Psychosocial Implications of Patients with Tracheostomy - a Suggestive Example of Interdisciplinarity
Keywords:tracheostomy care, psychological impairment, psychotherapy, multidisciplinary team
Performed urgently or out of necessity, tracheostomy is one of the most traumatic surgeries that seriously affects the patient's quality of life. It has a profound impact on the ability to communicate and on self-esteem, so that the patient can experience a storm of emotions and major changes that can affect their existence.
The patient with tracheostomy is a special patient with special needs. The care of such a patient involves a constant multidisciplinary effort supported by specialists in many fields: ENT specialists, oncologists, radiotherapists, anesthetists, neurosurgeons, general surgeons, physiotherapists, speech therapists, nutritionists especially psychotherapists.
Tracheostomy affects the basic needs of the individual: communication, nutrition, sexuality, social relationships.
Numerous studies show that patients with tracheostomy show a high level of psychological distress. Depression, anxiety, low self-esteem, frustration, alienation, isolation, tendency to suicide are the negative consequences of this mutilating surgery.
Perceived as a permanent disability, tracheostomy requires special care from a psychological point of view.
Sometimes, however, it is observed that both patients and their families are not sufficiently informed about the management of tracheostomy. Due to lack of means or staff, not enough emphasis is placed on preoperative training so that the patient fully understands both the benefits and the disadvantages of this surgical technique. Therefore, often the patient's family, which later assumes the role of caregivers of the tracheotomized, perceives it as a burden, excessive fatigue, helplessness, abandonment from society.
This paper aims to highlight the importance of pre- and postoperative psychological training of both the patient and his family and to demonstrate that tracheostomy care can be one of the most suggestive examples of interdisciplinarity that seeks to provide effective solutions in this regard.
Billington, J., & Luckett, A. (2019). Care of the critically ill patient with a tracheostomy. Nursing Standard, 34(2), 59–65. https://doi.org/10.7748/ns.2019.e11297
Bolos, A., Ciubara, A. M., Chirita, R. (2012). Moral and ethical aspects of the relantionship between depression and suicide. Revista Romana de Bioetica, 10(3),71-79.
Bonvento, B., Wallace, S., Lynch, J., Coe, B., & McGrath, B. A. (2017). Role of the multidisciplinary team in the care of the tracheostomy patient. Journal of Multidisciplinary Healthcare, 10, 391–398. https://doi.org/10.2147/JMDH.S118419
Călărașu, R., Dimitriu, T., & Safta, D. (2013). Îndrumar pentru examenul de specialitatea ORL și chirurgie cervico-facială [Guide for the ENT and cervico-facial surgery exam]. https://www.scribd.com/document/370247815/Indrumar-Pt-Examenul-Practic-in-Specialitatea-ORL-Si-Chirurgie-Cervico-Faciala-1
Curis, C., Ciubară, A. B., Nechita, A., Nechita, L., Kantor, C., & Moroianu, L. A. (2018). The role of the motivational interview in treatment. Revista Medico-Chirurgicală a Societății de Medici și Naturaliști, 122(2), 375–380. https://www.revmedchir.ro/index.php/revmedchir/article/view/1172
Freeman-Sanderson, A. L., Togher, L., Elkins, M., & Kenny, B. (2018). Quality of life improves for tracheostomy patients with return of voice: A mixed methods evaluation of the patient experience across the care continuum. Intensive and Critical Care Nursing, 46, 10–16. https://doi.org/10.1016/j.iccn.2018.02.004
Gosak, M., Gradišar, K., Rotovnik Kozjek, N., & Strojan, P. (2020). Psychological distress and nutritional status in head and neck cancer patients: a pilot study. European Archives of Oto-Rhino-Laryngology, 277(4), 1211–1217. https://doi.org/10.1007/s00405-020-05798-y
Ichikura, K., Nakayama, N., Matsuoka, S., Ariizumi, Y., Sumi, T., Sugimoto, T., Fukase, Y., Murayama, N., Tagaya, H., Asakage, T., & Matsushima, E. (2020). Efficacy of stress management program for depressive patients with advanced head and neck cancer: A single-center pilot study. International Journal of Clinical and Health Psychology, 20(3), 213–221. https://doi.org/10.1016/j.ijchp.2020.06.003
Paduraru, I. M., Vollmer, J., Diana, P., Bogdan, C. A., Hozan, C. T., Firescu, D., & Ciubara, A. (2019). Anxiety and depression in patients with cancer. A case report. BRAIN. Broad Research in Artificial Intelligence and Neuroscience, 10(3), 55-59.
