title: Pre-operative counselling for laryngectomy patients: a systematic review.
abstract: OBJECTIVE
  This study aimed to undertake a systematic review of the literature about pre-operative counselling for laryngectomy patients, identify its practice and patient and (where possible) carer perceptions.
  
  
  METHODS
  A search strategy was formulated using a concept map and a Population, Intervention, Comparative Interaction and Outcomes ('PICO') schema. All publications from 1975 to 2015 reporting pre-operative counselling of laryngectomy patients were included. Papers were retrieved and critiqued, and those included were assigned a level of evidence (according to the Joanna Briggs Institute schema).
  
  
  RESULTS
  Of the 56 papers retrieved, 21 were included in the review. The literature is limited: studies demonstrate bias and are of poor methodological quality. There are clear, persistent reports by patients and carers of shortfalls in clinical practice.
  
  
  CONCLUSIONS
  Studies on pre-operative counselling for laryngectomees are flawed in design and represent weak levels of evidence. Pre-operative counselling has not been operationalised, resulting in differing paradigms being examined. Aggregation of data and/or results is not possible and the veracity of many studies is questioned.
authors.affiliation: Department of Clinical Therapies,University of Limerick,Ireland.
authors.forename: E
authors.initials: E
authors.lastname: Fitzgerald
authors.affiliation: Faculty of Education and Health Sciences,University of Limerick,Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Perry
mesh_terms: D003376:Counseling / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007825:Laryngectomy / Q000379:methods*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011300:Preoperative Care / Q000379:methods
keywords: Counseling; Head and Neck Neoplasms; Information Services; Laryngectomy