Speech impairment in the postoperative head and neck cancer patient: nurses' and patients' perceptions

Communication between postoperative head and neck cancer patients with speech impairment and their health care providers is challenging. These challenges emerge during a period when the patient must communicate needs related to symptoms such as pain or concerns of significance in the absence of the traditional communication process. Content analysis methods facilitated understanding of the perspective of the postoperative head and neck cancer patient experiencing pain and a speech impairment, and the examination of the nurses' view in the assessment and management of this population. The authors identified self-report of pain as a critical component of pain assessment regardless of the presence of a speech impairment. Significant levels of frustration were associated with the nurses' goal of addressing the pain management needs of the speech impaired and the patients' pursuit of reporting the uniqueness of their pain experience.