title: Social withdrawal after laryngectomy.
abstract: This investigation focuses on the psychosocial concomitants of a laryngectomy. Semistructured interviews were conducted with 218 laryngectomized patients. Standardised questionnaires were used to assess patients' social activity (FPAL, EORTC QLQ-C30), intelligibility of speech (PLTT, FPAL), mental well-being (HADS), and perceived stigmatisation (FPAL). More than 40% of the patients withdrew from conversation. Only one-third of all patients regularly took part in social activities. About 87% perceived stigmatisation because of their changed voice and more than 50% felt embarrassed because of their tracheostoma. Almost one-third of the patients had increased anxiety and depression scores. Moderate objective speech intelligibility was found, though patients were not particularly satisfied with their voice. Social activity emerged to be independent from age, gender, treatment variables, and stage of disease. Multivariate analysis resulted in two independent factors representing two patterns of social withdrawal. On the one hand, there was withdrawal from conversation accompanied by increased depression and poor speech intelligibility. On the other hand, there were reduced social activities accompanied by increased anxiety and perceived stigmatisation.
authors.affiliation: Independent Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Strasse 55, 04103, Leipzig, Germany. helge.danker@medizin.uni-leipzig.de
authors.forename: Helge
authors.initials: H
authors.lastname: Danker
authors.forename: Dorit
authors.initials: D
authors.lastname: Wollbrück
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.forename: Michael
authors.initials: M
authors.lastname: Fuchs
authors.forename: Elmar
authors.initials: E
authors.lastname: Brähler
authors.forename: Alexandra
authors.initials: A
authors.lastname: Meyer
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000523:psychology*; D008297:Male; D009367:Neoplasm Staging; D012918:Social Alienation; D011795:Surveys and Questionnaires