Klaske van Sluis

ix 6 Interaction of functional and participation issues on quality of life after total laryngectomy 93 6.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 6.2 Materials and methods . . . . . . . . . . . . . . . . . . . . . . . 95 6.2.1 Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . 95 6.2.2 Statistical analysis . . . . . . . . . . . . . . . . . . . . . 95 6.2.3 Grouping of respondents . . . . . . . . . . . . . . . . . . 96 6.2.4 Grouping of questions . . . . . . . . . . . . . . . . . . . 96 6.2.5 Average number of reported experienced issues per theme 97 6.3 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 6.3.1 Respondents . . . . . . . . . . . . . . . . . . . . . . . . 99 6.3.2 r-QoL rating . . . . . . . . . . . . . . . . . . . . . . . . 99 6.3.3 Average number of reported experienced issues per theme 100 6.3.4 Correlations between r-QoL rating and themes . . . . . 100 6.4 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 6.5 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 6.6 Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . 106 6.7 Appendix A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 7 Expiratory muscle strength training in patients after total la- ryngectomy; a feasibility pilot study 113 7.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 7.2 Materials and Methods . . . . . . . . . . . . . . . . . . . . . . . 115 7.2.1 Expiratory muscle strength training and adjustment to use after total laryngectomy . . . . . . . . . . . . . . . . 115 7.2.2 Emst study training protocol . . . . . . . . . . . . . . . 116 7.2.3 Feasibility, safety, and compliance . . . . . . . . . . . . 117 7.2.4 Objective and subjective outcome measures . . . . . . . 117 7.2.5 Statistical analysis . . . . . . . . . . . . . . . . . . . . . 118 7.3 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 7.3.1 Feasibility, safety, and compliance . . . . . . . . . . . . 119 7.3.2 Objective and subjective outcome measures . . . . . . . 121 7.4 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 7.5 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 7.6 Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . 124 8 Women’s perspective on life after total laryngectomy: a quali- tative study 129 8.1 What this paper adds . . . . . . . . . . . . . . . . . . . . . . . 130 8.1.1 What is already known on the subject? . . . . . . . . . 130 8.1.2 What this paper adds to existing knowledge . . . . . . . 130 8.1.3 What are potential or actual clinical impications of this work? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 8.2 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 8.3 Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132