[Laryngectomies and nursing care]. / Laryngectomies et soins infirmiers.

A laryngectomy is a major operation with multiple repercussions. To help the patient get through this difficult ordeal and begin suitable rehabilitation, the nursing teams offer technical competencies combined with relational and educational skills. During the postoperative period, this approach is adopted as soon as the patient arrives in the recovery room. A team from Lille shares its experience.

[Larynx cancer]. / Le cancer du larynx.

Closely linked to heavy smoking, larynx cancer is more common in men but its occurrence is rising in line with the increase in the number of women smokers. France is one of the most affected countries in Europe with 3,735 new cases in 2005. In terms of treatment, new endoscopic surgical techniques or radiotherapy are suitable for treating the disease in its early stages. For advanced stages, some patients may benefit from a larynx preserving approach based on chemotherapy and radiotherapy. Otherwise, a total laryngectomy is necessary.

[Hospital care in the home after a laryngectomy]. / Le relais hospitalier à domicile après une laryngectomie.

Hospital care in the home offers patients suffering from larynx cancer and their family the possibility of returning home in optimal conditions of comfort and security. A multidisciplinary team takes over the patient's care from the hospital staff and draws up the personalised care project.

[Principles of larynx surgery and nurse surveillance]. / Principes de la chirurgie du larynx et surveillance infirmière.

Endoscopic transoral surgical techniques have developed, adapted to forms of early stage larynx cancer. A total laryngectomy remains the only treatment for patients suffering from an advanced stage cancer which is not receptive to organ preservation strategies. For all these patients, nurse surveillance combines technical and relational care.

[Laryngectomy, why me?]. / Laryngectomisée, pourquoi moi?

Christiane, aged 49, is married with children. In this article she writes about her care pathway from her larynx cancer diagnosis through to her rehabilitation and return to an almost normal life.

When negative rights become positive entitlements: complicity, conscience, and caregiving.

Clinicians have an obligation to ensure that patients with adequate capacity can make autonomous decisions. Thus, patients who choose to forego treatment and leave hospitals "against medical advice" are typically allowed to do so. But what happens when they require clinicians' assistance to physically leave? Is it incumbent upon clinicians to not only respect and fulfill patients' requests with which they disagree, but to physically assist in their fulfillment? We attempt to develop an ethical framework wherein clinicians can honor patients' wishes without necessarily sacrificing their own moral position.

Humor as a nursing intervention.

This article describes the use of humor as a nursing intervention and asks if nurses can justify the integration of the use of humor into the repertoire of nursing interventions. Several uses for humor are illustrated, and humor is differentiated from laughter. The article quotes many nurse leaders' opinions about humor and identifies do's and do not's of appropriate humor; it discusses six research studies in which health care professionals used humor as a treatment protocol. The studies were in the areas of preoperative teaching, clinical evaluation, strategies to prevent hopelessness in adolescents with oncologic illness, and group cohesiveness. Results of these six studies give some evidence, although not robust, that humor is an effective intervention. Methods of determining and implementing humor as an appropriate nursing intervention are included.

Nursing care of patients with laryngeal carcinoma.

The patient with cancer of the larynx can provide a challenge to the nursing staff. All aspects of nursing management are encompassed in providing care to this unique group of patients. Prevention and early detection are mandatory in the treatment of the patient with cancer of the larynx. Acute care/intensive care nursing, teaching, general medical surgical nursing, rehabilitative nursing, and psychological counseling are all required for any patient undergoing treatment for a cancer of the larynx. The nurse is in a key position to coordinate the care received by these patients and their family members in order for the patient to resume a reasonable quality of life.

Laser ablation of recurrent laryngeal papillomas in children.

Papillomas are the most common laryngeal tumors in childhood, and their etiology is thought to be viral. Papillomatosis (ie, widespread, multiple papillomas) may involve a child's airway from the epiglottis to the bronchi. Hoarseness is an early sign of juvenile laryngeal papillomas (JLP), and airway obstruction is a later, life-threatening sign. The recurrence and spread of JLP is common. An otorhinolaryngologist may perform a tracheostomy on a child with JLP; however, this procedure is avoided if possible, because a tracheostomy predisposes the trachea to papilloma seeding. Laser ablation of papillomas through the use of rigid endoscopic equipment and a carbon dioxide laser is the mainstay of therapy.

