Coping and Adjustment in Alaryngeal Speakers

In this investigation the coping, adjustment, self-esteem, general well-being, perceived communication abilities, and preferred communication modes of 41 patients with laryngectomies were evaluated. Specifically, we wanted to determine how well patients with laryngectomies adjust to and cope with their cancer, whether differences in coping and adjustment vary as a function either of the type of alaryngeal voice used or the amount of time since the laryngectomy, and whether relationships exist between the speech of patients with laryngectomies and their adjustment. Standardized interview protocols and tests were employed during face-to-face interviews. Results revealed that 73% of the sample showed good adjustment and used predominantly problem-focused and seeking-social-support strategies to cope with their cancer. The 27% who were classified as poor copers also performed poorly on self-esteem and general well-being measures and used more self-blame and avoidance strategies. There were no significant differences among different types of preferred communication modes. Significant differences existed between patients with recent and distant laryngectomies; the latter showed better overall adjustment. The subjects who were well adjusted also tended to view their voice rehabilitation as more beneficial and rated themselves as more easily understood by listeners than did those subjects demonstrating psychological distress and poor adjustment. Implications for advanced voice therapy, the need for counseling and referrals, and the relationship among voice, self-esteem, and therapy are discussed.