Klaske van Sluis

132 8.3. Methods that women experience more sexual problems than their male counterparts do following total laryngectomy. Furthermore, these female laryngectomees report that there is less openness in discussing the consequences of their condition in the family [8]. It is shown that women have a lower global health status and quality of life after total laryngectomy [7]. The procedure might impact women more in social functioning than men because of the lower pitched voice and altered appearance [6]. Qualitative research can contribute in gaining insight in women-specific needs, since it highlights issues and needs from the patient’s perspective. How- ever, the number of qualitative studies into the daily impact of total laryn- gectomy is still limited [12–15]. Existing studies focus on daily functional and psychological difficulties of patients, demonstrating that they struggle with the cancer diagnosis, psychological issues (e.g. anxiety, depression), and adjusting to life after total laryngectomy. Because this body of literature predominantly features the perspective of men, little is known about experiences specific to women. Gardner (1966) first describes the impact of total laryngectomy in affected women. Their focus on proper wifely duties and attitudes is fairly outdated, although it does confirm the presence of gender-specific issues [16]. Dooks et al. (2012) present a single female participant in their qualitative study as a contrast case, since she was the most tearful and depressed [13]. Bickford et al. (2013) suggest that women after total laryngectomy have specific needs, since one of the female participants in their qualitative study indicates that she would appreciate having contact with other young female laryngectomees [12]. Several authors state that future research should address the specific issues and needs of women [6, 12, 13]. Addressing this gap in the literature, the present article aims to provide insight in the everyday impact of total laryngectomy on women, while examin- ing their specific rehabilitation needs. This study uses a qualitative approach to investigate women’s experiences following total laryngectomy, with a special focus on the period surrounding the procedure and long-term functional and psychosocial outcomes. 8.3 Methods This article is based on a qualitative descriptive study focusing on women’s ex- periences following total laryngectomy. Interpretative phenomenological anal- ysis as a qualitative approach is used in order to explore and understand the experience of a particular phenomenon, in this case experiences of women living with total laryngectomy. Braun et al.’s method for thematic analysis was used as a guideline to structure the analysis process [17]. After obtaining ethical approval, possible participants were selected from The Netherlands Cancer institute Antoni van Leeuwenhoek. Inclusion criteria were: female; the total laryngectomy was at least one year ago; and they did not have recurrent disease. There were 32 possible candidates. A maximum