Caring for the patient with laryngeal cancer at home.

Clients experiencing various stages of laryngeal cancer frequently are cared for at home with the help of home healthcare nursing and other agency personnel. This article provides the clinician with an organized way of assessing and intervening with these clients and their families. Strategies, practical tips, and hints are given to assist the nurse in providing high-quality care.

[Cancer of the larynx]. / Cancer du larynx.

Cancer of the larynx and total laryngectomies have devastating consequences on the patient and his/her family. During a specialized field placement in family nursing care, the author used the Calgary Family Assessment Model to better understand the relationship between the disease, the surgical procedure and the resulting family dynamics. She found that nursing interventions not only helped the family regain a sense of balance but facilitated the patient's adjustment process.

Proceso de enfermería para hombres con cáncer de laringe fundamentado en el modelo de Neuman / Processo de enfermagem para homens com câncer de laringe fundamentado no modelo de Neuman / Nursing process to men with laryngeal cancer based on Neuman model

El objetivo fue operar el proceso de enfermería propuesto por Betty Neuman para hombres con cáncer de laringe para la identificación de los factores de estrés y patrones de enfrentamiento desencadenados en la vivencia de la neoplasia maligna. Se trata de un estudio exploratorio, descriptivo, cualitativo, se utilizó como referencial teórico el Modelo de Betty Neuman con 30 hombres sometidos a tratamiento de cáncer de laringe, que pertenecen a un grupo de apoyo que se encuentra en São Paulo, Brasil. Los clientes han proporcionado algunos diagnósticos de enfermería causados por factores de estrés identificados y relacionados con el tratamiento de cáncer de laringe. A partir de esto, se elaboraron los objetivos y resultados de enfermería que permitieron hacer frente a los factores estresantes y la restauración de las líneas de defensa, obteniéndose intervenciones satisfactorias para minimizar el estrés experimentado. Se encontró que las dificultades de tratamiento del cáncer de laringe se pueden resolver con una práctica de enfermería centrada en la atención y el diálogo, basándose en un método científico adecuado (AU)

Objetivou-se operacionalizar o processo de enfermagem, proposto por Betty Neuman, para homens com câncer de laringe, visando a identificação de estressores e padrões de enfrentamento deflagrados na vivência da neoplasia maligna. Trata-se de um estudo exploratório-descritivo, qualitativo, utilizou como referencial teórico o Modelo de Betty Neuman com 30 homens em tratamento para câncer de laringe, pertencentes a um grupo de apoio, localizado no estado de São Paulo, Brasil. Os clientes apresentaram alguns diagnósticos de enfermagem ocasionados pelos estressores identificados e relacionados ao tratamento do câncer de laringe. A partir disso, traçaram-se as metas e resultados de enfermagem que possibilitaram o enfrentamento das forças estressoras e a reconstituição das linhas de defesa, obtendo-se intervenções satisfatórias na minimização do estresse vivenciado. Verificou-se que as dificuldades do tratamento do câncer de laringe podem ser solucionadas com uma prática de enfermagem voltada para atenção e diálogo, apoiando-se em um método científico adequado (AU)

The objective was to operate the nursing process proposed by Betty Neuman men with laryngeal cancer in identifying stressors and coping patterns triggered in cancer experience. Exploratory, descriptive, qualitative study used as a theoretical model of the Betty Neuman with 30 men undergoing treatment for cancer of the larynx, belonging to a support group, located in São Paulo, Brazil. Customers have provided some nursing diagnoses caused by stressors identified and related to the treatment of laryngeal cancer. From this, drew up the goals and nursing outcomes that enabled coping with stressful forces and the restoration of lines of defense, yielding satisfactory interventions to minimize the stress experienced. It was found that the difficulties of treatment of laryngeal cancer could be solved with a nursing practice focused on attention and dialogue, relying on sound scientific method (AU)

Perspectives on coping among patients with head and neck cancer receiving radiation.

