems and problems with intimacy after total laryngectomy are present in both male and female laryngectomees [8, 11]. The study of Offerman et al. (2015) demonstrates