The laryngectomy patient’s need for support groups in a hospital setting : a social work perspective
Thesis (M Social Work(Social Work))--University of Stellenbosch,2009.
A laryngectomy is mostly indicated as treatment for an advanced stage of cancer of the larynx, during which the patient’s voice box is removed. This operation can hold major psycho-social implications for the patient and family. To cope with the challenges in daily life, patients need social support. A lack of available literature and research regarding the role of the social worker in facilitating support groups for these patients and families was identified and motivated this research study. The goal of the study was to gain a better understanding of the laryngectomy patient’s need for support groups in a hospital setting when attending the follow-up clinic at the hospital. A combination of both the exploratory and descriptive research designs together with a combination of mainly a qualitative and to a certain extent the quantitative research approaches, was used. From this, knowledge, insight and an understanding of the need for support groups in a hospital setting from a social work perspective were obtained. Permission to conduct the proposed study was granted by the Committee for Human Research at the University of Stellenbosch. The literature study first focused on medical aspects of a laryngectomy and social work intervention services within a hospital setting as part of the multi-disciplinary approach. Second, psycho-social effects of a laryngectomy from an ecological perspective were discussed, referring to the physical, social and psychological effects of surgery upon the patient and family. Third, support and aftercare were discussed with specific reference to the role of the social worker in offering social support to the patient and family. For the empirical study, twenty laryngectomy patients from the service area of Tygerberg Hospital were involved from January 2008 to May 2008. Criteria for inclusion in the study referred to patients who had their operation not less than three months previously, attended the support group during follow-up visits at the hospital and who had successfully acquired tragea-oesophageal speech. Based on the literature review, a semi-structured questionnaire and face-to-face interview were used as research instruments to overcome the limitation of illiteracy. The results of the investigation mainly confirmed the findings of the literature study namely that laryngectomy patients can benefit from support groups in order to address their need for social support in dealing with daily life challenges. Patients indicated that they mainly needed information regarding post-operative adaptation as this was where problems were mostly experienced. The majority of patients suggested the use of support groups in this regard. Focus was placed on an exploration and description of patients’ needs for such support groups. Benefits of support groups were found to be totally compatible with the role of the social worker. The results therefore gave an indication of social work intervention services and referred to: provision of information, problem-solving, offer of social and emotional support, and promotion of rehabilitation opportunities, thereby improving the patient’s quality of life. Recommendations were aimed at social work intervention services relating to support and aftercare offered to laryngectomy patients and relatives. Future research to develop social work programmes for health care professionals in order to effectively support these patients and their families was proposed. From practical experience of support groups a study regarding the role of pre- and primary schoolchildren or grandchildren in the rehabilitation of laryngectomy patients was also suggested.