Validating the Changes to Self-identity After Total Laryngectomy.

Area of Science:

• Qualitative Health Research
• Psychosocial Oncology
• Rehabilitation Science

Background:

• Total laryngectomy prolongs life but causes long-term disablement and complex care needs.
• Current clinical practice focuses on immediate recovery, with less support for long-term psychosocial and identity changes.
• Significant changes to personhood and ongoing medical needs persist post-surgery.

Purpose of the Study:

• To explore the lived experiences of individuals with a total laryngectomy and their supporters at least one year after surgery.
• To understand the long-term subjective experience of identity change and the need for psychosocial support.
• To identify factors influencing the adaptation and reframing of self post-laryngectomy.

Main Methods:

• Constructivist grounded theory and symbolic interactionism guided the study.
• Interview data were collected and analyzed from 28 participants: 12 individuals with a laryngectomy, 9 primary supporters, and 7 health professionals.
• Explored the phenomenon of "validating the altered self after total laryngectomy."

Main Results:

• Individuals post-laryngectomy navigate interactions due to disrupted self-expression, competencies, and roles.
• Four reframing patterns of self-validation emerged: destabilized, resigned, resolute, and transformed.
• Developing competence, resilience, support, and personal factors influenced these reframing patterns.

Conclusions:

• Findings deepen understanding of long-term identity shifts after laryngectomy.
• There is a persistent and significant need for ongoing psychosocial support for individuals and their families.
• Evidence supports strengthening the continuum of care and social participation, optimizing person-centered practices.