| Purpose:To compare the influence of the forward rehabilitation conceptions with traditional ideas for the total layngectomy patients' pronunciation reconstruction. To explore the effects of two different methods on pronunciation reconstruction, and evaluate the result of pronunciation and the quality of life.Methods:Sixty-six patients (from 10.2013 to 12.2014 in the 1st hospital of the Jilin university of Changchun) with the total layngectomy were randomly divided into 2 groups (Experimental group and the control group). Control group underwent total laryngectomy patients to adopt the conventional mode of voice rehabilitation, namely the postoperative body recovery after speech rehabilitation training before leaving hospital, one of the first to voice reconstruction theory training, training in the form of PPT, including electronic accessories of artificial larynx, pronunciation principle, explain the use of each part and operation skills, interpretation of electronic throat best call point. The second speech reconstruction of successful examples for patients to enhance confidence. Third cooperate with electronic artificial larynx to patients in the actual operation, helping patients to find the best operating point, electronic pipes, the hand operation and swallow mouth, from single tone to practise words to the last sentenceThe experimental group received the forward rehabilitation conceptions and the other one with traditional ideas. The forward rehabilitation conceptions including:the forward of theoretic traing?Psychological intervention? Simulation training?Practical training. The Specific methods are (for the experimental group): the first step is forward of theoretic training, we explained the relevant theoretical knowledge about electronic larynx such as the accessories?pronunciation principle?the using skills and which is the best sound point and so on by using PPT and giving some home works after class in a quiet room in order to make the patients and their families known something about it in advance In their admission and before operation. The second step is forward of psychological intervention, we talked with patients and told them some successful examples of pronunciation reconstruction in a quiet room, so as to make the patients can accept the loss of phonation and enhance confidence to recovery pronunciation. The third step is forward of simulation training, we showed the patients how to use the electronic larynx and they didn't stop practicing until they can use it skillfully. The last step is Practical training, in this step we gave every patient an electronic larynx and helped them find the best way to coordinate the manual operation of the electronic larynx with the swallow mouth when their vital signs were stable?the neck wound dressings were removed. They practiced from one word to a phrase to a sentence step by step till they can rebuild the pronunciation. They left hospital a month later, we used the A?(QLQ-C30)?B?and C to collect data. Spss 13.0 software was used to analyze the data.Result:there were 33 patients in two groups and there was no Statistical difference in age, gender, and disease (P>0.05), but the Experimental group's pronunciation reconstruction.Was better than the control group's (P<0.05) and the quality of life was better (P<0.05).there were not increase the complications directly about the pronunciation reconstruction during they were in hospital.Conclusion:The forward rehabilitation conceptions apply to pronunciation reconstruction area not only improves the result of the pronunciation reconstruction but also the quality of life and does not cause complications. It helped patients recognize self value? participate family activities actively?enhance the confidence of work and life. |
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