Other Titles

Changes in Psychological Adjustment Among Laryngectomized Patients Through Nursing Intervention Care: Randomized Controlled Trial [Poster Title]

Abstract

Purpose: The purpose of this study was to examine changes in psychological adjustment among laryngectomized patients through nursing interventions and to verify the effectiveness of these interventions.

Methods: Of the 76 hospitalized laryngectomy patients who received the study explanation and provided consent, 74 were included. The intervention involved providing information through interviews and a guidebook. The study method involved conducting follow-up surveys at preoperative, pre-discharge, and three months, six months, and one year post-discharge to examine the temporal changes in psychological adjustment. This study used the Nottingham Psychological Adjustment Scale for laryngectomized patients. The higher the subscale score, the greater the psychological adjustment. For anxiety and depression, a higher score indicates less anxiety/depression. Basic attributes surveyed included age, gender, and employment status. The longitudinal changes in psychological adjustment were analyzed using repeated measures analysis of variance. Ethical considerations included obtaining approval from each hospital’s medical ethics review committee.

Results: The mean age was 69.9 years and 70.4 years in the nursing intervention (N=38) and control (N=36) groups, respectively. No significant changes were observed in any of the seven psychological adjustment items. Self-efficacy showed a tendency to be higher in the intervention group (66.9) than in the control group (55.1) at three months post-discharge. Anxiety and depression tended to be higher in the control group (70.6) than in the intervention group (62.2) before surgery. However, this reversed three months after discharge, with the intervention group (76.4) tending to be higher than the 71.3 control group.

Conclusion: The self-efficacy of the latent variable “Recognition of oneself as a voluntary agent,” increased in the intervention group three months after discharge. This suggests that nursing intervention enhanced the sense of “I might be able to do something.” Furthermore, since acceptance of disability remained stable, it was suggested that individuals cannot reach acceptance unless they can engage in actively positive actions. The tendency for anxiety and depression to begin decreasing in the intervention group starting three months after discharge may be attributed to the nursing intervention providing opportunities for social interaction, such as dialogue with others (human support), yielding positive effects.

Notes

References:

Ando F. (2005). Psychological and social factors of being housebound (Tojikomori) and its measure, Rehabilitation for Disuse Syndrome. Rehabilitation Medicine, 42(10): 684-690.

Armstrong E., Isman, K., Dooley P., Brine D., Riley N., Dentice R., Khanbhai F. (2001). An investigation into the quality of life of individuals after laryngectomy. Head & Neck, 23(1): 16-24. doi: 10.1002/1097-0347(200101)23:1<16::aid-hed3>3.0.co;2-4

Birkhaug E.J., Aarstad H.J., Aarstad A.K., Olofsson J..(2002). Relation between mood, social support and the quality of life in patients with larngectomees. Eur. Arch. Otorhinolaryngol. 259 (4): 197-204.

Kotake K., Suzukamo Y., Kai I., Sato M., Imatome S.(2006). Importance of Formal Support for the Patients after Laryngectomy—An Analysis of Participants in Self Help Groups , J. Jpn. Acad. Nurs. Sci. 26 (4): 46-54.

Kotake, K., Suzukamo, Y., Kai, I., Iwanaga, K., & Takahashi, A. Social support and substitute voice acquisition on psychological adjustment among patients after laryngectomy. Eur Arch Otorhinolaryngol, 2017; 274(3), 1557-1565. doi:10.1007/s00405-016-4310-0.

Kotake K, Kai I, Iwanaga K, Suzukamo Y, Takahashi A (2019). Effects of occupational status on social adjustment after laryngectomy in patients with laryngeal and hypopharyngeal cancer, Eur Arch Otorhinolaryngol. , May, 276 (5), 1439-1446, doi: 10.1007/s00405-019-05378-9.

Description

The purpose of this study was to examine changes in psychological adjustment among laryngectomized patients through continuous nursing interventions care and to verify the effectiveness of these interventions.

The observed variable “self-efficacy” of the latent variable “Recognition of oneself as a voluntary agent,” increased in the intervention group three months after discharge. This suggests that nursing intervention enhanced the sense of “I might be able to do something.”

Author Details

Kumiko Kotake, PhD; Kaori Haba, MSN; Mami Kurita, PhD; Ichiro Ota, PhD; Kazuyo Iwanaga, PhD; Yoshimi Suzukamo, PhD; Ichiro Kai, MD; Aya Takahashi, Master's degree;  Yoko Ishibashi, Master's degree; Yoriko Hara; Hirokazu Uemura, PhD

Sigma Membership

Tau Nu

Type

Poster

Format Type

Text-based Document

Study Design/Type

Randomized Controlled Trial

Research Approach

Quantitative Research

Keywords:

Primary Care, Long-Term Health Care, Sub-Acute Care, Laryngectomees, Laryngectomy, Psychological Adjustment, Psychological Adaptation, Nursing Interventions

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-12

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Changes in Psychological Adjustment Among Laryngectomized Patients Through Nursing Intervention: RCT

Toronto, Ontario, Canada

Purpose: The purpose of this study was to examine changes in psychological adjustment among laryngectomized patients through nursing interventions and to verify the effectiveness of these interventions.

Methods: Of the 76 hospitalized laryngectomy patients who received the study explanation and provided consent, 74 were included. The intervention involved providing information through interviews and a guidebook. The study method involved conducting follow-up surveys at preoperative, pre-discharge, and three months, six months, and one year post-discharge to examine the temporal changes in psychological adjustment. This study used the Nottingham Psychological Adjustment Scale for laryngectomized patients. The higher the subscale score, the greater the psychological adjustment. For anxiety and depression, a higher score indicates less anxiety/depression. Basic attributes surveyed included age, gender, and employment status. The longitudinal changes in psychological adjustment were analyzed using repeated measures analysis of variance. Ethical considerations included obtaining approval from each hospital’s medical ethics review committee.

Results: The mean age was 69.9 years and 70.4 years in the nursing intervention (N=38) and control (N=36) groups, respectively. No significant changes were observed in any of the seven psychological adjustment items. Self-efficacy showed a tendency to be higher in the intervention group (66.9) than in the control group (55.1) at three months post-discharge. Anxiety and depression tended to be higher in the control group (70.6) than in the intervention group (62.2) before surgery. However, this reversed three months after discharge, with the intervention group (76.4) tending to be higher than the 71.3 control group.

Conclusion: The self-efficacy of the latent variable “Recognition of oneself as a voluntary agent,” increased in the intervention group three months after discharge. This suggests that nursing intervention enhanced the sense of “I might be able to do something.” Furthermore, since acceptance of disability remained stable, it was suggested that individuals cannot reach acceptance unless they can engage in actively positive actions. The tendency for anxiety and depression to begin decreasing in the intervention group starting three months after discharge may be attributed to the nursing intervention providing opportunities for social interaction, such as dialogue with others (human support), yielding positive effects.