Melissant, H. C., Jansen, F., Schutte, L. E. R., Lissenberg-Witte, B. I., Buter, J., Leemans, C. R., Sprangers, M. A., Vergeer, M. R., Laan, E. T. M., & Verdonck-de Leeuw, I. M. (2018). The course of sexual interest and enjoyment in head and neck cancer patients treated with primary (chemo)radiotherapy. Oral Oncology, 83, 120–126. https://doi.org/10.1016/j.oraloncology.2018.06.016
Mirea, L., Ungureanu, R., Mirea, D., Țigliș, M., Grințescu, I. C., Neagu, P. T., & Grințescu, I. M. (2017). The timing of tracheostomy in critically ill patient. ORL.Ro, 2(35), 20. https://doi.org/10.26416/orl.35.2.2017.794
Nakarada-Kordic, I., Patterson, N., Wrapson, J., & Reay, S. D. (2018). A systematic review of patient and caregiver experiences with a tracheostomy. Patient, 11(2), pp. 175–191. https://doi.org/10.1007/s40271-017-0277-1
Osazuwa‐Peters, N., Simpson, M. C., Zhao, L., Boakye, E. A., Olomukoro, S. I., Deshields, T., Loux, T. M., Varvares, M. A., & Schootman, M. (2018). Suicide risk among cancer survivors: Head and neck versus other cancers. Cancer, 124(20), 4072–4079. https://doi.org/10.1002/cncr.31675
Rovira, A., Dawson, D., Walker, A., Tornari, C., Dinham, A., Foden, N., Surda, P., Archer, S., Lonsdale, D., Ball, J., Ofo, E., Karagama, Y., Odutoye, T., Little, S., Simo, R., & Arora, A. (2021). Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline. European Archives of Oto-Rhino-Laryngology, 278(2), 313–321. https://doi.org/10.1007/s00405-020-06126-0
Schorn, L., Lommen, J., Sproll, C., Krüskemper, G., Handschel, J., Nitschke, J., Prokein, B., Gellrich, N. C., & Holtmann, H. (2020). Evaluation of patient specific care needs during treatment for head and neck cancer. Oral Oncology, 110, 104898. https://doi.org/10.1016/j.oraloncology.2020.104898
Semple, C., Parahoo, K., Norman, A., Mccaughan, E., Humphris, G., & Mills, M. (2013). Psychosocial interventions for patients with head and neck cancer. Cochrane Database of Systematic Reviews, 2013(7). https://doi.org/10.1002/14651858.CD009441.pub2
Sutt, A. L., Tronstad, O., Barnett, A. G., Kitchenman, S., & Fraser, J. F. (2020). Earlier tracheostomy is associated with an earlier return to walking, talking, and eating. Australian Critical Care, 33(3), 213–218. https://doi.org/10.1016/j.aucc.2020.02.006
Swain, S. K., Acharya, S., & Das, S. (2021). Social impact of tracheostomy: Our experiences at a tertiary care teaching hospital of Eastern India. Journal of the Scientific Society, 47(3), 148. https://doi.org/10.4103/JSS.JSS_61_20
Twigg, J. A., Anderson, J. M., Humphris, G., Nixon, I., Rogers, S. N., & Kanatas, A. (2020). Best practice in reducing the suicide risk in head and neck cancer patients: a structured review. British Journal of Oral and Maxillofacial Surgery, 58(9), 6–15. https://doi.org/10.1016/j.bjoms.2020.06.035
Wang, C., Wang, J., Wang, B., Jing, X., & Huang, Y. (2018). Effect of enteral nutrition tolerance assessment standardized process management on ventilator associated pneumonia and prognosis in patients with tracheotomy and long-term mechanical ventilation in intensive care unit. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 30(12), 1173–1177. https://doi.org/10.3760/cma.j.issn.2095-4352.2018.12.014
Watchara, T., & Kiwanuka, F. (2019). Special article family caregivers for older adults with a tracheostomy during hospitalization: Psychological impacts and support. In International Journal of Caring Sciences, 12(2), 1244-1250. http://www.internationaljournalofcaringsciences.org/docs/75_1-tabootwong_special_12_2.pdf
How to Cite
Copyright (c) 2021 The Authors & LUMEN Publishing House
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant this journal right of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work, with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g. post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g. in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as an earlier and greater citation of published work (See The Effect of Open Access).
BRAIN. Broad Research in Artificial Intelligence and Neuroscience Journal has an Attribution-NonCommercial-NoDerivs