title: [Assessment of degree of psychological health involvement in pre-laryngectomized patients].
abstract: OBJECTIVE
  Several authors have found increased anxiety in patients the day before an intervention and its correlation with anxiety levels the post-operative period. In this study, we determined a number of problems to which patients who underwent total laryngectomy often objected: the tracheostomy, being left without a voice and it being an aggressive, major surgery. Our objective was to assess the degree of anxiety and fears of the patient prior to total laryngectomy.
  
  
  METHODS
  We compared 2 groups of 20 patients who underwent operation for total laryngectomy and for other ENT pathologies. On the day before the operation, we collected demographic and medical data and administered the Spanish versions of the Folstein Mini-Mental State Examination (MMSE) and the Goldberg General Health Questionnaire (GHQ-28). We also investigated whether the patients had any fear or fear of surgery and what that fear was.
  
  
  RESULTS
  Completion of the MMSE revealed cognitive impairment in only one patient. We subsequently conducted the GHQ-28 and found psychological distress in 20-25% of our cases. When the different fears in both groups were compared by X(2), the results were not statistically significant.
  
  
  CONCLUSIONS
  Total laryngectomy causes the loss of oral communication and impairs self-image, contributing to a strong emotional reaction. It is essential to have effective rehabilitation, which considers all aspects of health-sickness, such as the recovery of spoken language, social aspects and the psychological characteristics, vital for proper comprehensive patient management.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España. Raquelartal@Hotmail.com
authors.forename: Raquel
authors.initials: R
authors.lastname: Artal Sánchez
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Alfonso Collado
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Sebastián
authors.forename: Alfredo
authors.initials: A
authors.lastname: Bondía
authors.forename: Héctor
authors.initials: H
authors.lastname: Vallés
mesh_terms: D000368:Aged; D059031:Anticipation, Psychological; D001007:Anxiety / Q000175:diagnosis* / Q000209:etiology; D001044:Aphonia / Q000209:etiology / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D059026:Diagnostic Self Evaluation; D004644:Emotions; D005239:Fear; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000523:psychology; D007825:Laryngectomy / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000523:psychology; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care; D012649:Self Concept; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014140:Tracheotomy / Q000523:psychology