PURPOSE/OBJECTIVES: To describe coping among patients with laryngeal and oropharyngeal cancer during definitive radiation with or without chemotherapy. RESEARCH APPROACH: Qualitative content analysis conducted within a larger study. SETTING: Two radiation oncology outpatient clinics in Baltimore, MD. PARTICIPANTS: 21 patients with oropharyngeal or laryngeal cancer. METHODOLOGIC APPROACH: Interviews with open-ended questions were conducted during treatment. Questions covered topics such as coping during treatment, treatment-related issues, and resources. MAIN RESEARCH VARIABLES: Coping, treatment, and coping resources. FINDINGS: Patients' self-assessments suggested they were coping or that coping was rough or upsetting. Issues that required coping varied over four time points. Physical side effects were problematic during and one month after treatment completion. Patients used coping to manage the uncertainties of physical and psychological aspects of their experience. Family and friend support was a common coping strategy used by patients, with the intensity of side effects corresponding with the support provided across time points. CONCLUSIONS: Findings confirm previous research, but also provide new information about ways in which patients with head and neck cancer cope with their illness experience. Emergent themes provide insight into patients' feelings, issues, and assistance received with coping. INTERPRETATION: Patients with head and neck cancer need education on the amount and severity of side effects and should be appraised of potential difficulties with scheduling, driving, and other logistic issues. Patients also should be informed of helpful types of support and coping strategies. Additional research is needed to expand the findings related to patients' coping with treatment and to explore the experiences of family and friends who provide social support.

Assistência aos portadores de câncer de laringe sob a perspectiva da integralidade: abordagem do enfermeiro no Inca / Asistencia a los pacientes con cáncer de laringe bajo la perspectiva de integridad: enfoque de enfermeras en la Inca / Care for larynx cancer patients under a holistic perspective: nursing approach in the Inca

Objective: Demonstrate the importance of the concept of the Extended Clinic in the disease process, from the experience of professional nursing with larynx cancer patients, and surveying the nursing interventions conducted from the Holistic healthcare perspective. Method: Analysis of secondary data of records of laryngeal cancer patients, enrolled in the outpatient Head and Neck Section of INCA in the period from 01 March 2012 to 23 May 2013. Results: showed the importance of the records to prove team’s work and the importance of the Extended Clinical Nursing philosophy and tool to the work processes in health turn to the production of care focused on clients and contradictions in trying to inter-relationship with health services outside the institution.

Objetivos: Demonstrar a importância da concepção de Clínica Ampliada no processo saúde-doença, a partir da experiência do profissional de Enfermagem com portadores de câncer de laringe; e levantar as intervenções de Enfermagem realizadas na perspectiva da integralidade do cuidado em saúde. Método: Análise de dados secundários dos prontuários de portadores de câncer de laringe, matriculados no ambulatório da Seção de Cirurgia de Cabeça e Pescoço do INCA no período de 01 de março de 2012 a 23 de maio de 2013. Resultados: Mostrou a importância dos registros para a comprovação do trabalho da equipe de Enfermagem e a importância da Clínica Ampliada como filosofia e ferramenta para que os processos de trabalho em saúde se voltem para a produção do cuidado centrado nos clientes e as contradições na tentativa de inter-relação com serviços de saúde fora da instituição.

Objetivos: Demostrar la importancia del diseño del proceso de la enfermedad clínica ampliada, a partir dela experiencia de los profesionales de enfermería con los pacientes con cáncer y aumentar las intervenciones de enfermería realizadas en vista de la integridad de la atención sanitaria. Métodos: análisis secundario de datos de los registros de los pacientes con cáncer de laringe, se matriculó en la sección ambulatoria de Cabeza y Cuello INCA en el período comprendido entre marzo 1, 2012 hasta mayo 23, 2013. Resultados: muestran la importancia de los registros para demostrar el trabajo en equipo y la importancia de la Enfermería Clínica filosofía extendido y una herramienta para los procesos de trabajo envez de la salud a la producción de la atención centrada en los clientes y contradicciones al tratar de interrelación con los servicios de salud fuera de la institución.